Camels are increasingly becoming the livestock of choice for pastoralists reeling from effects of climate change in semi-arid and arid parts of Kenya. As the population of camels rises, better understanding of their role in the epidemiology of zoonotic diseases in Kenya is a public health priority. Rift Valley fever (RVF), brucellosis and Q fever are three of the top priority diseases in the country but the involvement of camels in the transmission dynamics of these diseases is poorly understood. We analyzed 120 camel serum samples from northern Kenya to establish seropositivity rates of the three pathogens and to characterize the infecting Brucella species using molecular assays. We found seropositivity of 24.2% (95% confidence interval [CI]: 16.5–31.8%) for Brucella, 20.8% (95% CI: 13.6–28.1%) and 14.2% (95% CI: 7.9–20.4%) for Coxiella burnetii and Rift valley fever virus respectively. We found 27.5% (95% CI: 19.5–35.5%) of the animals were seropositive for at least one pathogen and 13.3% (95% CI: 7.2–19.4%) were seropositive for at least two pathogens. B. melitensis was the only Brucella spp. detected. The high sero-positivity rates are indicative of the endemicity of these pathogens among camel populations and the possible role the species has in the epidemiology of zoonotic diseases. Considering the strong association between human infection and contact with livestock for most zoonotic infections in Kenya, there is immediate need to conduct further research to determine the role of camels in transmission of these zoonoses to other livestock species and humans. This information will be useful for designing more effective surveillance systems and intervention measures.
Background: High maternal mortality rate is a major public health concern in developing countries. Skilled birth delivery is central to reducing maternal mortality, yet health facility delivery remains low in Kitui County, Kenya. Our study estimated prevalence of unskilled delivery and identified factors associated with health facility delivery in Kitui County. Methods: A cross-sectional study was conducted December 2017-February 2018. 245 women from five administrative wards were interviewed. A structured questionnaire was used to collect data. Variables that had p value ≤0.05 in bivariate analysis were included in multivariable regression model to assess for confounders. Variables with a p value of ≤0.05 in multivariate analysis were considered statistically significant at 95% CI. Results: We interviewed 245 (240 analyzed) women from the five wards; the majority were 16-25 years age group (45.5%; 110/240). Mean age was 27±6.6 years. Prevalence of health facility delivery was 50.4%. Distance from a health facility, number of children in a household, occupation of the respondent’s partner, number of antenatal clinic (ANC) visits and means of transport were significant factors for not delivering in a health facility. On multivariate analysis, women who lived >5km from health facility were less likely to deliver in a health facility (AOR =0.36; 95% CI 0.15- 0.86). Women who attended ≥ 4 ANC visits were 4 times more likely to deliver in a health facility (95% CI 2.01-8.79). Conclusions: More than half of the respondents delivered in a health facility. A long distance from the health facility is a hindrance to accessing ANC services. Inadequate ANC visits was associated with home delivery. Improving accessibility of health care services and health education on family planning would increase delivery at a health facility. We recommend Kitui County introduce five satellite clinics/ambulatory services for expectant women to access ANC and maternal services.
Background: High maternal mortality rate is a major public health concern in developing countries. Skilled birth delivery is central to reducing maternal mortality, yet health facility delivery remains low in Kitui County, Kenya. Our study estimated prevalence of unskilled delivery and identified factors associated with health facility delivery in Kitui County. Methods: A cross-sectional study was conducted December 2017-February 2018. 245 women from five administrative wards were interviewed. A structured questionnaire was used to collect data. Variables that had p value ≤0.05 in bivariate analysis were included in multivariable regression model to assess for confounders. Variables with a p value of ≤0.05 in multivariate analysis were considered statistically significant at 95% CI. Results: We interviewed 245 (240 analyzed) women from the five wards; the majority were 16-25 years age group (45.5%; 110/240). Mean age was 27±6.6 years. Prevalence of health facility delivery was 50.4%. Distance from a health facility, number of children in a household, occupation of the respondent’s partner, number of antenatal clinic (ANC) visits and means of transport were significant factors for not delivering in a health facility. On multivariate analysis, women who lived >5km from health facility were less likely to deliver in a health facility (AOR =0.36; 95% CI 0.15- 0.86). Women who attended ≥ 4 ANC visits were 4 times more likely to deliver in a health facility (95% CI 2.01-8.79). Conclusions: More than half of the respondents delivered in a health facility. A long distance from the health facility is a hindrance to accessing ANC services. Inadequate ANC visits was associated with home delivery. Improving accessibility of health care services and health education on family planning would increase delivery at a health facility. We recommend Kitui County introduce five satellite clinics/ambulatory services for expectant women to access ANC and maternal services.
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