AimTyphoid fever is a vaccine-preventable bacterial disease that causes significant morbidity and mortality throughout Africa. This paper describes an upsurge of typhoid fever cases in Moyale Sub-County (MSC), Kenya, 2014–2015.MethodsWe conducted active hospital and health facility surveillance and laboratory and antimicrobial sensitivity testing for all patients presenting with headache, fever, stomach pains, diarrhea, or constipation at five MSC health facilities between December 2014 and January 2015. We also conducted direct observation of the residential areas of the suspected cases to assess potential environmental exposures and transmission mechanisms. Demographic, clinical, and laboratory data were entered into, and descriptive statistics were calculated with, MS Excel.ResultsA total of 317 patients were included in the study, with mean age 24 ± 8.1 years, and 51% female. Of the 317 suspect cases, 155 (49%) were positive by Widal antigen reaction test. A total of 188 (59%) specimens were subjected to culture and sensitivity testing, with 71 (38%) culture positive and 54 (76%), 43 (60%), and 33 (46%) sensitive to ceftriaxone, cefuroxime, and ciprofloxacin, respectively. Environmental assessments through direct observations showed that commercial and residential areas had limited (1) clean water sources, (2) latrines, and (3) hygiene stations for street food hawkers and their customers.ConclusionsTyphoid fever is endemic in MSC and causes significant disease across age and sex groups. The local health department should develop policies to (1) assure community access to potable water and hygiene stations and (2) vaccinate specific occupations, such as food and drink handlers, against typhoid.

We report the case of a 9-month-old male infant diagnosed in the field with extra-pulmonary tuberculosis (TB). Use of innovative global positioning system tracking of pregnant pastoralist women allowed staff to find the mother, locate the infant and enroll the infant in care and treatment. Due to this innovative intervention of case finding and tracking, the infant was prevented from defaulting and completed his anti-TB regimen.

Background Antenatal care services help decrease neonatal mortality. Laboratory profiling is a highly recommended part of antenatal care services, but it is often neglected. Aims To explore the importance of comprehensive antenatal care services in reducing neonatal mortality among births at Moyale Sub-County Referral Hospital in Kenya. Methods A retrospective review was conducted of maternity records of all women aged 15 years old or more who gave birth at Moyale Sub-County Referral Hospital between June 2014 and May 2015. Stillbirths were excluded from the analysis. Data were entered into Microsoft Excel and descriptive statistics calculated. A total of 1062 women were included in the study, with mean age of 24 ± 9.1 years. Of these, 11% had no antenatal care visits, 2% were HIV-positive, and all lived within 10 km of Moyale Sub-County Referral Hospital. Findings Children of women who had no antenatal care visits were 2.7 times more likely to die within 28 days of birth compared to children born to women who had 1 antenatal care visit, and 8.5 times more likely to die compared to women who had at least three antenatal care visits. Conclusions Antenatal care profiling helps reduce neonatal mortality by capturing early diagnosis of preventable conditions that affect birth outcomes.