Background Around 443,000 pregnant women are at risk of malaria each year in Rwanda. LLINs are freely distributed to women at health centers during antenatal care visit and vaccination services. Methods A cross-sectional design was used to explore pregnant women’s knowledge and factors associated to LLINs use in five cells of Tumba sector. Data was collected through interviews and questionnaires. The data was analyzed using SPSS 21. Bivariate and multivariate analyses were performed with Chi-square test to assess the association between LLINs ownership and utilization of LLINs. Results All respondents had high knowledge and knew that sleeping under LLINs helps to avoid mosquito bites whereas 381 (99.2%) knew that the use of LLIN helps to fight against the burden of malaria. LLIN ownership was 323 (84.1%) while usage was 283 (87.6%) among LLINs owners. LLIN ownership is significantly influenced by the level of education (p=0.001) and utilization (p=0.001). Although LLINs coverage was high, its utilization was low. Sixty-one respondents (15.9 %) do not have LLINs and 84 (22%) of respondents had low knowledge on LLINs. Conclusion Regular training on LLINs may increase awareness of pregnant women on the benefits of LLIN utilization. Keywords: Malaria; Households; Long-lasting insecticidal nets; Ownership; Rwanda

School children bear a significant burden of intestinal parasitic infections. Because they spend most of their time at home and school, it is necessary to identify the key water, sanitation, and hygiene (WASH) factors associated with these infections in both environments. This was a cross-sectional survey conducted in Mwea West, Kirinyaga County. 180 primary school children aged 8–14 years were randomly selected from three schools (Mianya, Mbui Njeru, and Mukou primary schools). Questionnaires and checklists were administered and single stool samples were collected. Stool samples were microscopically examined for Schistosoma mansoni, soil-transmitted helminths, and protozoan infections. Data on WASH were obtained at home and school. The factors significantly associated with S. mansoni and intestinal protozoa infections in the school children were determined using univariable and multivariable logistic regression models reporting the odds ratio at 95% confidence intervals. The overall prevalence of S. mansoni and intestinal protozoa infections was 70.5% (95% CI: 59.1–84.3) and 32.7% (95% CI: 26.8–40.1), respectively. Only one case of STH (A. lumbricoides) was identified. The prevalence of coinfections of S. mansoni and intestinal protozoa infections was 22.8% (95% CI: 19.2–27.1). An increased prevalence of S. mansoni infection was associated with children above 12 years (aOR = 3.19, p=0.015), those in Mianya primary (aOR = 1.23, p=0.001), those in Mukou primary (aOR = 3.19, p=0.001), and reported behavior of wearing shoes at home (aOR = 1.67, p=0.010). However, handwashing behavior after defecation at home (aOR = 0.39, p=0.001) was protective against S. mansoni infection. For any protozoan infection, male children had increased odds of infection (aOR = 2.41, p=0.001) while use of wiping material (aOR = 0.55, p=0.019) and water contact (aOR = 0.32, p=0.001) was protective against intestinal protozoa infections. Infections with S. mansoni and any protozoa and their coinfection were present. Findings revealed that several hygiene factors were protective against infections while other were risk factors. Therefore, deworming should be complemented with behavior education on hygienic habits.

Background: Kenya is home to an estimated 1.7 million people living with HIV/AIDS. According to the Kenya AIDS Indicator survey KAIS 2012, HIV prevalence in the age group 15-24 stood at 2.2%. Globally, young people aged 15-24 are a highly vulnerable population with respect to HIV/AIDS infection and transmission. HIV testing and counseling services play a critical role as an entry point to care and treatment. However, uptake of HIV testing and counseling services among the youth in Kenya has been reportedly low. Youths at Universities are among the priority populations in HIV/AIDS programs.Objectives: This study aimed to determine the barriers to uptake and utilization of institution-based voluntary counseling and testing VCT services among students aged 18-24 in selected public universities in Kenya. The specific objectives were to determine the factors associated with uptake and utilization and the association between various socio-demographic factors and service uptake in institutional VCT facilities.Methods: This research utilized a descriptive cross-sectional study design where primarily, data was collected using semi-structured questionnaires and through focus group discussions held with the students in the sampled Universities. Data available at Jomo Kenyatta University of Agriculture and Technology JKUAT Hospital VCT were reviewed for the period 2010 and 2016 to give an insight into service utilization rates among students. Multi-stage sampling technique was utilized to reach a student sample size of 305 from the selected public Universities in Kenya.Results: Uptake of institutional VCT services among University students sampled stood at 45% from a population where 84.4% were aware of the presence of these services on their campuses. More males than females utilized the services. Emerging themes from the study indicated that participants utilized the services for different reasons. Accessibility to test site, testing hours, fear to be seen at site and fear of test result were also identified as factors affecting service uptake. These factors also were also reported when students were asked about their desired characteristics of a VCT facility on campus.Conclusion: This study has unraveled the factors that are associated with testing and counseling in institutional facilities. University students seem to seek and utilize VCT services for different reasons. It is also clear that patterns of services utilization vary from group to another as observed in the case of year of study, gender and age category.Recommendations: It is necessary for policy makers in institutions of higher learning together with those tasked with managing healthcare services in these institutions to adopt approaches that will overcome the barriers to utilization of VCT services among students. With knowledge of the factors associated with uptake and utilization of VCT services in institutional facilities, efforts to tackle the barriers and maximize on enhancers should be utilized fully in order to improve uptake and utilization of services. More research should also focus on the persisting risky sexual behaviors among University students despite the high knowledge they have on HIV/AIDS.Keywords: Higher learning institutions, voluntary counseling and testing, HIV, barriers and uptake.

Malnutrition being one of the major public health problems in developing countries, it is still unacceptably high and progress to reduce it in most regions of the world is low. In Eastern Africa region, stunting and being underweight is estimated at 48 and 36% and are expected to increase over the next decade. There is limited information available on the prevalence of malnutrition in this area. This study determined nutritional status, and examined correlates of stunting among the children. This was a cross-sectional study undertaken among 125 preschoolers in western province, drawn from 37 clusters. For each cluster a total of 10 households were selected using systematic simple random sampling. Data were collected on nutritional status, socioeconomic status, food consumption and current malaria infection status. The prevalence of stunting (Z-scores for height for age [HAZ] <-2), wasting (Z-scores for weight for height [WHZ] < -2) and being underweight (Z-scores for weight for age [WAZ] < -2) was 28.9, 1.7 and 6.6%, respectively. Stunting was associated with poverty (OR=4.29, 95% CI: 1.06-17.36, p= 0.037) and lack of consumption of solid foods that include ripe mangoes, pawpaw and guavas (OR=3.15, 95% CI: 1.11-8.94, p=0.025), fish (OR=4.1, 95% CI: 1.15-14.61, p=0.021) and eggs (OR=4.42, 95% CI: 0.97-20.08, p=0.039). Child growth is a good indicator of nutritional status of both the individual and the community. The study demonstrates a high prevalence of stunting. Given the acute and long term consequences of malnutrition, interventions aimed at reducing child malnutrition in such a population should focus on all children less than 5 years of age.

IntroductionIron deficiency is a major public health concern. Globally, iron deficiency ranks number 9 and is responsible for about 60% of all anemia cases among preschool children. In Africa iron deficiency is 43-52% while in Kenya, children under 5 years constitute the largest burden with 69% of them being deficient. There is limited iron deficiency data in Kenya. This study determined haemoglobin levels, serum ferritin levels, nutritional status and P.falciparum malaria infection in preschool children.MethodsA household cross sectional study was undertaken among 125 preschoolers in Western province, drawn from 37 clusters. Systematic random sampling was used for sample selection. Data was collected using pretested structured questionnaires, entered in Microsoft package. Data analysis was done in Statistical package for social science (SPSS) version 20 using bivariate and multivariate logistic regression and differences were considered significant at P < 0.05.ResultsThe prevalence of iron deficiency (Serum ferritin <12mg/l), anaemia (Hb < 110g/l) and plasmodium falciparum malaria were 20.8%, 25% and 6.8% respectively. There was a significant association between iron deficiency and anaemia (OR = 3.43, 95% CI: 1.33-8.84, p = 0.008). A preschool child with anaemia was 3.43 times likely to be iron deficient compared to a preschool child who was not anaemic.ConclusionIron deficiency, anaemia and plasmodium falciparum malaria was prevalent among preschool children. The findings revealed a significant association between iron deficiency and anaemia. Therefore effective interventions to improve iron status will have large health benefits by greatly reducing anaemia in preschool children.