Several foci of cutaneous leishmaniasis have been identified in central Kenya and the Rift Valley. One of these was the Utut focus of Leishmania tropica on the floor of the Rift Valley between Gilgil and Elementaita, where intense transmission was detected. High infection and scar rates were detected among illegal charcoal burners in a previously uninhabited forest reserve on a lava flow containing numerous caves and rock crevices inhabited by sandflies and mammals which included hyraxes. Multiple lesions, predominantly in the head region, were common. 33% of cases occurred in people who had been less than one year in the area. Although most lesions healed within one or 2 years, some large, recrudescing lesions lasted several years.

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Background: Physiological characteristics (age and blood feeding status) of malaria vectors can influence their susceptibility to the current vector control tools that target their feeding and resting behaviour. To ensure the sustainability of the current and future vector control tools an understanding of how physiological characteristics may contribute to insecticide tolerance in the field is fundamental for shaping resistance management strategies and vector control tools. The aim of this study was to determine whether blood meal and mosquito age affect pyrethroid tolerance in field-collected Anopheles gambiae from western Kenya. Methods: Wild mosquito larvae were reared to adulthood alongside the pyrethroid-susceptible Kisumu strain. Adult females from the two populations were monitored for deltamethrin resistance when they were young at 2-5 days old and older 14-16 days old and whether fed or unfed for each age group. Metabolic assays were also performed to determine the level of detoxification enzymes. Mosquito specimens were further identified to species level using the polymerase chain reaction (PCR) method. Results: Anopheles gambiae sensu stricto was the predominant species comprising 96% of specimens and 2.75% Anopheles arabiensis. Bioassay results showed reduced pyrethroid induced mortality with younger mosquitoes compared to older ones (mortality rates 83% vs. 98%), independently of their feeding status. Reduced mortality was recorded with younger females of which were fed compared to their unfed counterparts of the same age with a mortality rate of 35.5% vs. 83%. Older blood-fed females showed reduced susceptibility after exposure when compared to unfed females of the same age (mortality rates 86% vs. 98%). For the Kisumu susceptible population, mortality was straight 100% regardless of age and blood feeding status. Blood feeding status and mosquito age had an effect on enzyme levels in both populations, with blood fed individuals showing higher enzyme elevations compared to their unfed counterparts (P < 0.0001). The interaction between mosquito age and blood fed status had significant effect on mosquito mortality. Conclusion: The results showed that mosquito age and blood feeding status confers increased tolerance to insecticides as blood feeding may be playing an important role in the toxicity of deltamethrin, allowing mosquitoes to rest on insecticide-treated materials despite treatment. These may have implications for the sustained efficacy of indoor residual spraying and insecticide-treated nets based control programmes that target indoor resting female mosquitoes of various gonotrophic status.

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A rapid health assessment of the Turkwel Gorge hydroelectric dam and proposed irrigation project in Kenya is described. The project will lead to increased risk of a number of communicable diseases including malaria and schistosomiasis, to the human population in the surrounding area. Mitigation measures are available and should be incorporated in the design and operation of the irrigation project to maximise costeffectiveness.