Publications by authors named "Daniel Langat"
Cholera continues to cause many outbreaks in low and middle-income countries due to inadequate water, sanitation, and hygiene services. We describe a protracted cholera outbreak in Nairobi City County, Kenya in 2017. We reviewed the cholera outbreak line lists from Nairobi City County in 2017 to determine its extent and factors associated with death.
View Article and Find Full Text PDFKenya has experienced cholera outbreaks since 1971, with the most recent wave beginning in late 2014. Between 2015-2020, 32 of 47 counties reported 30,431 suspected cholera cases. The Global Task Force for Cholera Control (GTFCC) developed a Global Roadmap for Ending Cholera by 2030, which emphasizes the need to target multi-sectoral interventions in priority cholera burden hotspots.
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- Cholera has been a significant public health issue in Kenya since its first outbreak in 1971, with recent cases reported in 2021, linked to factors like open defecation, population growth, and inadequate sanitation.
- The Kenyan Ministry of Health has updated the national cholera control strategy to focus on hotspot identification and align it with global goals for cholera elimination, using specific epidemiological indicators to pinpoint high-burden areas.
- Out of 290 sub-counties, 30 have been identified as high priority areas for intervention, affecting nearly 4.89 million people, and the government plans to introduce oral cholera vaccines alongside improvements in water, sanitation, and hygiene (WASH).
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- Kenya's first COVID-19 case was detected on March 13, 2020, and by July 30, 2020, there were nearly 18,000 cases reported, with a case fatality rate of 1.6%.
- A study analyzed 2,796 case records to find patterns in demographics, clinical characteristics, and exposure, focusing on socio-demographics and underlying health conditions.
- Key findings revealed that older individuals and those with pre-existing medical conditions had higher odds of severe COVID-19, while transport sector workers had lower odds of contracting the virus.
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- A study of over 3 million camels in Kenya found that many have antibodies against MERS-CoV, although human infections in Africa are quite rare.
- Researchers followed 243 camels from 33 homesteads for two years, testing nasal swabs for the virus and documenting illnesses, primarily respiratory issues among the camels.
- Out of the camels tested, a small percentage showed positive results for MERS-CoV, and there was evidence of sporadic transmission to humans, particularly during outbreaks.
Rapid detection and response to infectious disease outbreaks requires a robust surveillance system with a sufficient number of trained public health workforce personnel. The Frontline Field Epidemiology Training Program (Frontline) is a focused 3-month program targeting local ministries of health to strengthen local disease surveillance and reporting capacities. Limited literature exists on the impact of Frontline graduates on disease surveillance completeness and timeliness reporting.
View Article and Find Full Text PDFIntroduction: in 2015, a cholera outbreak was confirmed in Nairobi county, Kenya, which we investigated to identify risk factors for infection and recommend control measures.
Methods: we analyzed national cholera surveillance data to describe epidemiological patterns and carried out a case-control study to find reasons for the Nairobi county outbreak. Suspected cholera cases were Nairobi residents aged >2 years with acute watery diarrhea (>4 stools/≤12 hours) and illness onset 1-14 May 2015.
Background: The poliovirus has been targeted for eradication since 1988. Kenya reported its last case of indigenous Wild Poliovirus (WPV) in 1984 but suffered from an outbreak of circulating Vaccine-derived Poliovirus type 2 (cVDPV2) in 2018. We aimed to describe Kenya's polio surveillance performance 2016-2018 using WHO recommended polio surveillance standards.
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- - The transition of Kenya's public health surveillance from a standalone web system to an integrated District Health Information System 2 (DHIS2) aimed to improve outbreak response by providing better training to surveillance officers.
- - An evaluation comparing 13 intervention counties (trained in DHIS2) with 13 comparisons (not trained) showed that the intervention led to significant increases in both completeness (from 45% to 62%) and timeliness (from 30% to 51%) of reporting.
- - Challenges identified for poor reporting included lack of government budget support, insufficient airtime for reporting, health worker strikes, and issues with healthcare facility resources.
Kenya is endemic for cholera with different waves of outbreaks having been documented since 1971. In recent years, new variants of Vibrio cholerae O1 have emerged and have replaced most of the traditional El Tor biotype globally. These strains also appear to have increased virulence, and it is important to describe and document their phenotypic and genotypic traits.
View Article and Find Full Text PDFIntroduction: Measles is targeted for elimination in the World Health Organization African Region by the year 2020. In 2011, Kenya was off track in attaining the 2012 pre-elimination goal. We describe the epidemiology of measles in Kenya and assess progress made towards elimination.
View Article and Find Full Text PDFChikungunya is a reemerging vector borne pathogen associated with severe morbidity in affected populations. Lamu, along the Kenyan coast was affected by a major chikungunya outbreak in 2004. Twelve years later, we report on entomologic investigations and laboratory confirmed chikungunya cases in northeastern Kenya.
View Article and Find Full Text PDFBackground: From December 2014 to September 2016, a cholera outbreak in Kenya, the largest since 2010, caused 16,840 reported cases and 256 deaths. The outbreak affected 30 of Kenya's 47 counties and occurred shortly after the decentralization of many healthcare services to the county level. This mixed-methods study, conducted June-July 2015, assessed cholera preparedness in Homa Bay, Nairobi, and Mombasa counties and explored clinic- and community-based health care workers' (HCW) experiences during outbreak response.
View Article and Find Full Text PDFBackground: Dengue fever, a mosquito-borne disease, is associated with illness of varying severity in countries in the tropics and sub tropics. Dengue cases continue to be detected more frequently and its geographic range continues to expand. We report the largest documented laboratory confirmed circulation of dengue virus in parts of Kenya since 1982.
View Article and Find Full Text PDFBackground: Shigellosis is the major cause of bloody diarrhoea worldwide and is endemic in most developing countries. In Kenya, bloody diarrhoea is reported weekly as part of priority diseases under Integrated Disease Surveillance and Response System (IDSR) in the Ministry of Health.
Methods: We conducted a case control study with 805 participants (284 cases and 521 controls) between January and December 2012 in Kilifi and Nairobi Counties.
Notes from the Field: Ongoing Cholera Outbreak - Kenya, 2014-2016.
MMWR Morb Mortal Wkly Rep
January 2016
On January 6, 2015, a man aged 40 years was admitted to Kenyatta National Hospital in Nairobi, Kenya, with acute watery diarrhea. The patient was found to be infected with toxigenic Vibrio cholerae serogroup O1, serotype Inaba. A subsequent review of surveillance reports identified four patients in Nairobi County during the preceding month who met either of the Kenya Ministry of Health suspected cholera case definitions: 1) severe dehydration or death from acute watery diarrhea (more than four episodes in 12 hours) in a patient aged ≥5 years, or 2) acute watery diarrhea in a patient aged ≥2 years in an area where there was an outbreak of cholera.
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- Informal settlements in Nairobi face a high risk for epidemic disease due to inadequate water and sanitation systems, particularly during cholera outbreaks.
- A study in 2010 analyzed water quality in 398 households, finding varying levels of chlorine residual and E. coli contamination; some water sources met international safety guidelines while others did not.
- Higher free chlorine residual levels and access to household water treatment significantly reduced E. coli contamination, suggesting that improving water quality in these communities could mitigate cholera transmission risks.
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- Cholera is a major public health issue in Kenya, with significant cases and deaths reported in 2009, prompting an ecological study to understand its distribution.
- The study used district-level data from 1999 to 2009, examining various climatic, environmental, and demographic factors influencing cholera outbreaks.
- Key findings revealed that increased risk of cholera was linked to distance from health facilities, proximity to water bodies, and specific rainfall patterns, while factors like population density and poverty had no significant impact.
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- Cholera outbreaks in Kenya in 2009 resulted in 11,425 cases and 264 deaths, with significant variations in case fatality rates (CFRs) across districts.
- The study surveyed two districts, East Pokot and Turkana South, finding a higher CFR in East Pokot (11.7%) compared to Turkana South (1.0%), alongside major differences in healthcare access.
- Awareness of cholera and oral rehydration solutions (ORS) was high among households, but shortages of ORS and intravenous fluids were common, particularly in East Pokot, contributing to the high CFRs.
Background: Kenya has experienced multiple cholera outbreaks since 1971. Cholera remains an issue of major public health importance and one of the 35 priority diseases under Kenya's updated Integrated Disease Surveillance and Response strategy.
Methods: We reviewed the cholera surveillance data reported to the World Health Organization and the Kenya Ministry of Public Health and Sanitation from 1997 through 2010 to determine trends in cholera disease for the 14-year period.