Kenya
Malaria
Africa, Eastern
Bedding and Linens
Antimalarials
Malaria, Falciparum
United States Department of Agriculture
Budgets
United States Department of Homeland Security
Harm Reduction
Transmission of epidemic Vibrio cholerae O1 in rural western Kenya associated with drinking water from Lake Victoria: an environmental reservoir for cholera? (1/2422)
Sub-Saharan Africa has the highest reported cholera incidence and mortality rates in the world. In 1997, a cholera epidemic occurred in western Kenya. Between June 1997 and March 1998, 14,275 cholera admissions to hospitals in Nyanza Province in western Kenya were reported. There were 547 deaths (case fatality rate = 4%). Of 31 Vibrio cholerae O1 isolates tested, all but one were sensitive to tetracycline. We performed a case-control study among 61 cholera patients and age-, sex-, and clinic-matched controls. Multivariate analysis showed that risk factors for cholera were drinking water from Lake Victoria or from a stream, sharing food with a person with watery diarrhea, and attending funeral feasts. Compared with other diarrheal pathogens, cholera was more common among persons living in a village bordering Lake Victoria. Cholera has become an important public health concern in western Kenya, and may become an endemic pathogen in the region. (+info)Studies of human immunodeficiency virus type 1 mucosal viral shedding and transmission in Kenya. (2/2422)
If human immunodeficiency virus type 1 (HIV-1) vaccines are to be highly effective, it is essential to understand the virologic factors that contribute to HIV-1 transmission. It is likely that transmission is determined, in part, by the genotype or phenotype (or both) of infectious virus present in the index case, which in turn will influence the quantity of virus that may be exchanged during sexual contact. Transmission may also depend on the fitness of the virus for replication in the exposed individual, which may be influenced by whether a virus encounters a target cell that is susceptible to infection by that specific variant. Of interest, our data suggest that the complexity of the virus that is transmitted may be different in female and male sexual exposures. (+info)User charges in government health facilities in Kenya: effect on attendance and revenue. (3/2422)
In this paper we study demand effects of user charges in a district health care system using cross-sectional data from household and facility surveys. The effects are examined in public as well as in private health facilities. We also look briefly at the impact of fees on revenue and service quality in government facilities. During the period of cost-sharing in public clinics, attendance dropped by about 50%. This drop prompted the government to suspend the fees for approximately 20 months. Over the 7 months after suspension of fees, attendance at government health centres increased by 41%. The suspension further caused a notable movement of patients from the private sector to government health facilities. The revenue generated by user fees covered 2.4% of the recurrent health budget. Some 40% of the facilities did not spend the fee revenue they collected, mainly due to cumbersome procedures of expenditure approvals. The paper concludes with lessons from Kenya's experience with user charges. (+info)The fall and rise of cost sharing in Kenya: the impact of phased implementation. (4/2422)
The combined effects of increasing demand for health services and declining real public resources have recently led many governments in the developing world to explore various health financing alternatives. Faced with a significant decline during the 1980s in its real per capita expenditures, the Kenya Ministry of Health (MOH) introduced a new cost sharing programme in December 1989. The programme was part of a comprehensive health financing strategy which also included social insurance, efficiency measures, and private sector development. Early implementation problems led to the suspension in September 1990 of the outpatient registration fee, the major revenue source at the time. In 1991, the Ministry initiated a programme of management improvement and gradual re-introduction of an outpatient fee, but this time as a treatment fee. The new programme was carried out in phases, beginning at the national and provincial levels and proceeding to the local level. The impact of these changes was assessed with national revenue collection reports, quality of care surveys in 6 purposively selected indicator districts, and time series analysis of monthly utilization in these same districts. In contrast to the significant fall in revenue experienced over the period of the initial programme, the later management improvements and fee adjustments resulted in steady increases in revenue. As a percentage of total non-staff expenditures, fiscal year 1993-1994 revenue is estimated to have been 37% at provincial general hospitals, 20% at smaller hospitals, and 21% at health centres. Roughly one third of total revenue is derived from national insurance claims. Quality of care measures, though in some respects improved with cost sharing, were in general somewhat mixed and inconsistent. The 1989 outpatient registration fee led to an average reduction in utilization of 27% at provincial hospitals, 45% at district hospitals, and 33% at health centres. In contrast, phased introduction of the outpatient treatment fee beginning in 1992, combined with somewhat broader exemptions, was associated with much smaller decreases in outpatient utilization. It is suggested that implementing user fees in phases by level of health facility is important to gain patient acceptance, to develop the requisite management systems, and to orient ministry staff to the new systems. (+info)Evaluating the community education programme of an insecticide-treated bed net trial on the Kenyan coast. (5/2422)
Increased interest in the potential contribution of insecticide-impregnated bed nets (ITBN) to malaria control has led to research efforts to determine the impact and sustainability of ITBN programmes in differing environments. There is a need to develop effective, feasible educational strategies that will both inform and motivate community members, and thus maximize the correct usage of ITBN. This is especially true in communities where indigenous usage of bed nets is low. This paper describes the educational component of a randomized controlled community intervention trial of ITBN, with childhood malaria morbidity as an outcome. The educational approach and messages for the ITBN trial were developed from anthropological survey data collected 4 years before the trial, and from community surveys conducted by project researchers. Low levels of understanding amongst mothers of the aetiological link between mosquitos and malaria led to the exclusion of the term 'malaria' from the initial educational messages promoting the use of ITBN. Appropriate individuals within the existing district health care structure were trained as community educators in the project. These educators conducted intensive teaching in the community through public meetings and group teaching in the first 6 months of the trial. The impact of these initial activities was assessed through interviews with a random sample of 100 mothers and 50 household heads. This allowed the identification of messages which had not been well understood and further educational methods were chosen to address the areas pinpointed. The community assessment also demonstrated that, in 1994, over 90% of mothers understood a protective role for bed nets against malaria and the ITBN education messages were changed to take account of this. The school programme was evaluated through determining outreach (the number of households accessed), changes in participant children's knowledge, post-teaching assessment of mothers' knowledge and discussions with parent-teacher associations. It was shown that 40% of intervention homes with children in the target group were accessed, participant children learned the educational messages well (scores increased from a pre-teaching mean of 59% to a post-teaching mean of 92%) and a high level of awareness of the ITBN trial was achieved in these homes (75%). However, specific messages of the education programmed were not well transferred to the home (30%). The discussion emphasises the need for allocation of adequate resources for education in programmes dependent on achieving a change in community practices. We also describe the value of ongoing communication between programme planners and a target population in maximizing the effectiveness of messages and methods used. (+info)The impact of face-to-face educational outreach on diarrhoea treatment in pharmacies. (6/2422)
Private pharmacies are an important source of health care in developing countries. A number of studies have documented deficiencies in treatment, but little has been done to improve practices. We conducted two controlled trials to determine the efficacy of face-to-face educational outreach in improving communication and product sales for cases of diarrhoea in children in 194 private pharmacies in two developing countries. A training guide was developed to enable a national diarrhoea control programme to identify problems and their causes in pharmacies, using quantitative and qualitative research methods. The guide also facilitates the design, implementation, and evaluation of an educational intervention, which includes brief one-on-one meetings between diarrhoea programme educators and pharmacists/owners, followed by one small group training session with all counter attendants working in the pharmacies. We evaluated the short-term impact of this intervention using a before-and-after comparison group design in Kenya, and a randomized controlled design in Indonesia, with the pharmacy as unit of analysis in both countries (n = 107 pharmacies in Kenya; n = 87 in Indonesia). Using trained surrogate patients posing as mothers of a child under five with diarrhoea, we measured sales of oral rehydration salts (ORS); sales of antidiarrhoeal agents; and history-taking and advice to continue fluids and food. We also measured knowledge about dehydration and drugs to treat diarrhoea among Kenyan pharmacy employees after training. Major discrepancies were found at baseline between reported and observed behaviour. For example, 66% of pharmacy attendants in Kenya, and 53% in Indonesia, reported selling ORS for the previous case of child diarrhoea, but in only 33% and 5% of surrogate patient visits was ORS actually sold for such cases. After training, there was a significant increase in knowledge about diarrhoea and its treatment among counter attendants in Kenya, where these changes were measured. Sales of ORS in intervention pharmacies increased by an average of 30% in Kenya (almost a two-fold increase) and 21% in Indonesia compared to controls (p < 0.05); antidiarrhoeal sales declined by an average of 15% in Kenya and 20% in Indonesia compared to controls (p < 0.05). There was a trend toward increased communication in both countries, and in Kenya we observed significant increases in discussion of dehydration during pharmacy visits (p < 0.05). We conclude that face-to-face training of pharmacy attendants which targets deficits in knowledge and specific problem behaviours can result in significant short-term improvements in product sales and communication with customers. The positive effects and cost-effectiveness of such programmes need to be tested over a longer period for other health problems and in other countries. (+info)Prevalence of exercise induced bronchospasm in Kenyan school children: an urban-rural comparison. (7/2422)
BACKGROUND: Higher rates of exercise induced bronchospasm (EIB) have been reported for urban than for rural African schoolchildren. The change from a traditional to a westernized lifestyle has been implicated. This study was undertaken to examine the impact of various features of urban living on the prevalence of EIB in Kenyan school children. METHODS: A total of 1226 children aged 8-17 years attending grade 4 at five randomly selected schools in Nairobi (urban) and five in Muranga district (rural) underwent an exercise challenge test. A respiratory health and home environment questionnaire was also administered to parents/guardians. This report is limited to 1071 children aged < or = 12 years. Prevalence rates of EIB for the two areas were compared and the differences analysed to model the respective contributions of personal characteristics, host and environmental factors implicated in childhood asthma. RESULTS: A fall in forced expiratory volume in one second (FEV1) after exercise of > or = 10% occurred in 22.9% of urban children and 13.2% of rural children (OR 1.96, 95% CI 1.41 to 2.71). The OR decreased to 1.65 (95% CI 1.10 to 2.47) after accounting for age, sex, and host factors (a family history of asthma and breast feeding for less than six months), and to 1.21 (95% CI 0.69 to 2.11) after further adjustment for environmental factors (parental education, use of biomass fuel and kerosene for cooking, and exposure to motor vehicle fumes). CONCLUSIONS: The EIB rates in this study are higher than any other reported for African children, even using more rigorous criteria for EIB. The study findings support a view which is gaining increasing credence that the increase in prevalence of childhood asthma associated with urbanisation is the consequence of various harmful environmental exposures acting on increasingly susceptible populations. (+info)Seroconversion to circumsporozoite antigen of Plasmodium falciparum demonstrates a high risk of malaria transmission in travelers to East Africa. (8/2422)
Circumsporozoite (CS) antibodies have been shown to be reliable indicators of malaria transmission in endemic areas. Their prevalence in travelers can indicate the degree of exposure to plasmodial infection. Two hundred sixty-two short-term travelers to Kenya were recruited to a prospective study to determine the incidence of CS antibody conversion. All travelers were receiving malaria chemoprophylaxis. Serum samples were drawn before departure and 4-6 weeks after their return to Germany. Sera from 310 volunteers who did not leave Germany served as controls. Serum specimens from 13 (4.96%) of the 262 travelers were found to be positive after return. None of the travelers developed symptoms of clinical malaria or antibodies against the blood stages of Plasmodium falciparum. All 310 control samples tested negative. These data demonstrate a considerable risk of malaria transmission for short-term travelers to East Africa. (+info)I'm sorry for any confusion, but "Kenya" is not a medical term. It is the name of a country located in East Africa, known for its diverse wildlife and geography, including savannas, lakelands, the dramatic Great Rift Valley, and mountain highlands. It is also where you can find the Maasai Mara Reserve, known for its annual wildebeest migrations, and vast Nairobi National Park. The capital city of Kenya is Nairobi. If you have any questions about medical terms or concepts, I would be happy to help with those!
Malaria is not a medical definition itself, but it is a disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. Here's a simple definition:
Malaria: A mosquito-borne infectious disease caused by Plasmodium parasites, characterized by cycles of fever, chills, and anemia. It can be fatal if not promptly diagnosed and treated. The five Plasmodium species known to cause malaria in humans are P. falciparum, P. vivax, P. ovale, P. malariae, and P. knowlesi.
"Eastern Africa" is a geographical term used to describe the eastern portion of the African continent. The United Nations defines Eastern Africa as consisting of the following countries: Burundi, Comoros, Djibouti, Eritrea, Ethiopia, Kenya, Madagascar, Malawi, Mauritius, Mozambique, Réunion, Rwanda, Seychelles, Somalia, South Sudan, Tanzania, Uganda, Zambia, and Zimbabwe.
In a medical context, "Eastern Africa" may be used to describe the epidemiology, distribution, or prevalence of various diseases or health conditions in this region. However, it is important to note that there can be significant variation in health outcomes and healthcare systems within Eastern Africa due to factors such as socioeconomic status, infrastructure, and cultural practices. Therefore, any medical definition of "Eastern Africa" should be used with caution and may require further qualification or specification depending on the context.
A rural population refers to people who live in areas that are outside of urban areas, typically defined as having fewer than 2,000 residents and lacking certain infrastructure and services such as running water, sewage systems, and paved roads. Rural populations often have less access to healthcare services, education, and economic opportunities compared to their urban counterparts. This population group can face unique health challenges, including higher rates of poverty, limited access to specialized medical care, and a greater exposure to environmental hazards such as agricultural chemicals and industrial pollutants.
'Anopheles' is a genus of mosquitoes that are known for their role in transmitting malaria parasites to humans. These mosquitoes have a distinctive resting posture, with their abdomens raised and heads down, and they typically feed on human hosts at night. Only female Anopheles mosquitoes transmit the malaria parasite, as they require blood meals to lay eggs.
There are over 400 species of Anopheles mosquitoes worldwide, but only about 30-40 of these are considered significant vectors of human malaria. The distribution and behavior of these mosquitoes can vary widely depending on the specific species and geographic location.
Preventing and controlling the spread of malaria involves a variety of strategies, including the use of insecticide-treated bed nets, indoor residual spraying, antimalarial drugs, and vaccines. Public health efforts to reduce the burden of malaria have made significant progress in recent decades, but the disease remains a major global health challenge, particularly in sub-Saharan Africa.
Permethrin is a type of medication that belongs to the class of chemicals called pyrethroids. It's commonly used as a topical treatment for scabies and lice infestations. Permethrin works by disrupting the nervous system of these parasites, leading to their paralysis and death.
In medical terms, permethrin is defined as a synthetic pyrethroid insecticide and acaricide with contact and stomach activity. It's used topically in the form of creams or lotions to treat infestations of lice and scabies mites on the skin. Permethrin is considered safe and effective for use in adults and children, including infants over two months old.
It's important to note that permethrin should be used as directed by a healthcare professional, and it may have some potential side effects such as skin irritation, redness, or itching.
'Bedding and linens' is a term that refers to the items used to cover, clean, and maintain beds and other furniture in medical and residential settings. These items include:
1. Sheets: These are flat pieces of cloth that are placed on top of the mattress and beneath the blankets or comforters. They come in various sizes (twin, full, queen, king) to fit different mattress sizes.
2. Blankets/Comforters: These are thicker, often quilted or filled, pieces of fabric that provide warmth and comfort to the user.
3. Pillows and pillowcases: Pillows are used to support the head and neck during sleep, while pillowcases are the removable covers that protect the pillows from dirt, sweat, and stains.
4. Mattress pads/protectors: These are additional layers placed between the mattress and the sheets to provide extra protection against spills, stains, or allergens.
5. Bed skirts: These are decorative pieces of fabric that cover the space between the box spring and the floor, hiding any storage area or providing a more finished look to the bed.
6. Towels and washcloths: While not directly related to the bed, these linens are often included in the 'bedding and linens' category as they share similar cleaning and maintenance requirements.
In medical settings, such as hospitals and nursing homes, strict infection control protocols are followed for handling, washing, and storing bedding and linens to prevent the spread of infectious diseases.
Antimalarials are a class of drugs that are used for the prevention, treatment, and elimination of malaria. They work by targeting the malaria parasite at various stages of its life cycle, particularly the erythrocytic stage when it infects red blood cells. Some commonly prescribed antimalarials include chloroquine, hydroxychloroquine, quinine, mefloquine, and artemisinin-based combinations. These drugs can be used alone or in combination with other antimalarial agents to increase their efficacy and prevent the development of drug resistance. Antimalarials are also being investigated for their potential use in treating other diseases, such as autoimmune disorders and cancer.
Malaria, Falciparum is defined as a severe and often fatal form of malaria caused by the parasite Plasmodium falciparum. It is transmitted to humans through the bites of infected Anopheles mosquitoes. This type of malaria is characterized by high fever, chills, headache, muscle and joint pain, and vomiting. If left untreated, it can cause severe anemia, kidney failure, seizures, coma, and even death. It is a major public health problem in many tropical and subtropical regions of the world, particularly in Africa.
The United States Department of Agriculture (USDA) is not a medical organization or entity, so it does not provide medical definitions. However, I can give you some information about what the USDA is and what it does.
The USDA is a federal executive department of the U.S. government responsible for developing and executing federal laws related to farming, forestry, and food. It was established in 1862 by President Abraham Lincoln and is headed by the Secretary of Agriculture, who is a member of the President's cabinet.
The USDA has several key missions, including:
* Promoting agricultural trade and production
* Ensuring the safety of the food supply
* Providing nutrition assistance to vulnerable populations
* Protecting natural resources and the environment
* Promoting rural development and economic stability
In terms of food and nutrition, the USDA plays an important role in setting dietary guidelines for Americans, establishing standards for school meals and other federal food programs, and regulating the safety of meat, poultry, and egg products. The agency also conducts research on agricultural and food-related topics and provides education and outreach to farmers, ranchers, and consumers.
In medical terminology, a budget is not explicitly defined. However, in a general sense, it refers to a financial plan that outlines the anticipated costs and expenses for a specific period. In healthcare, budgets can be used by hospitals, clinics, or other medical facilities to plan for and manage their finances.
A healthcare organization's budget may include expenses related to:
* Salaries and benefits for staff
* Equipment and supply costs
* Facility maintenance and improvements
* Research and development expenses
* Insurance and liability coverage
* Marketing and advertising costs
Budgets can help healthcare organizations manage their finances effectively, allocate resources efficiently, and make informed decisions about spending. They may also be used to plan for future growth and expansion.
I'm sorry for any confusion, but the 'United States Department of Homeland Security' (DHS) is not a medical term or concept. It's a cabinet department of the U.S. federal government, created in response to the September 11 attacks, with the primary responsibilities of protecting the United States from terrorism and managing border control. The DHS includes several components, including the U.S. Coast Guard, Transportation Security Administration (TSA), Federal Emergency Management Agency (FEMA), Customs and Border Protection (CBP), and Immigration and Customs Enforcement (ICE), among others.
If you have any medical questions or terms you would like defined, I'd be happy to help!
I'm sorry for any confusion, but "Uganda" is not a medical term or concept. It is the name of a country located in East Africa, known officially as the Republic of Uganda. If you have any questions about medical terms or concepts, I would be happy to help with those!
"Harm reduction" is a public health strategy and philosophy that seeks to minimize the negative health, social, and economic consequences associated with various human behaviors, including the use of substances such as drugs and alcohol. The goal of harm reduction is not necessarily to eliminate these behaviors but rather to reduce the potential harm that can come from them.
Examples of harm reduction strategies include providing access to clean needles for people who inject drugs, in order to prevent the spread of bloodborne diseases like HIV and hepatitis C; offering supervised consumption sites where people can use drugs under medical supervision, reducing the risk of overdose; and providing opioid agonist therapy (such as methadone or buprenorphine) to help individuals manage their dependence on opioids and reduce the risks associated with illicit drug use.
Harm reduction recognizes that abstinence may not be a realistic goal for everyone, and seeks to meet people where they are at in terms of their substance use, while still providing them with the support and resources they need to improve their health and well-being.
The United States Department of Defense (DoD) is not a medical term or organization, but rather it is the federal department responsible for coordinating and supervising all agencies and functions of the government directly related to national security and the United States Armed Forces. The Secretary of Defense is the head of the department and serves as a member of the President's cabinet.
The Department of Defense includes three main military branches: the Army, Navy, and Air Force, as well as several other organizations such as the National Security Agency (NSA), the Defense Intelligence Agency (DIA), and the National Geospatial-Intelligence Agency (NGA). The DoD also operates a number of medical facilities and research institutions, including military hospitals and the Uniformed Services University of the Health Sciences. However, it is not primarily a medical organization or institution.