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Larson PS, Ndemwa M, Thomas AF, Tamari N, Diela P, Changoma M, Mohamed A, Larson MC, Ketenci KC, Goto K, Kaneko S. Snakebite victim profiles and treatment-seeking behaviors in two regions of Kenya: results from a health demographic surveillance system. Trop Med Health 2022; 50:31. [PMID: 35488352 PMCID: PMC9052588 DOI: 10.1186/s41182-022-00421-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/11/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Snakebites are a major cause of permanent injury and death among poor, rural populations in developing countries, including those in East Africa. This research characterizes snakebite incidence, risk factors, and subsequent health-seeking behaviors in two regions of Kenya using a mixed methods approach. METHODS As a part of regular activities of a health demographic surveillance system, household-level survey on snakebite incidence was conducted in two areas of Kenya: Kwale along the Kenyan Coast and Mbita on Lake Victoria. If someone in the home was reported to have been bitten in the 5 years previous to the visit, a survey instrument was administered. The survey gathered contextual information on the bite, treatment-seeking behavior and clinical manifestations. To obtain deeper, contextual information, respondents were also asked to narrate the bite incident, subsequent behavior and outcomes. RESULTS 8775 and 9206 households were surveyed in Kwale and Mbita, respectively. Out of these, 453 (5.17%) and 92 (1.00%) households reported that at least one person had been bitten by a snake in the past 5 years. Deaths from snakebites were rare (4.04%), but patterns of treatment seeking varied. Treatment at formal care facilities were sought for 50.8% and at traditional healers for 53.3%. 18.4% sought treatment from both sources. Victims who delayed receiving treatment from a formal facility were more likely to have consulted a traditional healer (OR 8.8995% CI [3.83, 20.64]). Delays in treatment seeking were associated with significantly increased odds of having a severe outcome, including death, paralysis or loss of consciousness (OR 3.47 95% CI [1.56; 7.70]). CONCLUSION Snakebite incidence and outcomes vary by region in Kenya, and treatment-seeking behaviors are complex. Work needs to be done to better characterize the spatial distribution of snakebite incidence in Kenya and efforts need to be made to ensure that victims have sufficient access to effective treatments to prevent death and serious injury.
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Affiliation(s)
- Peter S Larson
- Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute (NUITM-KEMRI) Project, Kenya, Nagasaki, Nagasaki, Japan. .,Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA. .,University of Michigan Institute for Social Research, Ann Arbor, MI, USA.
| | - Morris Ndemwa
- Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute (NUITM-KEMRI) Project, Kenya, Nagasaki, Nagasaki, Japan
| | - Aleksandra F Thomas
- University of Michigan, Literature, Science and the Arts, Ann Arbor, MI, USA
| | - Noriko Tamari
- Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute (NUITM-KEMRI) Project, Kenya, Nagasaki, Nagasaki, Japan
| | - Paul Diela
- Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute (NUITM-KEMRI) Project, Kenya, Nagasaki, Nagasaki, Japan
| | - Mwatasa Changoma
- Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute (NUITM-KEMRI) Project, Kenya, Nagasaki, Nagasaki, Japan.,Kenya Medical Research Institute, Nairobi, Kenya
| | | | | | - Kaan Cem Ketenci
- University of Michigan Institute for Social Research, Ann Arbor, MI, USA
| | - Kensuke Goto
- Division of Health and Safety Sciences Education, Osaka Kyoiku University, Osaka, Japan
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Hyuga A, Larson PS, Ndemwa M, Muuo SW, Changoma M, Karama M, Goto K, Kaneko S. Environmental and Household-Based Spatial Risks for Tungiasis in an Endemic Area of Coastal Kenya. Trop Med Infect Dis 2021; 7:2. [PMID: 35051118 PMCID: PMC8778305 DOI: 10.3390/tropicalmed7010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 11/23/2022] Open
Abstract
Tungiasis is a cutaneous parasitosis caused by an embedded female sand flea. The distribution of cases can be spatially heterogeneous even in areas with similar risk profiles. This study assesses household and remotely sensed environmental factors that contribute to the geographic distribution of tungiasis cases in a rural area along the Southern Kenyan Coast. Data on household tungiasis case status, demographic and socioeconomic information, and geographic locations were recorded during regular survey activities of the Health and Demographic Surveillance System, mainly during 2011. Data were joined with other spatial data sources using latitude/longitude coordinates. Generalized additive models were used to predict and visualize spatial risks for tungiasis. The household-level prevalence of tungiasis was 3.4% (272/7925). There was a 1.1% (461/41,135) prevalence of infection among all participants. A significant spatial variability was observed in the unadjusted model (p-value < 0.001). The number of children per household, earthen floor, organic roof, elevation, aluminum content in the soil, and distance to the nearest animal reserve attenuated the odds ratios and partially explained the spatial variation of tungiasis. Spatial heterogeneity in tungiasis risk remained even after a factor adjustment. This suggests that there are possible unmeasured factors associated with the complex ecology of sand fleas that may contribute to the disease's uneven distribution.
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Affiliation(s)
- Ayako Hyuga
- Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki-shi 852-8523, Nagasaki, Japan;
- Department of Eco-Epidemiology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki-shi 852-8523, Nagasaki, Japan;
| | - Peter S. Larson
- Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute (NUITM-KEMRI) Project, C/O Centre for Microbiology Research, KEMRI, Nairobi P.O. Box 19993-00202, Kenya; (P.S.L.); (S.W.M.); (M.C.)
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Morris Ndemwa
- Department of Eco-Epidemiology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki-shi 852-8523, Nagasaki, Japan;
- Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute (NUITM-KEMRI) Project, C/O Centre for Microbiology Research, KEMRI, Nairobi P.O. Box 19993-00202, Kenya; (P.S.L.); (S.W.M.); (M.C.)
| | - Sheru W. Muuo
- Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute (NUITM-KEMRI) Project, C/O Centre for Microbiology Research, KEMRI, Nairobi P.O. Box 19993-00202, Kenya; (P.S.L.); (S.W.M.); (M.C.)
| | - Mwatasa Changoma
- Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute (NUITM-KEMRI) Project, C/O Centre for Microbiology Research, KEMRI, Nairobi P.O. Box 19993-00202, Kenya; (P.S.L.); (S.W.M.); (M.C.)
| | - Mohamed Karama
- Centre of Public Health Research, Kenya Medical Research Institute (KEMRI), Off Mbagathi Road, Nairobi P.O. Box 54840-00200, Kenya;
| | - Kensuke Goto
- Division of Health and Safety Sciences Education, Department of Educational Collaboration, Osaka Kyoiku University, 4-698-1 Asahigaoka, Kashiwara-shi 582-8582, Osaka, Japan;
| | - Satoshi Kaneko
- Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki-shi 852-8523, Nagasaki, Japan;
- Department of Eco-Epidemiology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki-shi 852-8523, Nagasaki, Japan;
- Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute (NUITM-KEMRI) Project, C/O Centre for Microbiology Research, KEMRI, Nairobi P.O. Box 19993-00202, Kenya; (P.S.L.); (S.W.M.); (M.C.)
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Larson PS, Ono M, Changoma M, Goto K, Kaneko S, Moji K, Minakawa N. Presence of dogs and proximity to a wildlife reserve increase household level risk of tungiasis in Kwale, Kenya. Trop Med Health 2021; 49:54. [PMID: 34225821 PMCID: PMC8256484 DOI: 10.1186/s41182-021-00338-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 05/26/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction Tungiasis is a ectopic skin disease caused by some species of fleas in the Tunga genus, most notably T. penetrans. The disease afflicts poor and marginalized communities in developing countries. Transmission of tungiasis comprises a complex web of factors including domesticated animals and wildlife. This research explores animal and environmental risk factors for tungiasis in an area adjacent to a wildlife reserve in Kwale, Kenya. Methods A two-stage complex sampling strategy was used. Households were selected from three areas in and around Kwale Town, Kenya, an area close to the Kenyan Coast. Households were listed as positive if at least one member had tungiasis. Each household was administered a questionnaire regarding tungiasis behaviors, domesticated animal assets, and wild animal species that frequent the peridomiciliary area. Associations of household tungiasis were tests with household and environmental variables using regression methods. Results The study included 319 households. Of these, 41 (12.85%) were found to have at least one person who had signs of tungiasis. There were 295 (92.48%) households that possessed at least one species of domesticated animal. It was reported that wildlife regularly come into the vicinity of the home 90.59% of households. Presence of dogs around the home (OR 3.85; 95% CI 1.84; 8.11) and proximity to the park were associated with increased risk for tungiasis infestation in humans in a multivariate regression model. Conclusions Human tungiasis is a complex disease associated with domesticated and wild animals. Canines in particular appear to be important determinants of household level risk.
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Affiliation(s)
- Peter S Larson
- Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute (NUITM-KEMRI) project, Kenya, Nagasaki, Nagasaki, Japan. .,University of Michigan School of Natural Resources and Environment, Ann Arbor, MI, USA.
| | - Masanobu Ono
- Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute (NUITM-KEMRI) project, Kenya, Nagasaki, Nagasaki, Japan
| | - Mwatasa Changoma
- Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute (NUITM-KEMRI) project, Kenya, Nagasaki, Nagasaki, Japan.,Chemi Chemi, Kwale, Kenya
| | - Kensuke Goto
- Division of Health and Safety Sciences Education, Osaka Kyoiku University, Osaka, Japan
| | - Satoshi Kaneko
- Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute (NUITM-KEMRI) project, Kenya, Nagasaki, Nagasaki, Japan
| | - Kazuhiko Moji
- Nagasaki University School of Tropical Medicine and Global Health (TMGH), Nagasaki, Japan
| | - Noboru Minakawa
- Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute (NUITM-KEMRI) project, Kenya, Nagasaki, Nagasaki, Japan
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Numair T, Harrell DT, Huy NT, Nishimoto F, Muthiani Y, Nzou SM, Lasaphonh A, Palama K, Pongvongsa T, Moji K, Hirayama K, Kaneko S. Barriers to the Digitization of Health Information: A Qualitative and Quantitative Study in Kenya and Lao PDR Using a Cloud-Based Maternal and Child Registration System. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126196. [PMID: 34201107 PMCID: PMC8228682 DOI: 10.3390/ijerph18126196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/29/2021] [Accepted: 06/04/2021] [Indexed: 12/23/2022]
Abstract
Digitalization of health information can assist patient information management and improve health services even in low middle-income countries. We have implemented a mother and child health registration system in the study areas of Kenya and Lao PDR to evaluate barriers to digitalization. We conducted in-depth interviews with 20 healthcare workers (HCWs) who used the system and analyzed it qualitatively with thematic framework analysis. Quantitatively, we analyzed the quality of recorded data according to missing information by the logistic regression analysis. The qualitative analysis identified six themes related to digitalization: satisfaction with the system, mothers’ resistance, need for training, double work, working environment, and other resources. The quantitative analysis showed that data entry errors improved around 10% to 80% based on odds ratios in subsequent quarters compared to first quarter periods. The number of registration numbers was not significantly related to the data quality, but the motivation, including financial incentives among HCWs, was related to the registration behavior. Considering both analysis results, workload and motivation to maintain high performance were significant obstacles to implementing a digital health system. We recommend enhancing the scope and focus on human needs and satisfaction as a significant factor for digital system durability and sustainability.
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Affiliation(s)
- Tarek Numair
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan;
- Department of Ecoepidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan;
| | - Daniel Toshio Harrell
- Department of Ecoepidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan;
- Dell Medical School, The University of Texas in Austin, Austin, TX 78712, USA
| | - Nguyen Tien Huy
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan; (N.T.H.); (F.N.); (K.M.)
| | - Futoshi Nishimoto
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan; (N.T.H.); (F.N.); (K.M.)
| | - Yvonne Muthiani
- Nairobi Research Station, Nagasaki University-Institute of Tropical Medicine—Kenya Medical Research Institute (NUITM-KEMRI) Project, Nairobi 19993-00202, Kenya; (Y.M.); (S.M.N.)
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland
| | - Samson Muuo Nzou
- Nairobi Research Station, Nagasaki University-Institute of Tropical Medicine—Kenya Medical Research Institute (NUITM-KEMRI) Project, Nairobi 19993-00202, Kenya; (Y.M.); (S.M.N.)
- Centre for Microbiology Research, Kenya Medical Research Institute (KEMRI), Nairobi 54840-00200, Kenya
| | - Angkhana Lasaphonh
- Savannakhet Provincial Health Department, Savannakhet 13000, Laos; (A.L.); (K.P.); (T.P.)
| | - Khomsonerasinh Palama
- Savannakhet Provincial Health Department, Savannakhet 13000, Laos; (A.L.); (K.P.); (T.P.)
| | - Tiengkham Pongvongsa
- Savannakhet Provincial Health Department, Savannakhet 13000, Laos; (A.L.); (K.P.); (T.P.)
| | - Kazuhiko Moji
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan; (N.T.H.); (F.N.); (K.M.)
| | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan;
| | - Satoshi Kaneko
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan;
- Department of Ecoepidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan;
- Nairobi Research Station, Nagasaki University-Institute of Tropical Medicine—Kenya Medical Research Institute (NUITM-KEMRI) Project, Nairobi 19993-00202, Kenya; (Y.M.); (S.M.N.)
- Correspondence: ; Tel.: +81-95-819-7866
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Areru HA, Dangisso MH, Lindtjørn B. Births and deaths in Sidama in southern Ethiopia: findings from the 2018 Dale-Wonsho Health and Demographic Surveillance System (HDSS). Glob Health Action 2021; 13:1833511. [PMID: 33115376 PMCID: PMC7598947 DOI: 10.1080/16549716.2020.1833511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Sidama is one of the most densely populated areas in Ethiopia. Information about the demographic characteristics is scarce, and most studies were census based on interviews. Earlier population studies from Ethiopia did not sufficiently address the validity of measuring births, deaths, and age-composition. Objective To investigate the population characteristics in Sidama with an emphasis on fertility estimates, age, and death reporting. Methods This is a mixed-method cross-sectional study, conducted in Sidama in southern Ethiopia, using baseline data of newly established Dale-Wonsho Health and Demographic Surveillance System site in 2018. We used quantitative data of 5179 randomly selected households having 25,144 individuals. We collected information on deaths in the same study period and population from the traditional burial associations (Iddir). Qualitative data were collected using focus group discussions, and in-depth interviews. Life tables, age reliability indices and logistic regression were used to analyse the data. Results The total fertility rate was 2.9 children/woman, the crude birth rate was 22.8/1000 population and the crude death rate was 5.2/1000 population. The dependency ratio was 66/100 working-age population. Urban residents had higher birth rates (OR = 1.4 (95% CL: 1.05–1.78), and women with basic education had lower birth rates (OR = 0.6 (95% CL: 0.46–0.78) compared to those with no education. The age accuracy indices showed unreliable age reporting. The number of deaths increased from 29 to 132 when death reports from the Iddirs were included. There was under-reporting of neonatal and deaths of young children. Substituting national and regional mortality estimates, the life expectancy declined to an average of 53 years (range 48–58 years). Conclusion The fertility rate in Sidama is lower than previously reported and is affected by age, residence and education. As we have identified important measurement and reporting errors, future demographic surveillance sites should consider these limitations.
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Affiliation(s)
- Hiwot Abera Areru
- School of Public Health, Hawassa University , Hawassa, Ethiopia.,Centre for International Health, University of Bergen , Bergen, Norway
| | | | - Bernt Lindtjørn
- School of Public Health, Hawassa University , Hawassa, Ethiopia.,Centre for International Health, University of Bergen , Bergen, Norway
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Fukuda H, Hayashi Y, Toda K, Kaneko S, Wagaiyu E. Perceived general health in relation to oral health status in a rural Kenyan elderly population. BMC Oral Health 2021; 21:154. [PMID: 33761927 PMCID: PMC7989241 DOI: 10.1186/s12903-021-01525-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/16/2021] [Indexed: 12/02/2022] Open
Abstract
Background This study aimed to determine the present oral health status of the rural Kenyan elderly population and to investigate whether oral health status is associated with the perceived general health. Methods A total of 131 individuals aged 65 years and over in Mbita Constituency, Homa Bay County in Kenya were randomly selected and visited at home. The home visit study, which was conducted from 2014 to 2016, included oral examination by a dentist and administration of a self-reporting questionnaire. The number of teeth present and functional tooth unit (FTU) points were calculated using the dental chart. Perceived general health, subjective masticatory ability, and self-reported periodontal symptoms were collected using a questionnaire sheet. Fisher’s exact test and nonparametric test were used to determine the difference in percentage and means. The odds ratio of good general health based on the participants’ masticatory satisfaction was calculated by logistic analysis. Results Satisfactory mastication was dependent on the number of teeth present, FTU points, and self-reported “gum bleeding” and “tooth mobility”. Furthermore, satisfactory mastication was associated with perceived general health status independent of sex and age. The adjusted odds ratio of good perceived general health was 2.29 (95% confidence interval 1.05–4.99) for participants who had the subjective masticatory ability. Conclusion Among the Kenyan elderly population, satisfactory mastication was related to the number of teeth present, FTU points, and self-reported periodontal symptoms. Furthermore, satisfactory mastication was associated with perceived general health status independently.
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Affiliation(s)
- Hideki Fukuda
- National Institute of Public Health, 2-3-6 Minami, Wako City, Saitama Prefecture, 351-0197, Japan.
| | - Yoshihiko Hayashi
- Graduated School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki City, Nagasaki Prefecture, 852-8588, Japan
| | - Kazuo Toda
- Graduated School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki City, Nagasaki Prefecture, 852-8588, Japan
| | - Satoshi Kaneko
- Department of Ecoepidemiology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki City, Nagasaki Prefecture, 852-8523, Japan
| | - Evelyn Wagaiyu
- School of Dental Sciences, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya
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Berrueta M, Ciapponi A, Bardach A, Cairoli FR, Castellano FJ, Xiong X, Stergachis A, Zaraa S, Meulen AST, Buekens P. Maternal and neonatal data collection systems in low- and middle-income countries for maternal vaccines active safety surveillance systems: A scoping review. BMC Pregnancy Childbirth 2021; 21:217. [PMID: 33731029 PMCID: PMC7968860 DOI: 10.1186/s12884-021-03686-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/01/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Most post-licensure vaccine pharmacovigilance in low- and middle-income countries (LMICs) are passive reporting systems. These have limited utility for maternal immunization pharmacovigilance in LMIC settings and need to be supplemented with active surveillance. Our study's main objective was to identify existing perinatal data collection systems in LMICs that collect individual information on maternal and neonatal health outcomes and could be developed to inform active safety surveillance of novel vaccines for use during pregnancy. METHODS A scoping review was performed following the Arksey and O'Malley six-stage approach. We included studies describing electronic or mixed paper-electronic data collection systems in LMICs, including research networks, electronic medical records, and custom software platforms for health information systems. Medline PubMed, EMBASE, Global Health, Cochrane Library, LILACS, Bibliography of Asian Studies (BAS), and CINAHL were searched through August 2019. We also searched grey literature including through Google and websites of existing relevant perinatal data collection systems, as well as contacted authors of key studies and experts in the field to validate the information and identify additional sources of relevant unpublished information. RESULTS A total of 11,817 records were identified. The full texts of 264 records describing 96 data collection systems were assessed for eligibility. Eight perinatal data collection systems met our inclusion criteria: Global Network's Maternal Newborn Health Registry, International Network for the Demographic Evaluation of Populations and their Health; Perinatal Informatic System; Pregnancy Exposure Registry & Birth Defects Surveillance; SmartCare; Open Medical Record System; Open Smart Register Platform and District Health Information Software 2. These selected systems were qualitatively characterized according to seven different domains: governance; system design; system management; data management; data sources, outcomes and data quality. CONCLUSION This review provides a list of active maternal and neonatal data collection systems in LMICs and their characteristics as well as their outreach, strengths, and limitations. Findings could potentially help further understand where to obtain population-based high-quality information on outcomes to inform the conduct of maternal immunization active vaccine safety surveillance activities and research in LMICs.
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Affiliation(s)
- Mabel Berrueta
- Instituto de Efectividad Clínica y Sanitaria (IECS), Dr. Emilio Ravignani 2024 (C1014CPV), Buenos Aires, Argentina.
| | - Agustin Ciapponi
- Instituto de Efectividad Clínica y Sanitaria (IECS), Dr. Emilio Ravignani 2024 (C1014CPV), Buenos Aires, Argentina
| | - Ariel Bardach
- Instituto de Efectividad Clínica y Sanitaria (IECS), Dr. Emilio Ravignani 2024 (C1014CPV), Buenos Aires, Argentina
| | - Federico Rodriguez Cairoli
- Instituto de Efectividad Clínica y Sanitaria (IECS), Dr. Emilio Ravignani 2024 (C1014CPV), Buenos Aires, Argentina
| | - Fabricio J Castellano
- Instituto de Efectividad Clínica y Sanitaria (IECS), Dr. Emilio Ravignani 2024 (C1014CPV), Buenos Aires, Argentina
| | - Xu Xiong
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, 70112, USA
| | | | - Sabra Zaraa
- University of Washington, Seattle, WA, 98195-7631, USA
| | | | - Pierre Buekens
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, 70112, USA
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Zeleke AA, Naziyok T, Fritz F, Christianson L, Röhrig R. Data Quality and Cost-effectiveness Analyses of Electronic and Paper-Based Interviewer-Administered Public Health Surveys: Systematic Review. J Med Internet Res 2021; 23:e21382. [PMID: 33480859 PMCID: PMC7864777 DOI: 10.2196/21382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/03/2020] [Accepted: 10/28/2020] [Indexed: 12/15/2022] Open
Abstract
Background A population-level survey (PLS) is an essential and standard method used in public health research that supports the quantification of sociodemographic events, public health policy development, and intervention designs. Data collection mechanisms in PLS seem to be a significant determinant in avoiding mistakes. Using electronic devices such as smartphones and tablet computers improves the quality and cost-effectiveness of public health surveys. However, there is a lack of systematic evidence to show the potential impact of electronic data collection tools on data quality and cost reduction in interviewer-administered surveys compared with the standard paper-based data collection system. Objective This systematic review aims to evaluate the impact of the interviewer-administered electronic data collection methods on data quality and cost reduction in PLS compared with traditional methods. Methods We conducted a systematic search of MEDLINE, CINAHL, PsycINFO, the Web of Science, EconLit, Cochrane CENTRAL, and CDSR to identify relevant studies from 2008 to 2018. We included randomized and nonrandomized studies that examined data quality and cost reduction outcomes, as well as usability, user experience, and usage parameters. In total, 2 independent authors screened the title and abstract, and extracted data from selected papers. A third author mediated any disagreements. The review authors used EndNote for deduplication and Rayyan for screening. Results Our search produced 3817 papers. After deduplication, we screened 2533 papers, and 14 fulfilled the inclusion criteria. None of the studies were randomized controlled trials; most had a quasi-experimental design, for example, comparative experimental evaluation studies nested on other ongoing cross-sectional surveys. A total of 4 comparative evaluations, 2 pre-post intervention comparative evaluations, 2 retrospective comparative evaluations, and 4 one-arm noncomparative studies were included. Meta-analysis was not possible because of the heterogeneity in study designs, types, study settings, and level of outcome measurements. Individual paper synthesis showed that electronic data collection systems provided good quality data and delivered faster compared with paper-based data collection systems. Only 2 studies linked cost and data quality outcomes to describe the cost-effectiveness of electronic data collection systems. Field data collectors reported that an electronic data collection system was a feasible, acceptable, and preferable tool for their work. Onsite data error prevention, fast data submission, and easy-to-handle devices were the comparative advantages offered by electronic data collection systems. Challenges during implementation included technical difficulties, accidental data loss, device theft, security concerns, power surges, and internet connection problems. Conclusions Although evidence exists of the comparative advantages of electronic data collection compared with paper-based methods, the included studies were not methodologically rigorous enough to combine. More rigorous studies are needed to compare paper and electronic data collection systems in public health surveys considering data quality, work efficiency, and cost reduction. International Registered Report Identifier (IRRID) RR2-10.2196/10678
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Affiliation(s)
- Atinkut Alamirrew Zeleke
- Medical Informatics, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.,Division of Medical Informatics, Carl von Ossitetzky University Oldenburg, Oldenburg, Germany
| | - Tolga Naziyok
- Division of Medical Informatics, Carl von Ossitetzky University Oldenburg, Oldenburg, Germany
| | - Fleur Fritz
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - Lara Christianson
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Rainer Röhrig
- Division of Medical Informatics, Carl von Ossitetzky University Oldenburg, Oldenburg, Germany.,Institute for Medical Informatics, Medical Faculty of RWTH University Aachen, Aachen, Germany
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Minakawa N, Kongere JO, Sonye GO, Lutiali PA, Awuor B, Kawada H, Isozumi R, Futami K. A preliminary study on designing a cluster randomized control trial of two new mosquito nets to prevent malaria parasite infection. Trop Med Health 2020; 48:98. [PMID: 33372641 PMCID: PMC7720478 DOI: 10.1186/s41182-020-00276-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although long-lasting insecticidal nets (LLINs) are the most effective tool for preventing malaria parasite transmission, the nets have some limitations. For example, the increase of LLIN use has induced the rapid expansion of mosquito insecticide resistance. More than two persons often share one net, which increases the infection risk. To overcome these problems, two new mosquito nets were developed, one incorporating piperonyl butoxide and another covering ceilings and open eaves. We designed a cluster randomized controlled trial (cRCT) to evaluate these nets based on the information provided in the present preliminary study. RESULTS Nearly 75% of the anopheline population in the study area in western Kenya was Anopheles gambiae s. l., and the remaining was Anopheles funestus s. l. More female anophelines were recorded in the western part of the study area. The number of anophelines increased with rainfall. We planned to have 80% power to detect a 50% reduction in female anophelines between the control group and each intervention group. The between-cluster coefficient of variance was 0.192. As the number of clusters was limited to 4 due to the size of the study area, the estimated cluster size was 7 spray catches with an alpha of 0.05. Of 1619 children tested, 626 (48%) were Plasmodium falciparum positive using a rapid diagnostic test (RDT). The prevalence was higher in the northwestern part of the study area. The number of children who slept under bed nets was 929 (71%). The P. falciparum RDT-positive prevalence (RDTpfPR) of net users was 45%, and that of non-users was 55% (OR 0.73; 95% CI 0.56, 0.95). Using 45% RDTpfPR of net users, we expected each intervention to reduce prevalence by 50%. The intracluster correlation coefficient was 0.053. With 80% power and an alpha of 0.05, the estimated cluster size was 116 children. Based on the distribution of children, we modified the boundaries of the clusters and established 300-m buffer zones along the boundaries to minimize a spillover effect. CONCLUSIONS The cRCT study design is feasible. As the number of clusters is limited, we will apply a two-stage procedure with the baseline data to evaluate each intervention.
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Affiliation(s)
- Noboru Minakawa
- Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
| | - James O Kongere
- Kenya Medical Research Institute, Nairobi, Kenya
- Center for Research in Tropical Medicine and Community Development (CRTMCD), Nairobi, Kenya
| | | | - Peter A Lutiali
- Kenya Medical Research Institute, Nairobi, Kenya
- Center for Research in Tropical Medicine and Community Development (CRTMCD), Nairobi, Kenya
| | | | - Hitoshi Kawada
- Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Rie Isozumi
- Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Kyoko Futami
- Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
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10
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Akiyama T, Njenga SM, Njomo DW, Takeuchi R, Kazama H, Mutua A, Walema B, Tomokawa S, Estrada CA, Henzan H, Asakura T, Shimada M, Ichinose Y, Kamiya Y, Kaneko S, Kobayashi J. Implementation of Kenyan comprehensive school health program: improvement and association with students' academic attainment. Health Promot Int 2020; 35:1441-1461. [PMID: 32125374 DOI: 10.1093/heapro/daaa005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
There is growing evidence supporting the effectiveness of a comprehensive school health program. However, implementation in developing countries is a challenge. Furthermore, the available information on the association between a comprehensive school health program and students' academic attainment is limited. In Kenya, a project to verify the effects of a comprehensive school health program was carried out in Mbita sub-county, Homa Bay County from September 2012 to August 2017. This study aimed to clarify the improvement of school health during the project years and the association between school health and students' academic attainment. Primary schools in Mbita sub-county were selected as study sites. We assessed 44 schools' scores on a school health checklist developed from the Kenyan Comprehensive School Health Program, the students' mean score on the Kenya Certificate of Primary Education (KCPE), and absenteeism during the project years (2013-16). The mean school health checklist score (n = 44 schools) was 135.6 in 2013, 169.9 in 2014, 158.2 in 2015 and 181.3 in 2016. The difference of the mean score between 2013 and 2016 was significant. In addition, correlation analysis showed a significant association between mean KCPE score in the project years and school health checklist score (Pearson's coefficient was 0.43, p = 0.004). The results of this study suggest improvements of school health by the implementation of the Kenyan Comprehensive School Health Program and students' academic attainment.
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Affiliation(s)
- Takeshi Akiyama
- Department of Health Science, Nagano College of Nursing, 694 Akaho, Komagane, Nagano 399-4117, Japan.,Japanese Consortium for Global School Health and Research, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Sammy M Njenga
- Kenya Medical Research Institute, PO Box 54840 00200, Off Mbagathi Road, Nairobi, Kenya
| | - Doris Wairimu Njomo
- Kenya Medical Research Institute, PO Box 54840 00200, Off Mbagathi Road, Nairobi, Kenya
| | - Rie Takeuchi
- Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Haruki Kazama
- Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Alex Mutua
- Ministry of Health, Afya House, Cathedral Road, PO Box 30016-00100, Nairobi, Kenya
| | - Barnett Walema
- State Department of Early Learning and Basic Education, Ministry of Education, PO Box 30040-00100, Nairobi, Kenya
| | - Sachi Tomokawa
- Japanese Consortium for Global School Health and Research, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.,Department of Sports and Health Sciences, Faculty of Education, Shinshu University, 6-Ro Nishi Nagano, Nagano City, Nagano 380-8544, Japan
| | - Crystal Amiel Estrada
- Department of Global Health, School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Hanae Henzan
- Department of Global Health, School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Takashi Asakura
- Japanese Consortium for Global School Health and Research, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.,Department of Education, Tokyo Gakugei University, 4-1-1 Nukuikita-machi, Koganei-shi, Tokyo 184-8501, Japan
| | - Masaaki Shimada
- Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Yoshio Ichinose
- Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Yasuhiko Kamiya
- Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Satoshi Kaneko
- Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Jun Kobayashi
- Japanese Consortium for Global School Health and Research, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.,Department of Global Health, School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
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11
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Improvement of Dietary Diversity and Attitude toward Recommended Feeding through Novel Community Based Nutritional Education Program in Coastal Kenya-An Intervention Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197269. [PMID: 33027966 PMCID: PMC7579186 DOI: 10.3390/ijerph17197269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 12/11/2022]
Abstract
Community-based nutritional intervention to improve the practice of dietary diversity and child nutrition by community health workers (CHWs) involving Nyumba Kumi as small neighborhood units (SNUs) in communities has not yet been explored. This study was conducted in two villages in rural Kenya between 2018 and 2019. In total, 662 participants (control vs. intervention: n = 339 vs. n = 323) were recruited. The intervention group received education on maternal and child nutrition and follow-up consultations. The custom-tailored educational guidelines were made based on Infant and Young Child Feeding and the mother and child health booklet. The educational effects on household caregivers’ feeding practice attitude and child nutritional status were analyzed using multiple linear regression. After the intervention, a total of 368 household caregivers (187 vs. 181) and 180 children (113 vs. 67) were analyzed separately. Between the groups, no significant difference was found in their background characteristics. This study successfully improved the dietary diversity score (β = 0.54; p < 0.01) and attitude score (β = 0.29; p < 0.01). The results revealed that the interventions using CHWs and SNUs were useful to improve dietary diversity and caregivers’ attitudes toward recommended feeding. This research has the potential to be successfully applied in other regions where child undernutrition remains.
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12
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Tanaka J, Yoshizawa K, Hirayama K, Karama M, Wanjihia V, Changoma MS, Kaneko S. Relationship between dietary patterns and stunting in preschool children: a cohort analysis from Kwale, Kenya. Public Health 2019; 173:58-68. [PMID: 31254679 DOI: 10.1016/j.puhe.2019.05.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/15/2019] [Accepted: 05/15/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Stunting is a significant cause of poor cognitive performance and lower school achievement. Stunting is observed among pre-school children in several areas in Africa; however, not all children are affected, and children with and without stunting are seen in the same communities. Therefore, this study aimed to identify nutritional and other factors that prevent stunting that may exist in local communities. STUDY DESIGN This is a prospective cohort study. METHODS Data were extracted from the Health and Demographic Surveillance System conducted in Kwale County, Kenya. The cohort consisted of all households with children less than five years old, within a radius of 2.2 km from a local health centre. A dietary pattern (DP) survey with a semi-quantitative food frequency questionnaire was conducted on caretakers of children who were voluntary participated from the cohort between June 2012 and August 2012. Using cluster analysis, the children were assigned to a DP group. Logistic regression analysis was applied to calculate the adjusted odds ratios (aORs) of DPs for stunting controlling for other factors. RESULTS In total, 402 children were included in the analysis. By cluster analysis, three DPs were identified: protein-rich DP; traditional DP; and traditional DP complemented by breastfeeding. The aOR of a child becoming stunted from a normal height during the study period among children who received a traditional DP compared with those who had a protein-rich DP was 2.78 (95% confidence interval [CI]: 1.02-7.55). However, the aOR for children who were already stunted at the start of the study and had a traditional DP was 1.49 (95% CI: 0.82-2.72). Increased aORs of stunting were observed among children aged over 12 months compared with children aged 6-11 months, and the effects of DPs were modified by age in months from 12 to 35 months; however, the effects were near the null value for children over 36 months of age, although these were not statistically significant. CONCLUSIONS We found that the traditional DP showed a higher risk for stunting compared with the protein-rich DP, and the most vulnerable age range for stunting was between 12 and 35 months. Interventions to prevent stunting should focus on providing 12- to 35-month-old children with locally available, protein-rich foods.
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Affiliation(s)
- J Tanaka
- Nagasaki University Graduate School of Biomedical Sciences, Japan; Department of Ecoepidemiology, Institute of Tropical Medicine, Nagasaki University, Japan.
| | - K Yoshizawa
- Department of Nutrition, Harvard T. H. Chan School of Public Health, USA.
| | - K Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine, Nagasaki University, Japan.
| | - M Karama
- Centre for Public Health Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya; Umma University, Kenya.
| | - V Wanjihia
- Centre for Public Health Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.
| | - M S Changoma
- Nagasaki University Institute of Tropical Medicine (NUITM)- Kenya Medical Research Institute (KEMRI) Project, Kenya.
| | - S Kaneko
- Department of Ecoepidemiology, Institute of Tropical Medicine, Nagasaki University, Japan; Nagasaki University Institute of Tropical Medicine (NUITM)- Kenya Medical Research Institute (KEMRI) Project, Kenya; School of Tropical Medicine & Global Health, Nagasaki University, Japan.
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13
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Chadeka EA, Nagi S, Cheruiyot NB, Bahati F, Sunahara T, Njenga SM, Hamano S. A high-intensity cluster of Schistosoma mansoni infection around Mbita causeway, western Kenya: a confirmatory cross-sectional survey. Trop Med Health 2019; 47:26. [PMID: 31015786 PMCID: PMC6463626 DOI: 10.1186/s41182-019-0152-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 03/21/2019] [Indexed: 06/24/2024] Open
Abstract
In Kenya, communities residing along the shores and islands of Lake Victoria bear a substantial burden of schistosomiasis. Although there is a school-based deworming program in place, the transmission of Schistosoma mansoni varies even at a fine scale. Given the focal nature of schistosomes’ transmission, we aim to identify areas with high intensity of S. mansoni infection in Mbita, Homabay County, western Kenya, for prioritized integrated control measures. Our findings confirm a high intensity of S. mansoni infection cluster around Mbita causeway. While the current efforts to curtail morbidity due to schistosomiasis through preventive chemotherapy in schools are crucial, fine-scale mapping of risk areas is necessary for specific integrated control measures.
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Affiliation(s)
- Evans Asena Chadeka
- 1Leading program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.,2Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.,3The Joint Usage/Research Center on Tropical Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Sachiyo Nagi
- 2Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.,3The Joint Usage/Research Center on Tropical Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Ngetich B Cheruiyot
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
| | - Felix Bahati
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
| | - Toshihiko Sunahara
- 3The Joint Usage/Research Center on Tropical Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.,5Department of Vector Ecology and Environment, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Sammy M Njenga
- 6Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Shinjiro Hamano
- 1Leading program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.,2Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.,3The Joint Usage/Research Center on Tropical Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.,Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
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14
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McLean E, Dube A, Saul J, Branson K, Luhanga M, Mwiba O, Kalobekamo F, Geis S, Crampin AC. Implementing electronic data capture at a well-established health and demographic surveillance site in rural northern Malawi. Glob Health Action 2018; 10:1367162. [PMID: 28922071 PMCID: PMC5645702 DOI: 10.1080/16549716.2017.1367162] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
This article aims to assess multiple issues of resources, staffing, local opinion, data quality, cost, and security while transitioning to electronic data collection (EDC) at a long-running community research site in northern Malawi. Levels of missing and error fields, delay from data collection to availability, and average number of interviews per day were compared between EDC and paper in a complex, repeated annual household survey. Three focus groups with field and data staff with experience using both methods, and in-depth interviews with participants were carried out. Cost for each method were estimated and compared. Missing data was more common on paper questionnaires than on EDC, and a similar number were carried out per day. Fieldworkers generally preferred EDC, but data staff feared for their employment. Most respondents had no strong preference for a method. The cost of the paper system was estimated to be higher than using EDC. The existing infrastructure and technical expertise could be adapted to using EDC, but changes have an impact on data processing jobs as fewer, and better qualified staff are required. EDC is cost-effective, and, for a long-running site, may offer further savings, as devices can be used in multiple studies and perform several other functions. EDC is accepted by fieldworkers and respondents, has good levels of quality and timeliness, and security can be maintained. EDC is well-suited for use in a well-established research site using and developing existing infrastructure and expertise.
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Affiliation(s)
- Estelle McLean
- a Malawi Epidemiology and Intervention Research Unit , Karonga , Malawi.,b Faculty of Epidemiology and Population Health , London School of Hygiene and Tropical Medicine , London , UK
| | - Albert Dube
- a Malawi Epidemiology and Intervention Research Unit , Karonga , Malawi
| | - Jacky Saul
- a Malawi Epidemiology and Intervention Research Unit , Karonga , Malawi.,b Faculty of Epidemiology and Population Health , London School of Hygiene and Tropical Medicine , London , UK
| | - Keith Branson
- a Malawi Epidemiology and Intervention Research Unit , Karonga , Malawi.,b Faculty of Epidemiology and Population Health , London School of Hygiene and Tropical Medicine , London , UK
| | - Mabvuto Luhanga
- a Malawi Epidemiology and Intervention Research Unit , Karonga , Malawi
| | - Oddie Mwiba
- a Malawi Epidemiology and Intervention Research Unit , Karonga , Malawi
| | | | - Steffen Geis
- a Malawi Epidemiology and Intervention Research Unit , Karonga , Malawi.,b Faculty of Epidemiology and Population Health , London School of Hygiene and Tropical Medicine , London , UK
| | - Amelia C Crampin
- a Malawi Epidemiology and Intervention Research Unit , Karonga , Malawi.,b Faculty of Epidemiology and Population Health , London School of Hygiene and Tropical Medicine , London , UK
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15
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High-density lipoprotein suppresses tumor necrosis factor alpha production by mycobacteria-infected human macrophages. Sci Rep 2018; 8:6736. [PMID: 29712918 PMCID: PMC5928146 DOI: 10.1038/s41598-018-24233-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 03/23/2018] [Indexed: 12/23/2022] Open
Abstract
Immune responses to parasitic pathogens are affected by the host physiological condition. High-density lipoprotein (HDL) and low-density lipoprotein (LDL) are transporters of lipids between the liver and peripheral tissues, and modulate pro-inflammatory immune responses. Pathogenic mycobacteria are parasitic intracellular bacteria that can survive within macrophages for a long period. Macrophage function is thus key for host defense against mycobacteria. These basic facts suggest possible effects of HDL and LDL on mycobacterial diseases, which have not been elucidated so far. In this study, we found that HDL and not LDL enhanced mycobacterial infections in human macrophages. Nevertheless, we observed that HDL remarkably suppressed production of tumor necrosis factor alpha (TNF-α) upon mycobacterial infections. TNF-α is a critical host-protective cytokine against mycobacterial diseases. We proved that toll-like receptor (TLR)-2 is responsible for TNF-α production by human macrophages infected with mycobacteria. Subsequent analysis showed that HDL downregulates TLR2 expression and suppresses its intracellular signaling pathways. This report demonstrates for the first time the substantial action of HDL in mycobacterial infections to human macrophages.
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16
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Ndemwa M, Wanyua S, Kaneko S, Karama M, Anselimo M. Nutritional status and association of demographic characteristics with malnutrition among children less than 24 months in Kwale County, Kenya. Pan Afr Med J 2017; 28:265. [PMID: 29881508 PMCID: PMC5989189 DOI: 10.11604/pamj.2017.28.265.12703] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 10/20/2017] [Indexed: 12/04/2022] Open
Abstract
Introduction Malnutrition is an underlying cause of mortality in about half of the cases that occur among children less than five years in developing countries. In Africa including Kenya, this problem may be exacerbated by socio-demographic and socio-economic factors. This study aimed at determining nutritional status and association of demographic characteristics with malnutrition among children aged 1 day to 24 months in Kwale County, Kenya. Methods A cross-sectional study was done in Mwaluphamba Location, Kwale County, Kenya. Data was collected using a semi-structured questionnaire and administered to 380 randomly selected mothers who had children under the age of two years. Nutrition status was determined using anthropometric measurements. Data was analyzed using descriptive statistics and associations were determined by univariate logistic regression. Results Malnutrition prevalence for children in Kwale was high with 29.2% of the children being stunted and 13.4% being severely stunted. Underweight prevalence was at 20.8% of whom 9.5% were severely underweight. The global acute malnutrition rate was 18.9%. Stunting differed significantly between sex (males 35.1% compared to females 21.7%; p = 0.005). Significant differences were also observed in stunting and underweight due to age (p < 0.005). Conclusion The prevalence of stunting, underweight and global acute malnutrition rates was high among the children. Male children were associated with a significantly higher prevalence of stunting than the females. The prevalence of underweight and stunting significantly increased with increasing age.
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Affiliation(s)
- Morris Ndemwa
- Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.,Nagasaki University Institute of Tropical Medicine, Nairobi, Kenya
| | - Sheru Wanyua
- African Population Health Research Center, Nairobi, Kenya
| | - Satoshi Kaneko
- Nagasaki University Institute of Tropical Medicine, Nairobi, Kenya.,Department of Eco-Epidemiology, Institute of Tropical Medicine, Nagasaki University, Japan
| | - Mohammed Karama
- Nagasaki University Institute of Tropical Medicine, Nairobi, Kenya.,Center for Public Health Research, Kenya Medical Research Institute (KEMRI) Nairobi, Kenya
| | - Makokha Anselimo
- Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
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17
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Chadeka EA, Nagi S, Sunahara T, Cheruiyot NB, Bahati F, Ozeki Y, Inoue M, Osada-Oka M, Okabe M, Hirayama Y, Changoma M, Adachi K, Mwende F, Kikuchi M, Nakamura R, Kalenda YDJ, Kaneko S, Hirayama K, Shimada M, Ichinose Y, Njenga SM, Matsumoto S, Hamano S. Spatial distribution and risk factors of Schistosoma haematobium and hookworm infections among schoolchildren in Kwale, Kenya. PLoS Negl Trop Dis 2017; 11:e0005872. [PMID: 28863133 PMCID: PMC5599053 DOI: 10.1371/journal.pntd.0005872] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 09/14/2017] [Accepted: 08/14/2017] [Indexed: 11/19/2022] Open
Abstract
Background Large-scale schistosomiasis control programs are implemented in regions with diverse social and economic environments. A key epidemiological feature of schistosomiasis is its small-scale heterogeneity. Locally profiling disease dynamics including risk factors associated with its transmission is essential for designing appropriate control programs. To determine spatial distribution of schistosomiasis and its drivers, we examined schoolchildren in Kwale, Kenya. Methodology/Principal findings We conducted a cross-sectional study of 368 schoolchildren from six primary schools. Soil-transmitted helminths and Schistosoma mansoni eggs in stool were evaluated by the Kato-Katz method. We measured the intensity of Schistosoma haematobium infection by urine filtration. The geometrical mean intensity of S. haematobium was 3.1 eggs/10 ml urine (school range, 1.4–9.2). The hookworm geometric mean intensity was 3.2 eggs/g feces (school range, 0–17.4). Heterogeneity in the intensity of S. haematobium and hookworm infections was evident in the study area. To identify factors associated with the intensity of helminth infections, we utilized negative binomial generalized linear mixed models. The intensity of S. haematobium infection was associated with religion and socioeconomic status (SES), while that of hookworm infection was related to SES, sex, distance to river and history of anthelmintic treatment. Conclusions/Significance Both S. haematobium and hookworm infections showed micro-geographical heterogeneities in this Kwale community. To confirm and explain our observation of high S. haematobium risk among Muslims, further extensive investigations are necessary. The observed small scale clustering of the S. haematobium and hookworm infections might imply less uniform strategies even at finer scale for efficient utilization of limited resources. The World Health Organization is spearheading the war on neglected tropical diseases, including helminth infections, by encouraging its member states to intensify control efforts. This call has recently been answered in most endemic regions of helminthiasis and governments are scaling up chemotherapy-based control programs in collaboration with private and public partners. However, it is necessary to clearly understand factors driving local transmission dynamics of helminth infections to design effective control programs. Here, we conducted a cross-sectional survey of 368 primary schoolchildren in Kwale, Kenya, and identified factors associated with the intensity of Schistosoma haematobium and hookworm infections. The negative binomial generalized linear mixed model showed the intensity of S. haematobium infection was much higher among Muslims and schoolchildren from low socioeconomic status households. High intensity of hookworm infection was associated with sex, SES, distance to river and history of anthelmintic treatment. Our findings demonstrate considering social and cultural drivers of NTDs could be beneficial in designing of efficient control programs and expediting NTDs control.
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Affiliation(s)
- Evans Asena Chadeka
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Sachiyo Nagi
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Toshihiko Sunahara
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Department of Vector Ecology and Environment, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | | | - Felix Bahati
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
| | - Yuriko Ozeki
- Department of Bacteriology, Niigata University School of Medicine, Niigata, Japan
| | - Manabu Inoue
- Department of Bacteriology and Virology, Osaka-City University Graduate School of Medicine, Osaka, Japan
| | - Mayuko Osada-Oka
- Food Hygiene and Environmental Health Division of Applied Life Science, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, Kyoto, Japan
| | - Mayuko Okabe
- Department of Immunology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yukio Hirayama
- Department of Bacteriology, Niigata University School of Medicine, Niigata, Japan
| | - Mwatasa Changoma
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
| | - Keishi Adachi
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Department of Immunology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Faith Mwende
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Mihoko Kikuchi
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Risa Nakamura
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Yombo Dan Justin Kalenda
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Department of Eco-Epidemiology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Satoshi Kaneko
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
- Department of Eco-Epidemiology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Kenji Hirayama
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Masaaki Shimada
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
- Department of Eco-Epidemiology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Yoshio Ichinose
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
| | - Sammy M. Njenga
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Sohkichi Matsumoto
- Department of Bacteriology, Niigata University School of Medicine, Niigata, Japan
| | - Shinjiro Hamano
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
- * E-mail:
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Mercader HFG, Kabakyenga J, Katuruba DT, Hobbs AJ, Brenner JL. Female respondent acceptance of computer-assisted personal interviewing (CAPI) for maternal, newborn and child health coverage surveys in rural Uganda. Int J Med Inform 2016; 98:41-46. [PMID: 28034411 DOI: 10.1016/j.ijmedinf.2016.11.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 09/19/2016] [Accepted: 11/28/2016] [Indexed: 11/25/2022]
Abstract
INTRODUCTION High maternal and child mortality continues in low- and middle-income countries (LMIC). Measurement of maternal, newborn and child health (MNCH) coverage indicators often involves an expensive, complex, and lengthy household data collection process that is especially difficult in less-resourced settings. Computer-assisted personal interviewing (CAPI) has been proposed as a cost-effective and efficient alternative to traditional paper-and-pencil interviewing (PAPI). However, the literature on respondent-level acceptance of CAPI in LMIC has reported mixed outcomes. This is the first study to prospectively examine female respondent acceptance of CAPI and its influencing factors for MNCH data collection in rural Southwest Uganda. METHODS Eighteen women aged 15-49 years were randomly selected from 3 rural villages to participate. Each respondent was administered a Women's Questionnaire with half of the survey questions asked using PAPI techniques and the other half using CAPI. Following this PAPI/CAPI exposure, semi-structured focus group discussions (FGDs) assessed respondent attitudes towards PAPI versus CAPI. FGD data analysis involved an immersion/crystallization method (thematic narrative analysis). RESULTS The sixteen FGD respondents had a median age of 27 (interquartile range: 24.8, 32.3) years old. The majority (62.5%) had only primary level education. Most respondents (68.8%) owned or regularly used a mobile phone or computer. Few respondents (31.3%) had previously seen but not used a tablet computer. Overall, FGDs revealed CAPI acceptance and the factors influencing CAPI acceptability were 'familiarity', 'data confidentiality and security', 'data accuracy', and 'modernization and development'. DISCUSSION Female survey respondents in our rural Southwest Ugandan setting found CAPI to be acceptable. Global health planners and implementers considering CAPI for health coverage survey data collection should accommodate influencing factors during survey planning in order to maximize and facilitate acceptance and support by local stakeholders and community participants. Further research is needed to generate best practices for CAPI implementation and LMIC; higher quality, timely, streamlined and budget-friendly collection of MNCH indicators could help direct and improve programming to save lives of mothers and children.
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Affiliation(s)
- Hannah Faye G Mercader
- Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
| | - Jerome Kabakyenga
- Maternal Newborn and Child Health Institute, Mbarara University of Science and Technology, P.O. Box 1410 Mbarara, Uganda.
| | - David Tumusiime Katuruba
- Maternal Newborn and Child Health Institute, Mbarara University of Science and Technology, P.O. Box 1410 Mbarara, Uganda.
| | - Amy J Hobbs
- Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
| | - Jennifer L Brenner
- Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
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Homan T, di Pasquale A, Onoka K, Kiche I, Hiscox A, Mweresa C, Mukabana WR, Masiga D, Takken W, Maire N. Profile: The Rusinga Health and Demographic Surveillance System, Western Kenya. Int J Epidemiol 2016; 45:718-27. [PMID: 27185811 DOI: 10.1093/ije/dyw072] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2016] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tobias Homan
- Laboratory of Entomology, Wageningen University and Research Centre, Wageningen, The Netherlands,
| | - Aurelio di Pasquale
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland
| | - Kelvin Onoka
- Department of Medical Entomology, International Centre of Insect Physiology and Ecology, Nairobi, Kenya and
| | - Ibrahim Kiche
- Department of Medical Entomology, International Centre of Insect Physiology and Ecology, Nairobi, Kenya and
| | - Alexandra Hiscox
- Laboratory of Entomology, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Collins Mweresa
- Department of Medical Entomology, International Centre of Insect Physiology and Ecology, Nairobi, Kenya and
| | | | - Daniel Masiga
- Department of Medical Entomology, International Centre of Insect Physiology and Ecology, Nairobi, Kenya and
| | - Willem Takken
- Laboratory of Entomology, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Nicolas Maire
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland
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Spatial Distributions of HIV Infection in an Endemic Area of Western Kenya: Guiding Information for Localized HIV Control and Prevention. PLoS One 2016; 11:e0148636. [PMID: 26862764 PMCID: PMC4749294 DOI: 10.1371/journal.pone.0148636] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 01/21/2016] [Indexed: 11/20/2022] Open
Abstract
HIV is still a major health problem in developing countries. Even though high HIV-risk-taking behaviors have been reported in African fishing villages, local distribution patterns of HIV infection in the communities surrounding these villages have not been thoroughly analyzed. The objective of this study was to investigate the geographical distribution patterns of HIV infection in communities surrounding African fishing villages. In 2011, we applied age- and sex-stratified random sampling to collect 1,957 blood samples from 42,617 individuals registered in the Health and Demographic Surveillance System in Mbita, which is located on the shore of Lake Victoria in western Kenya. We used these samples to evaluate existing antibody detection assays for several infectious diseases, including HIV antibody titers. Based on the results of the assays, we evaluated the prevalence of HIV infection according to sex, age, and altitude of participating households. We also used Kulldorff’s spatial scan statistic to test for HIV clustering in the study area. The prevalence of HIV at our study site was 25.3%. Compared with the younger age group (15–19 years), adults aged 30–34 years were 6.71 times more likely to be HIV-positive, and the estimated HIV-positive population among women was 1.43 times larger than among men. Kulldorff’s spatial scan statistic detected one marginally significant (P = 0.055) HIV-positive and one significant HIV-negative cluster (P = 0.047) in the study area. These results suggest a homogeneous HIV distribution in the communities surrounding fishing villages. In addition to individual behavior, more complex and diverse factors related to the social and cultural environment can contribute to a homogeneous distribution pattern of HIV infection outside of African fishing villages. To reduce rates of transmission in HIV-endemic areas, HIV prevention and control programs optimized for the local environment need to be developed.
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Lietz H, Lingani M, Sié A, Sauerborn R, Souares A, Tozan Y. Measuring population health: costs of alternative survey approaches in the Nouna Health and Demographic Surveillance System in rural Burkina Faso. Glob Health Action 2015; 8:28330. [PMID: 26257048 PMCID: PMC4530139 DOI: 10.3402/gha.v8.28330] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 07/02/2015] [Accepted: 07/06/2015] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND There are more than 40 Health and Demographic Surveillance System (HDSS) sites in 19 different countries. The running costs of HDSS sites are high. The financing of HDSS activities is of major importance, and adding external health surveys to the HDSS is challenging. To investigate the ways of improving data quality and collection efficiency in the Nouna HDSS in Burkina Faso, the stand-alone data collection activities of the HDSS and the Household Morbidity Survey (HMS) were integrated, and the paper-based questionnaires were consolidated into a single tablet-based questionnaire, the Comprehensive Disease Assessment (CDA). OBJECTIVE The aims of this study are to estimate and compare the implementation costs of the two different survey approaches for measuring population health. DESIGN All financial costs of stand-alone (HDSS and HMS) and integrated (CDA) surveys were estimated from the perspective of the implementing agency. Fixed and variable costs of survey implementation and key cost drivers were identified. The costs per household visit were calculated for both survey approaches. RESULTS While fixed costs of survey implementation were similar for the two survey approaches, there were considerable variations in variable costs, resulting in an estimated annual cost saving of about US$45,000 under the integrated survey approach. This was primarily because the costs of data management for the tablet-based CDA survey were considerably lower than for the paper-based stand-alone surveys. The cost per household visit from the integrated survey approach was US$21 compared with US$25 from the stand-alone surveys for collecting the same amount of information from 10,000 HDSS households. CONCLUSIONS The CDA tablet-based survey method appears to be feasible and efficient for collecting health and demographic data in the Nouna HDSS in rural Burkina Faso. The possibility of using the tablet-based data collection platform to improve the quality of population health data requires further exploration.
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Affiliation(s)
- Henrike Lietz
- Institute of Public Health, Heidelberg University, Heidelberg, Germany
| | | | - Ali Sié
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Rainer Sauerborn
- Institute of Public Health, Heidelberg University, Heidelberg, Germany
| | - Aurelia Souares
- Institute of Public Health, Heidelberg University, Heidelberg, Germany
| | - Yesim Tozan
- Institute of Public Health, Heidelberg University, Heidelberg, Germany.,Steinhardt School of Culture, Education and Human Development and College of Global Public Health, New York University, New York, NY, USA;
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Shinsugi C, Matsumura M, Karama M, Tanaka J, Changoma M, Kaneko S. Factors associated with stunting among children according to the level of food insecurity in the household: a cross-sectional study in a rural community of Southeastern Kenya. BMC Public Health 2015; 15:441. [PMID: 25924925 PMCID: PMC4428099 DOI: 10.1186/s12889-015-1802-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 04/24/2015] [Indexed: 12/23/2022] Open
Abstract
Background Chronic malnutrition or stunting among children under 5 years old is affected by several household environmental factors, such as food insecurity, disease burden, and poverty. However, not all children experience stunting even in food insecure conditions. To seek a solution at the local level for preventing stunting, a cross-sectional study was conducted in southeastern Kenya, an area with a high level of food insecurity. Methods The study was based on a cohort organized to monitor the anthropometric status of children. A structured questionnaire collected information on the following: demographic characteristics, household food security based on the Household Food Insecurity Access Scale (HFIAS), household socioeconomic status (SES), and child health status. The associations between stunting and potential predictors were examined by bivariate and multivariate stepwise logistic regression analyses. Furthermore, analyses stratified by level of food security were conducted to specify factors associated with child stunting in different food insecure groups. Results Among 404 children, the prevalence of stunting was 23.3%. The percentage of households with severe food insecurity was 62.5%. In multivariative analysis, there was no statistically significant association with child stunting. However, further analyses conducted separately according to level of food security showed the following significant associations: in the severely food insecure households, feeding tea/porridge with milk (adjusted Odds Ratio [aOR]: 3.22; 95% Confidence Interval [95% CI]: 1.43-7.25); age 2 to 3 years compared with 0 to 5 months old (aOR: 4.04; 95% CI: 1.01-16.14); in households without severe food insecurity, animal rearing (aOR: 3.24; 95% CI: 1.04-10.07); SES with lowest status as reference (aOR range: from 0.13 to 0.22). The number of siblings younger than school age was not significantly associated, but was marginally associated in the latter household group (aOR: 2.81; 95% CI: 0.92-8.58). Conclusions Our results suggest that measures against childhood stunting should be optimized according to food security level observed in each community.
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Affiliation(s)
- Chisa Shinsugi
- Graduate School of International Health Development, Nagasaki University, Nagasaki, Japan. .,Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Masaki Matsumura
- Graduate School of International Health Development, Nagasaki University, Nagasaki, Japan. .,Liaison Center for International Education, Nagasaki University, Nagasaki, Japan.
| | - Mohamed Karama
- Graduate School of International Health Development, Nagasaki University, Nagasaki, Japan. .,Centre for Public Health Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.
| | - Junichi Tanaka
- Department of Eco-epidemiology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan. .,Department of Nursing, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
| | - Mwatasa Changoma
- Nagasaki University Institute of Tropical Medicine (NUITM) - Kenya Medical Research Institute (KEMRI) Project, Nairobi, Kenya.
| | - Satoshi Kaneko
- Graduate School of International Health Development, Nagasaki University, Nagasaki, Japan. .,Department of Eco-epidemiology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
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Wanyua S, Ndemwa M, Goto K, Tanaka J, K'opiyo J, Okumu S, Diela P, Kaneko S, Karama M, Ichinose Y, Shimada M. Profile: the Mbita health and demographic surveillance system. Int J Epidemiol 2014; 42:1678-85. [PMID: 24415606 DOI: 10.1093/ije/dyt180] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Mbita Health and Demographic Surveillance System (Mbita HDSS), located on the shores of Lake Victoria in Kenya, was established in 2006. The main objective of the HDSS is to provide a platform for population-based research on relationships between diseases and socio-economic and environmental factors, and for the evaluation of disease control interventions. The Mbita HDSS had a population of approximately 54 014 inhabitants from 11 576 households in June 2013. Regular data are collected using personal digital assistants (PDAs) every 3 months, which includes births, pregnancies, migration events and deaths. Coordinates are taken using geographical positioning system (GPS) units to map all dwelling units during data collection. Cause of death is inferred from verbal autopsy questionnaires. In addition, other health-related data such as vaccination status, socio-economic status, water sources, acute illness and bed net distribution are collected. The HDSS has also provided a platform for conducting various other research activities such as entomology studies, research on neglected tropical diseases, and environmental health projects which have benefited the organization as well as the HDSS community residents. Data collected are shared with the community members, health officials, local administration and other relevant organizations. Opportunities for collaboration and data sharing with the wider research community are available and those interested should contact shimadam@nagasaki-u.ac.jp or mhmdkarama@yahoo.com.
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Affiliation(s)
- Sheru Wanyua
- Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute Project, Nairobi, Kenya, Department of Eco-Epidemiology, Nagasaki University, Nagasaki, Japan, Centre for Infectious Disease Research in Asia and Africa, Nagasaki University Institute of Tropical Medicine, Nairobi, Kenya and Centre for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
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Fujii Y, Kaneko S, Nzou SM, Mwau M, Njenga SM, Tanigawa C, Kimotho J, Mwangi AW, Kiche I, Matsumoto S, Niki M, Osada-Oka M, Ichinose Y, Inoue M, Itoh M, Tachibana H, Ishii K, Tsuboi T, Yoshida LM, Mondal D, Haque R, Hamano S, Changoma M, Hoshi T, Kamo KI, Karama M, Miura M, Hirayama K. Serological surveillance development for tropical infectious diseases using simultaneous microsphere-based multiplex assays and finite mixture models. PLoS Negl Trop Dis 2014; 8:e3040. [PMID: 25078404 PMCID: PMC4117437 DOI: 10.1371/journal.pntd.0003040] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 06/10/2014] [Indexed: 11/29/2022] Open
Abstract
Background A strategy to combat infectious diseases, including neglected tropical diseases (NTDs), will depend on the development of reliable epidemiological surveillance methods. To establish a simple and practical seroprevalence detection system, we developed a microsphere-based multiplex immunoassay system and evaluated utility using samples obtained in Kenya. Methods We developed a microsphere-based immuno-assay system to simultaneously measure the individual levels of plasma antibody (IgG) against 8 antigens derived from 6 pathogens: Entamoeba histolytica (C-IgL), Leishmania donovani (KRP42), Toxoplasma gondii (SAG1), Wuchereria bancrofti (SXP1), HIV (gag, gp120 and gp41), and Vibrio cholerae (cholera toxin). The assay system was validated using appropriate control samples. The assay system was applied for 3411 blood samples collected from the general population randomly selected from two health and demographic surveillance system (HDSS) cohorts in the coastal and western regions of Kenya. The immunoassay values distribution for each antigen was mathematically defined by a finite mixture model, and cut-off values were optimized. Findings Sensitivities and specificities for each antigen ranged between 71 and 100%. Seroprevalences for each pathogen from the Kwale and Mbita HDSS sites (respectively) were as follows: HIV, 3.0% and 20.1%; L. donovani, 12.6% and 17.3%; E. histolytica, 12.8% and 16.6%; and T. gondii, 30.9% and 28.2%. Seroprevalences of W. bancrofti and V. cholerae showed relatively high figures, especially among children. The results might be affected by immunological cross reactions between W. bancrofti-SXP1 and other parasitic infections; and cholera toxin and the enterotoxigenic E. coli (ETEC), respectively. Interpretation A microsphere-based multi-serological assay system can provide an opportunity to comprehensively grasp epidemiological features for NTDs. By adding pathogens and antigens of interest, optimized made-to-order high-quality programs can be established to utilize limited resources to effectively control NTDs in Africa. Monitoring the distribution of neglected tropical diseases (NTDs) is a key to controlling their spread in Africa. Currently, such surveillance is conducted independently for each NTD. To tackle this problem, we developed a microsphere-based system to permit simultaneous measurement of IgG antibody levels for antigens from six infectious diseases: Entamoeba histolytica, Leishmania donovani, Toxoplasma gondii, Wuchereria bancrofti, HIV, and Vibrio cholerae. Using this system, we conducted a serological survey using two health and demographic surveillance system (HDSS) areas in coastal and western Kenya. We randomly selected 4,600 individuals according to sex and age group, of whom 3411 agreed to participate in the study. Mathematical analyses of the distributions of the participants' reactivity to each antigen and the reactivity of the sero-positive and -negative controls indicated that this system could be used to monitor infections, especially, those associated with HIV, filariasis, toxoplasmosis, leishmaniasis, and amebiasis. For the practical development and eventual implementation of actual programs in Africa, pathogens and antigens of interest can be added to optimize made-to-order monitoring programs.
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Affiliation(s)
- Yoshito Fujii
- Department of Eco-Epidemiology, Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan
| | - Satoshi Kaneko
- Department of Eco-Epidemiology, Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan
- Graduate School of International Health Development, Nagasaki University, Nagasaki, Japan
- Nagasaki University Institute of Tropical Medicine (NUITM)- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
- * E-mail:
| | - Samson Muuo Nzou
- Nagasaki University Institute of Tropical Medicine (NUITM)- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
- Centre for Infectious and Parasitic Diseases Control Research, Kenya Medical Research Institute (KEMRI), Busia, Kenya
| | - Matilu Mwau
- Centre for Infectious and Parasitic Diseases Control Research, Kenya Medical Research Institute (KEMRI), Busia, Kenya
| | - Sammy M. Njenga
- Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Chihiro Tanigawa
- Department of Eco-Epidemiology, Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan
| | - James Kimotho
- Production Department, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Anne Wanjiru Mwangi
- Production Department, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Ibrahim Kiche
- Nagasaki University Institute of Tropical Medicine (NUITM)- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
- Thomas Odhiambo Campus, Mbita, International Center of Insect Physiology and Ecology (ICIPE), Mbita, Kenya
| | - Sohkichi Matsumoto
- Department of Bacteriology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Mamiko Niki
- Department of Bacteriology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Mayuko Osada-Oka
- Department of Bacteriology, Osaka City University Graduate School of Medicine, Osaka, Japan
- Food Hygiene and Environmental Health Division of Applied Life Science, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, Kyoto, Japan
| | - Yoshio Ichinose
- Nagasaki University Institute of Tropical Medicine (NUITM)- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
- Kenya Research Station, Nagasaki University, Nagasaki, Japan
| | - Manabu Inoue
- Department of Bacteriology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Makoto Itoh
- Department of Infection and Immunology, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Hiroshi Tachibana
- Department of Infectious Diseases, Tokai University School of Medicine, Kanagawa, Japan
| | - Kazunari Ishii
- Department of Microbiology and Immunology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Takafumi Tsuboi
- Division of Malaria Research, Proteo-Science Center, Ehime University, Ehime, Japan
| | - Lay Myint Yoshida
- Department of Paediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Dinesh Mondal
- International Center for Diarrheal Disease Research (ICDDR, B), Dhaka, Bangladesh
| | - Rashidul Haque
- International Center for Diarrheal Disease Research (ICDDR, B), Dhaka, Bangladesh
| | - Shinjiro Hamano
- Nagasaki University Institute of Tropical Medicine (NUITM)- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
- Department of Parasitology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Mwatasa Changoma
- Nagasaki University Institute of Tropical Medicine (NUITM)- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Tomonori Hoshi
- Department of Eco-Epidemiology, Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan
| | - Ken-ichi Kamo
- Department of Liberal Arts and Sciences, Sapporo Medical University, Sapporo, Japan
| | - Mohamed Karama
- Graduate School of International Health Development, Nagasaki University, Nagasaki, Japan
- Centre of Public Health Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Masashi Miura
- Department of Eco-Epidemiology, Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan
| | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
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Nagi S, Chadeka EA, Sunahara T, Mutungi F, Justin YKD, Kaneko S, Ichinose Y, Matsumoto S, Njenga SM, Hashizume M, Shimada M, Hamano S. Risk factors and spatial distribution of Schistosoma mansoni infection among primary school children in Mbita District, Western Kenya. PLoS Negl Trop Dis 2014; 8:e2991. [PMID: 25058653 PMCID: PMC4109881 DOI: 10.1371/journal.pntd.0002991] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 05/19/2014] [Indexed: 11/21/2022] Open
Abstract
Background An increasing risk of Schistosoma mansoni infection has been observed around Lake Victoria, western Kenya since the 1970s. Understanding local transmission dynamics of schistosomiasis is crucial in curtailing increased risk of infection. Methodology/Principal Findings We carried out a cross sectional study on a population of 310 children from eight primary schools. Overall, a total of 238 (76.8%) children were infected with S. mansoni, while seven (2.3%) had S. haematobium. The prevalence of hookworm, Trichuris trichiura and Ascaris lumbricoides were 6.1%, 5.2% and 2.3%, respectively. Plasmodium falciparum was the only malaria parasite detected (12.0%). High local population density within a 1 km radius around houses was identified as a major independent risk factor of S. mansoni infection. A spatial cluster of high infection risk was detected around the Mbita causeway following adjustment for population density and other potential risk factors. Conclusions/Significance Population density was shown to be a major factor fuelling schistosome infection while individual socio-economic factors appeared not to affect the infection risk. The high-risk cluster around the Mbita causeway may be explained by the construction of an artificial pathway that may cause increased numbers of S. mansoni host snails through obstruction of the waterway. This construction may have, therefore, a significant negative impact on the health of the local population, especially school-aged children who frequently come in contact with lake water. It is estimated that more than ten percent of the world's population is at risk of schistosome transmission, with over 90% of infections occurring in sub-Saharan Africa. In Kenya, schistosomiasis remains a major public health concern particularly around Lake Victoria. The objective of this study was to identify the risk factors associated with Schistosoma mansoni infection among schoolchildren on the shores and adjacent islands of Lake Victoria in Mbita district, western Kenya. High local population density was identified as an important risk factor for S. mansoni infection. Socio-economic factors were not found to be significantly associated with infection risk. Our study suggests that environmental changes related to causeway construction and the dense human population around Mbita town may result in favourable ecological conditions for S. mansoni transmission.
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Affiliation(s)
- Sachiyo Nagi
- Department of Parasitology, Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan
- Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan
| | - Evans A. Chadeka
- Department of Parasitology, Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan
| | - Toshihiko Sunahara
- Department of Vector Biology and Environment, Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan
| | - Faith Mutungi
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Yombo K. Dan Justin
- Department of Parasitology, Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan
- Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan
| | - Satoshi Kaneko
- Department of EcoEpidemiology, Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan
| | - Yoshio Ichinose
- Nagasaki University Nairobi Research Station, NUITM-KEMRI Project, Nairobi, Kenya
| | - Sohkichi Matsumoto
- Department of Infectious Disease Control and International Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Sammy M. Njenga
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Masahiro Hashizume
- Department of Paediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan
| | - Masaaki Shimada
- Department of EcoEpidemiology, Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan
- Nagasaki University Nairobi Research Station, NUITM-KEMRI Project, Nairobi, Kenya
- * E-mail: (MS); (SH)
| | - Shinjiro Hamano
- Department of Parasitology, Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan
- Nagasaki University Nairobi Research Station, NUITM-KEMRI Project, Nairobi, Kenya
- * E-mail: (MS); (SH)
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Knipe DW, Pearson M, Borgstrøm R, Pieris R, Weerasinghe M, Priyadarshana C, Eddleston M, Gunnell D, Metcalfe C, Konradsen F. Challenges and opportunities of a paperless baseline survey in Sri Lanka. BMC Res Notes 2014; 7:452. [PMID: 25027231 PMCID: PMC4118630 DOI: 10.1186/1756-0500-7-452] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 06/27/2014] [Indexed: 12/05/2022] Open
Abstract
Background Personal digital assistants (PDAs) have been shown to reduce costs associated with survey implementation and digitisation, and to improve data quality when compared to traditional paper based data collection. Few studies, however, have shared their experiences of the use of these devices in rural settings in Asia. This paper reports on our experiences of using a PDA device for data collection in Sri Lanka as part of a large cluster randomised control trial. Findings We found that PDAs were useful for collecting data for a baseline survey of a large randomised control trial (54,000 households). We found that the PDA device and survey format was easy to use by inexperienced field staff, even though the survey was programmed in English. The device enabled the rapid digitisation of survey data, providing a good basis for continuous data quality assurance, supervision of staff and survey implementation. An unexpected advantage was the improved community opinion of the research project as a result of the device, because the use of the technology gave data collectors an elevated status amongst the community. In addition the global positioning system (GPS) functionality of the device allowed precise mapping of households, and hence distinct settlements to be identified as randomisation clusters. Future users should be mindful that to save costs the piloting should be completed before programming. In addition consideration of a local after-care service is important to avoid costs and time delays associated with sending devices back to overseas providers. Discussion Since the start of this study, PDA devices have rapidly developed and are increasingly used. The use of PDA or similar devices for research is not without its problems; however we believe that the universal lessons learnt as part of this study are even more important for the effective utilisation of these rapidly developing technologies in resource poor settings.
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Affiliation(s)
- Duleeka W Knipe
- School of Social and Community Medicine, University of Bristol, Bristol, UK.
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Weldearegawi B, Spigt M, Berhane Y, Dinant G. Mortality level and predictors in a rural Ethiopian population: community based longitudinal study. PLoS One 2014; 9:e93099. [PMID: 24675840 PMCID: PMC3968055 DOI: 10.1371/journal.pone.0093099] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 03/03/2014] [Indexed: 12/16/2022] Open
Abstract
Background Over the last fifty years the world has seen enormous decline in mortality rates. However, in low-income countries, where vital registration systems are absent, mortality statistics are not easily available. The recent economic growth of Ethiopia and the parallel large scale healthcare investments make investigating mortality figures worthwhile. Methods Longitudinal health and demographic surveillance data collected from September 11, 2009 to September 10, 2012 were analysed. We computed incidence of mortality, overall and stratified by background variables. Poisson regression was used to test for a linear trend in the standardized mortality rates. Cox-regression analysis was used to identify predictors of mortality. Households located at <2300 meter and ≥2300 meter altitude were defined to be midland and highland, respectively. Results An open cohort, with a baseline population of 66,438 individuals, was followed for three years to generate 194,083 person-years of observation. The crude mortality rate was 4.04 (95% CI: 3.77, 4.34) per 1,000 person-years. During the follow-up period, incidence of mortality significantly declined among under five (P<0.001) and 5–14 years old (P<0.001), whereas it increased among 65 years and above (P<0.001). Adjusted for other covariates, mortality was higher in males (hazard ratio (HR) = 1.42, 95% CI: 1.22, 1.66), rural population (HR = 1.74, 95% CI: 1.32, 2.31), highland (HR = 1.20, 95% CI: 1.03, 1.40) and among those widowed (HR = 2.25, 95% CI: 1.81, 2.80) and divorced (HR = 1.80, 95% CI: 1.30, 2.48). Conclusions Overall mortality rate was low. The level and patterns of mortality indicate changes in the epidemiology of major causes of death. Certain population groups had significantly higher mortality rates and further research is warranted to identify causes of higher mortality in those groups.
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Affiliation(s)
- Berhe Weldearegawi
- Department of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
- CAPHRI, School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
- * E-mail:
| | - Mark Spigt
- Department of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
- CAPHRI, School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
| | - Yemane Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - GeertJan Dinant
- CAPHRI, School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
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Mondal MNI, Shitan M. Relative importance of demographic, socioeconomic and health factors on life expectancy in low- and lower-middle-income countries. J Epidemiol 2013; 24:117-24. [PMID: 24390415 PMCID: PMC3956691 DOI: 10.2188/jea.je20130059] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background We attempted to identify the pathways by which demographic changes, socioeconomic inequalities, and availability of health factors influence life expectancy in low- and lower-middle-income countries. Methods Data for 91 countries were obtained from United Nations agencies. The response variable was life expectancy, and the determinant factors were demographic events (total fertility rate and adolescent fertility rate), socioeconomic status (mean years of schooling and gross national income per capita), and health factors (physician density and human immunodeficiency virus [HIV] prevalence rate). Path analysis was used to determine the direct, indirect, and total effects of these factors on life expectancy. Results All determinant factors were significantly correlated with life expectancy. Mean years of schooling, total fertility rate, and HIV prevalence rate had significant direct and indirect effects on life expectancy. The total effect of higher physician density was to increase life expectancy. Conclusions We identified several direct and indirect pathways that predict life expectancy. The findings suggest that policies should concentrate on improving reproductive decisions, increasing education, and reducing HIV transmission. In addition, special attention should be paid to the emerging need to increase life expectancy by increasing physician density.
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Affiliation(s)
- Md Nazrul Islam Mondal
- Laboratory of Computational Statistics and Operations Research, Institute for Mathematical Research, University Putra Malaysia
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29
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Matsuyama A, Karama M, Tanaka J, Kaneko S. Perceptions of caregivers about health and nutritional problems and feeding practices of infants: a qualitative study on exclusive breast-feeding in Kwale, Kenya. BMC Public Health 2013; 13:525. [PMID: 23721248 PMCID: PMC3681582 DOI: 10.1186/1471-2458-13-525] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 05/20/2013] [Indexed: 11/23/2022] Open
Abstract
Background Despite the significant positive effect of exclusive breast-feeding on child health, only 32% of children under 6 months old were exclusively breast-fed in Kenya in 2008. The aim of this study was to explore perceptions and feeding practices of caregivers of children under 6 months old with special attention to the caregivers’ indigenous knowledge, perceptions about the health and nutritional problems of their infants, and care-seeking behaviors that affect feeding practices. Methods The study was exploratory and used an inductive approach. In all, 32 key informants, including mothers, mothers-in-law, and traditional healers, were interviewed in-depth. The number of participants in free-listing of perceived health problems of babies, in ranking of the perceived severity of these health problems, and in free-listing of food and drink given to children under 6 months old were 29, 28, and 32, respectively. Additionally, 28 babies under 6 months old were observed at home with regard to feeding practices. Data obtained using these methods were triangulated to formulate an ethnomedical explanatory model for mothers who do not practice exclusive breast-feeding. Results The informants stated that various types of food, drink, and medicine were given to infants under 6 months old. Direct observation also confirmed that 2- to 3-month-old babies were given porridge, water, juice, herbal medicine, and over-the-counter medicine. Mothers’ perceptions of insufficient breast milk production and a lack of proper knowledge about the value of breast milk were identified in key informant interviews, free-listing, and ranking as important factors associating with the use of food and drink other than breast milk; in addition, perceived ill health of babies appears to be associated with suboptimal practice of exclusive breast-feeding. Caregivers used various folk and popular medicines from the drugstore, their own backyard or garden, and traditional healers so that the mother or child would not be exposed to perceived risks during the vulnerable period after birth. Conclusions Mothers should be advised during their antenatal and postnatal care about exclusive breast-feeding. This should be done not as a single vertical message, but in relation to their concerns about the health and nutritional problems of their babies.
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Affiliation(s)
- Akiko Matsuyama
- School of International Health Development, Nagasaki University, Nagasaki, Japan.
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Kawakatsu Y, Kaneko S, Karama M, Honda S. Prevalence and risk factors of neurological impairment among children aged 6-9 years: from population based cross sectional study in western Kenya. BMC Pediatr 2012. [PMID: 23206271 PMCID: PMC3519515 DOI: 10.1186/1471-2431-12-186] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background The burden of disability is more severe among children in low income countries. Moreover, the number of children with disabilities (CWDs) in sub-Saharan Africa is predicted to increase with reduction in child mortality. Although the issue on CWDs is important in sub-Saharan Africa, there are few researches on risk factors of disabilities. The purpose of this study was to evaluate the risk factors of neurological impairment (NI) among children in western Kenya. Methods The present study was conducted in Mbita district (which has high HIV infectious prevalence), Kenya from April 2009 to December 2010. The study consisted of two phases. In phase 1, the Ten Question Questionnaire (TQQ) was administered to all 6362 caregivers of children aged 6–9 years. In phase two, all 413 children with TQQ positive and a similar number of controls (n=420) which were randomly selected from children with TQQ negative were examined for physical and cognitive status. In addition, a structured questionnaire was also conducted to their caregivers. Results The prevalence was estimated to be 29/1000. Among the types of impairments, cognitive impairment was the most common (24/1000), followed by physical impairment (5/1000). In multivariate analysis, having more than five children [adjusted odds ratio (AOR): 2.85; 95%IC: 1.25 – 6.49; p=0.013], maternal age older than 35 years old [AOR: 2.31; 95%IC: 1.05 – 5.07; p=0.036] were significant factors associated with NI. In addition, monthly income under 3000 ksh [AOR: 2.79; 95%IC: 1.28 – 6.08; p=0.010] and no maternal tetanus shot during antenatal care [AOR: 5.17; 95%IC: 1.56 – 17.14; p=0.007] were also significantly related with having moderate/severe neurological impairment. Conclusion It was indicated that increasing coverage of antenatal care including maternal tetanus shot and education of how to take care of neonatal children to prevent neurological impairment are important.
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Komazawa O, Kaneko S, K’Opiyo J, Kiche I, Wanyua S, Shimada M, Karama M. Are long-lasting insecticidal nets effective for preventing childhood deaths among non-net users? A community-based cohort study in western Kenya. PLoS One 2012; 7:e49604. [PMID: 23185378 PMCID: PMC3501471 DOI: 10.1371/journal.pone.0049604] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 10/11/2012] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Increasing the distribution and use of insecticide-treated nets (ITNs) in Sub-Saharan Africa has made controlling malaria with ITNs more practical. We evaluated community effects induced by ITNs, specifically long-lasting insecticidal nets (LLINs), under ordinary conditions in an endemic malaria area of Western Kenya. METHODS Using the database from Mbita Health and Demographic Surveillance System (HDSS), children younger than 5 years old were assessed over four survey periods. We analyzed the effect of bed net usage, LLIN density and population density of young people around a child on all-cause child mortality (ACCM) rates using Cox PH models. RESULTS During the study, 14,554 children were followed and 250 deaths were recorded. The adjusted hazard ratios (HRs) for LLIN usage compared with no net usage were not significant among the models: 1.08 (95%CI 0.76-1.52), 1.19 (95%CI 0.69-2.08) and 0.92 (95%CI 0.42-2.02) for LLIN users, untreated net users, and any net users, respectively. A significant increasing linear trend in risk across LLIN density quartiles (HR=1.25; 95%CI 1.03-1.51) and a decreasing linear trend in risk across young population density quartiles among non-net user children (HR=0.77; 95%CI 0.63-0.94) were observed. CONCLUSIONS Although our data showed that current LLIN coverage level (about 35%) could induce a community effect to protect children sleeping without bed nets even in a malaria-endemic area, it appears that a better system is needed to monitor the current malaria situation globally in order to optimize malaria control programs with limited resources.
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Affiliation(s)
- Osuke Komazawa
- Department of Eco-Epidemiology, Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan
| | - Satoshi Kaneko
- Department of Eco-Epidemiology, Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan
- Graduate School of International Health Development, Nagasaki University, Nagasaki, Japan
- NUITM-KEMRI Project, Nairobi, Kenya
| | | | - Ibrahim Kiche
- NUITM-KEMRI Project, Nairobi, Kenya
- Thomas Odhiambo Campus, Mbita, International Center of Insect Physiology and Ecology (ICIPE), Mbita, Kenya
| | | | - Masaaki Shimada
- Department of Eco-Epidemiology, Institute of Tropical Medicine, Nagasaki University (NUITM), Nagasaki, Japan
- NUITM-KEMRI Project, Nairobi, Kenya
| | - Mohamed Karama
- Graduate School of International Health Development, Nagasaki University, Nagasaki, Japan
- Centre for Public Health Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
- NUITM-KEMRI Project, Nairobi, Kenya
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