BackgroundSince obesity in urban women is prevalent in Kenya the study aimed to determine predictors of overweight and obesity in urban Kenyan women.MethodsA cross-sectional study was undertaken in Nairobi Province. The province was purposively selected because it has the highest prevalence of overweight and obesity in Kenya.A total of 365 women aged 25–54 years old were randomly selected to participate in the study.ResultsHigher age, higher socio-economic (SE) group, increased parity, greater number of rooms in the house, and increased expenditure showed greater mean body mass index (BMI),% body fat and waist circumference (WC) at highly significant levels (p <0.001). Most of the variance in BMI was explained by age, total physical activity, percentage of fat consumed, parity and SE group in that order, together accounting for 18% of the variance in BMI. The results suggest that age was the most significant predictor of all the dependent variables appearing first in all the models, while parity was a significant predictor of BMI and WC. The upper two SE groups had significantly higher mean protein (p <0.05), cholesterol (p <0.05) and alcohol (p <0.001) intakes than the lower SE groups; while the lower SE groups had significantly higher mean fibre (p <0.001) and carbohydrate (p <0.05) intakes. A fat intake greater than 100% of the DRI dietary reference intake (DRI) had a significantly greater mean BMI (p <0.05) than a fat intake less than the DRI.ConclusionsThe predictors of overweight and obesity showed that urbanization and the nutrition transition were well established in the sample of women studied in the high SE groups. They exhibited a sedentary lifestyle and consumed a diet high in energy, protein, fat, cholesterol, and alcohol and lower in fibre and carbohydrate compared with those in the low SE groups.

OBJECTIVEDeveloping countries are undergoing an epidemiologic transition accompanied by increasing burden of cardiovascular disease (CVD) linked to urbanization and lifestyle modifications. Metabolic syndrome is a cluster of CVD risk factors whose extent in Kenya remains unknown. The aim of this study was to determine the prevalence of metabolic syndrome and factors associated with its occurrence among an urban population in Kenya.RESEARCH DESIGN AND METHODSThis was a household cross-sectional survey comprising 539 adults (aged ≥18 years) living in Nairobi, drawn from 30 clusters across five socioeconomic classes. Measurements included waist circumference, HDL cholesterol, triacylglycerides (TAGs), fasting glucose, and blood pressure.RESULTSThe prevalence of metabolic syndrome was 34.6% and was higher in women than in men (40.2 vs. 29%; P < 0.001). The most frequently observed features were raised blood pressure, a higher waist circumference, and low HDL cholesterol (men: 96.2, 80.8, and 80%; women: 89.8, 97.2, and 96.3%, respectively), whereas raised fasting glucose and TAGs were observed less frequently (men: 26.9 and 63.3%; women: 26.9 and 30.6%, respectively). The main factors associated with the presence of metabolic syndrome were increasing age, socioeconomic status, and education.CONCLUSIONSMetabolic syndrome is prevalent in this urban population, especially among women, but the incidence of individual factors suggests that poor glycemic control is not the major contributor. Longitudinal studies are required to establish true causes of metabolic syndrome in Kenya. The Kenyan government needs to create awareness, develop prevention strategies, and strengthen the health care system to accommodate screening and management of CVDs.

Thika District, Kenya, is the site of an operational research study on the provision of comprehensive post-rape care, including the free provision of HIV post-exposure prophylaxis (PEP). It is a typical rural Kenyan district in terms of resources and patient throughput. The high rate of children attending for post-rape services was unexpected and had significant programming implications. An age-disaggregated analysis of existing quantitative data from the first 8 months of service provision was conducted. Ninety-four case records were reviewed, of whom 48 (51%) were in the age range 1.5-17 years inclusive. All three cases of male rape were in children. Children were more likely to know their assailant than adults and were more likely to be HIV-negative at baseline. The majority (86%) of children presented in time for PEP, with adherence and completion rates similar to adults but lower rates of 6-week follow-up. The use of weight bands to determine drug dosages greatly simplified the appropriate and early administration of paediatric PEP. The high rates of childhood rape and demand for post-rape services were an enormous challenge for service providers and policy-makers.

Limited data are available on the female athlete triad (Triad) in athletes from minority groups. We explored subclinical and clinical Triad components amongst adolescent elite Kenyan athletes (n = 61) and non-athletes (n = 49). Participants completed demographic, health, sport and menstrual history questionnaires as well as a 5-day weighed dietary record and exercise log to calculate energy availability (EA). Ultrasound assessed calcaneus bone mineral density (BMD). Eating Disorder Inventory subscales and the Three-Factor Eating Questionnaire's cognitive dietary restraint subscale measured disordered eating (DE). EA was lower in athletes than non-athletes (36.5 ± 4.5 vs. 39.5 ± 5.7 kcal ∙ kg FFM(-1) ∙ d(-1), P = 0.003). More athletes were identified with clinical low EA (17.9% vs. 2.2%, OR = 9.5, 95% CI 1.17-77, P = 0.021) and clinical menstrual dysfunction (32.7% vs. 18.3%, χ(2) = 7.1, P = 0.02). Subclinical (75.4% vs. 71.4%) and clinical DE (4.9% vs. 10.2%, P = 0.56) as well as BMD were similar between athletes and non-athletes. More athletes had two Triad components than non-athletes (8.9% vs. 0%, OR = 0.6, 95% CI 0.5-6.9, P = 0.05). Kenyan adolescent participants presented with one or more subclinical and/or clinical Triad component. It is essential that athletes and their entourage be educated on their energy needs including health and performance consequences of an energy deficiency.

The street food industry has an important role in the cities and towns of many developing countries in meeting the food demands of the urban dwellers. It feeds millions of people daily with a wide variety of foods that are relatively cheap and easily accessible. Street food sector symbolizes the street life in Africa and it operates in an unstable and precarious state because the sector lacks legal recognition. There have been noticeable increases of food vendors in Nairobi, who sell both raw and cooked food items. There are not regulated, they operate haphazardly without any monitoring of what they prepare and how they do it. A study to determine hygienic and sanitary practices of vendors of street foods in Nairobi was carried out using a descriptive survey design. A sample size of 80 street food vendors selling commonly consumed foods was selected. Data was collected using in-depth interview schedules and observation checklists. Information from the study shows that vendors lacked training on food preparation. About 62% obtained food preparation skills through observation while 33% were taught by their parents in non-formal settings. The preparation surfaces used for the preparation of raw foods were not washed regularly. Cooked foods were stored at ambient temperature in cupboards, plastic bowls, jugs and buckets were just left in the open uncovered. Eighty-five per cent of the vendors had garbage and waste bins beside the food stalls. Personal hygiene was not also observed, as the vendors never covered their heads, handled money and food at the same time and they did not wear overcoats/aprons and handled food with bare hand. Street food vendors were not aware of hygienic and sanitary practice. Th e food is sold to unsuspecting clients who are likely to get food-borne diseases. This study recommends the establishment of street food centres by the city council, the training of street food vendors on hygiene, sanitation and the establishment of code of practice for the street food industry and the empowerment of Public Health Officers.