Publications by authors named "Alice Ouma"
Use of 10-valent pneumococcal conjugate vaccine in Kenya has led to substantial reductions in vaccine-type pneumococcal carriage and invasive pneumococcal disease. However, analysis of recent surveillance data indicates an outbreak of vaccine-type serotype 1 in 2023 in Kibera, Kenya. Continued monitoring of invasive pneumococcal disease in Kenya is warranted.
View Article and Find Full Text PDFArticle Synopsis
- Kenya introduced the 10-valent pneumococcal conjugate vaccine, Synflorix™, in 2011, and early surveys indicated a decline in vaccine-type pneumococcal colonization among children but there was limited information on its long-term effectiveness.
- A 2017 cross-sectional survey in Kibera and Asembo involved 504 children under 5, showing a significant reduction in overall pneumococcal colonization compared to 2013, with over 90% of participants having received three doses of the vaccine.
- Despite the decrease in overall colonization, the prevalence of PCV10-GSK serotypes remained relatively stable, indicating a plateau effect in vaccine-type carriage six years after the vaccine's
Antibiotic exposure is associated with resistant bacterial colonization, but this relationship can be obscured in community settings owing to horizontal bacterial transmission and broad distributions. Locality-level exposure estimates considering inhabitants' length of stay, exposure history, and exposure conditions of areas nearby could clarify these relationships. We used prescription data filled during 2010-2015 for 23 antibiotic types for members of georeferenced households in a population-based infectious disease surveillance platform.
View Article and Find Full Text PDFArticle Synopsis
- The study examines how the COVID-19 pandemic altered healthcare seeking behaviors in low and middle-income countries, focusing on Asembo (a rural area in Kenya) and Kibera (an urban informal settlement).
- It found a significant decline in the odds of seeking healthcare at health facilities during the pandemic—19% in Asembo and 30% in Kibera—with specific decreases noted for certain illnesses.
- Conversely, there was an increase in healthcare seeking at chemists, indicating a shift in where people accessed care during the pandemic.
Article Synopsis
- The study investigates SARS-CoV-2 exposure in two distinct populations in Kenya—one urban (Kibera) and one rural (Asembo)—by measuring seroprevalence at two different times in 2021.
- Results showed an increase in seroprevalence from March to June/July 2021, with urban Kibera reaching 63.9% and rural Asembo 48.7%, highlighting significant geographical disparities.
- The low vaccination rates at the time (only 1.2% and 1.6%) indicate a need for strengthened public health measures to combat further spread of the virus.
Article Synopsis
- Research on COVID-19's impact on mortality in Africa is limited, but a study in Kenya used a population-based infectious disease surveillance platform to estimate excess deaths during the pandemic in two specific populations: rural Asembo and urban Kibera.
- The study found that all-cause mortality increased significantly in Asembo during the COVID-19 period, from 7.8 to 9.1 deaths per 1000 person-years; however, in Kibera, it slightly decreased from 3.1 to 2.6 deaths per 1000 person-years.
- The largest increase in mortality in Asembo was notably among individuals aged 50 to 64 years, with a 16% higher incidence rate ratio
Maternal respiratory syncytial virus (RSV) vaccines that are likely to be implementable in low- and middle-income countries (LMICs) are in final stages of clinical trials. Data on the number of women presenting for antenatal care (ANC) per day and proportion attending within the proposed gestational window for vaccine delivery, is a prerequisite to guide development of vaccine vial size and inform vaccine uptake in this setting. We undertook administrative review and abstraction of ANC attendance records from 2019 registers of 24 selected health facilities, stratified by the level of care, from Kilifi, Siaya and Nairobi counties in Kenya.
View Article and Find Full Text PDFBackground: Reliable mortality data are important for evaluating the impact of health interventions. However, data on mortality patterns among populations living in urban informal settlements are limited.
Objectives: To examine the mortality patterns and trends in an urban informal settlement in Kibera, Nairobi, Kenya.
Typhoid fever burden can vary over time. Long-term data can inform prevention strategies; however, such data are lacking in many African settings. We reexamined typhoid fever incidence and antimicrobial resistance (AMR) over a 10-year period in Kibera, a densely populated urban informal settlement where a high burden has been previously described.
View Article and Find Full Text PDFA high burden of Salmonella enterica subspecies enterica serovar Typhi (S. Typhi) bacteremia has been reported from urban informal settlements in sub-Saharan Africa, yet little is known about the introduction of these strains to the region. Understanding regional differences in the predominant strains of S.
View Article and Find Full Text PDFUrban informal settlements may be disproportionately affected by the COVID-19 pandemic due to overcrowding and other socioeconomic challenges that make adoption and implementation of public health mitigation measures difficult. We conducted a seroprevalence survey in the Kibera informal settlement, Nairobi, Kenya, to determine the extent of SARS-CoV-2 infection. Members of randomly selected households from an existing population-based infectious disease surveillance (PBIDS) provided blood specimens between 27 November and 5 December 2020.
View Article and Find Full Text PDFBackground: The relationship between antibiotic use and antimicrobial resistance varies with cultural, socio-economic, and environmental factors. We examined these relationships in Kibera, an informal settlement in Nairobi-Kenya, characterized by high population density, high burden of respiratory disease and diarrhea.
Methods: Two-hundred households were enrolled in a 5-month longitudinal study.
Background: Antibiotics are essential to treat for many childhood bacterial infections; however inappropriate antibiotic use contributes to antimicrobial resistance. For childhood diarrhea, empiric antibiotic use is recommended for dysentery (bloody diarrhea) for which first-line therapy is ciprofloxacin. We assessed inappropriate antibiotic prescription for childhood diarrhea in two primary healthcare facilities in Kenya.
View Article and Find Full Text PDFArticle Synopsis
- Kenya implemented the 10-valent pneumococcal conjugate vaccine (PCV10) for children under 1 year in 2011, along with catch-up vaccination for those aged 1-4 in certain areas, and a study examined the impact on pneumococcal carriage in both children and adults from 2009 to 2013.
- Surveys revealed significant reductions in PCV10-type carriage among children under 5 years and adults, with notable drops in carriage rates for both HIV-positive and HIV-negative adults, suggesting the vaccine's effectiveness.
- Despite the decline in PCV10-type carriage, the prevalence of penicillin nonsusceptible pneumococci (
Home-based HIV testing and counseling in rural and urban Kenyan communities.
J Acquir Immune Defic Syndr
February 2013
Background: In sub-Saharan Africa, most people with HIV do not know they are infected.
Methods: We conducted door-to-door home-based testing and counseling (HBTC) in rural western Kenya (Lwak) and an informal urban settlement in Nairobi (Kibera) in 2008. After consent, eligible persons (adults and adolescents aged 13 years or older and children aged 12 years or younger, whose biologic mother was HIV-infected or deceased) received parallel fingerstick HIV rapid testing and counseling.