Background: Leishmaniasis is protozoan disease, transmitted by Sandflies. The annual incidence of visceral leishmaniasis in East Africa is between 29,400 and 56,700 cases, accounting for approximately 15% of the global cases. Visceral leishmaniasis is endemic in Baringo County yet the current report on risk factor burden of the disease has not been documented. Objective was to assess risk factors associated with visceral leishmaniasis among residents of Baringo County, Kenya.Methods: Analytical cross sectional study design was conducted in Tiaty and Baringo south sub counties, Baringo County. The study population was 422 households selected through simple random sampling. The data collection tool were questionnaires. Data was analyzed using descriptive statistics, cross tabulations and chi square test of independence. Logistic regression was used to compute odds ratio. Variables with p value of less than 0.05 was considered statistically significant.Results: Findings showed that uneducated were majority (68%), higher number of the population had more than 6 persons per household (70.6%). On occupation, pastoralists were more affected (62.2%), those living in mud and cracked house were more (61.8%) (63.0 %) respectively p<0.01. Daily activity 35.24, p<0.01), sleeping under acacia tree 53.42, p<0.01), sleeping outside the house 112.7, p<0.01), and presence of ant hills nearby homestead 32.42, p<0.01) were individual risk factors significantly associated visceral leishmaniasis.Conclusions: The risk factors increased the exposure of the community to visceral leishmaniasis infection which needs to be addressed through control and prevention measures.

Assessment of clinical instructional strategies, learning activities, and clinical experiences occurs in a systematic and continuous manner through the process of clinical assessment. There is an evident gap between theory and practice in clinical medicine education, raising doubts about the quality of clinical learning assessment during college. The general  objective  of the study was  to determine perception and level of preparedness   towards clinical assessment in Clinical Medicine  Diploma programme in the Medical Training Colleges in Western Kenya. The specific objectives were to identify the methods used in clinical assessment, assess the level preparedness of students and teachers for clinical assessment and determine the perception of department  towards clinical assessment methods. This was a cross sectional descriptive study which included  138 students in the second academic year  and 10 lecturers from the four Medical Training Colleges offering Diploma Clinical Medicine . The students were selected using stratified proportionate sampling from the study population. The researcher sought approval from Masinde Muliro University of science and Technology ethics and Review committee. Eligible research participants  voluntarily gave informed consent and the risks and benefits of the study were explained to the participants.  Data was collected using a semi structured self -administered questionnaire, observation checklist and interview guide. Data was analyzed using chi-square and presented in tables .It was established that the methods used in the clinical assessment were  40.6%(56) objective structured clinical examination; 18.1% (25) short cases. All the students 138(100%) had learning objectives in the clinical areas and 66.7% (92)of the students were assessed after every clinical rotation  Majority (79%) (10) of clinical medicine students strongly agreed that clinical assessment helps in the identification of areas of weakness and provide learning. All 6 (100) of clinical medicine  lecturers strongly agreed   that clinical assessment helps in the identification of areas of weakness and provide learning opportunities for the students .In addition, it strongly agreed 6 (100%) that clinical assessment was a measure of essential clinical skills opportunities for them. In conclusion  majority of the students  perceived that clinical assessment helps them identify their weaknesses and provides  learning opportunities. The learners are well prepared for assessment and  both long cases and short cases are used to assess knowledge and skills .The study recommends that assessment should be done  frequently to prepare students  for clinical assessment and more information about clinical assessment methods should be provided to the students.

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