Factors associated with facility childbirth and skilled birth attendance in Migori County, Kenya and the effect of Lwala Community Alliance intervention: a cross-sectional assessment from the 2019 and 2021 Lwala household surveys.

Background: Despite evidence of the beneficial effects of skilled birth attendance (SBA) on maternal health and childbirth outcomes, there are disparities in access across counties in Kenya. These include Migori County which has historically recorded high maternal mortality rates. In 2007, the Lwala Community Alliance was founded to improve health outcomes in this county.

Diabetes mellitus and associated risk factors among HIV infected patients on HAART.

Understanding the impact of disease associations is becoming a priority in Kenya and other countries bearing the load of infectious diseases. With the increased incidences of non-communicable diseases and the endemicity of infectious diseases in Sub-Saharan Africa, their co-existence poses significant challenges to patients, health workers and an overwhelmed health sector. Classical risk factors for diabetes such as physical inactivity and unhealthy diet may not solely explain the current trends, suggesting the role of novel risk factors including infections/inflammation.

Childhood mortality and associated factors in Migori County, Kenya: evidence from a cross-sectional survey.

Objectives: The under-five mortality (U5M) rate in Kenya (41 per 1000 live births) remains significantly above international goals (25 per 1000 live births). This is further exacerbated by regional inequalities in mortality. We aimed to describe U5M in Migori County, Kenya, and identify associated factors that can serve as programming targets.

Training and experience outperform literacy and formal education as predictors of community health worker knowledge and performance, results from Rongo sub-county, Kenya.

Introduction: There is a growing recognition that Community Health Workers are effective at improving health outcomes and expanding health access. However, the design elements that lead to high-quality Community Health Worker programing are relatively understudied. We looked at the predictors of Community Health Worker knowledge of obstetric and early infant danger signs as well as performance in achieving antenatal care and immunization uptake among their clients.

Wealth and obesity in pre-adolescents and their guardians: A first step in explaining non-communicable disease-related behaviour in two areas of Nairobi City County.

The prevalence of non-communicable diseases is increasing in lower-middle-income countries as these countries transition to unhealthy lifestyles. The transition is mostly predominant in urban areas. We assessed the association between wealth and obesity in two sub-counties in Nairobi City County, Kenya, in the context of family and poverty.

Prevalence and correlates of compliance with 24-h movement guidelines among children from urban and rural Kenya-The Kenya-LINX project.

Background: Like many countries in sub-Saharan Africa, Kenya has experienced rapid urbanization in recent years. Despite the distinct socioeconomic and environmental differences, few studies have examined the adherence to movement guidelines in urban and rural areas. This cross-sectional study aimed at examining compliance to the 24-hour movement guidelines and their correlates among children from urban and rural Kenya.

Predictors of under-five healthcare utilization in Rongo sub-county of Migori County, Kenya: results of a population-based cross-sectional survey.

Introduction: to achieve the sustainable development goal for child survival, we must better understand the socioeconomic characteristics, household behaviors and access to community health services which predict care utilization for children. This study assessed predictors of health care utilization for children under five in Migori County, Kenya.

Methods: we used multivariable logistic regression in the context of an integrated health intervention which employed paid, trained, and supervised community health workers (CHWs), inclusive of traditional birth attendants (TBAs).

Characterizing multidimensional poverty in Migori County, Kenya and its association with depression.

Introduction: Narrow, unidimensional measures of poverty often fail to measure true poverty and inadequately capture its drivers. Multidimensional indices of poverty more accurately capture the diversity of poverty. There is little research regarding the association between multidimensional poverty and depression.

Population-based socio-demographic household assessment of livelihoods and health among communities in Migori County, Kenya over multiple timepoints (2021, 2024, 2027): A study protocol.

Migori County is located in western Kenya bordering Lake Victoria and has traditionally performed poorly on important health metrics, including child mortality and HIV prevalence. The Lwala Community Alliance is a non-governmental organization that serves to promote the health and well-being of communities in Migori County through an innovative model utilizing community health workers, community committees, and high-quality facility-based care. This has led to improved outcomes in areas served, including improvements in childhood mortality.

Determinants of modern contraceptive prevalence and unplanned pregnancies in Migori County, Kenya: results of a cross-sectional household survey.

Family planning and contraceptive utilization can have significant effects in reducing unplanned pregnancies and improving maternal and child health indicators. We conducted a retrospective cross-sectional study analyzing survey response data within six sub-locations of Migori County, Kenya in 2018 and 2019. We utilize this survey data to estimate both the prevalence of contraceptive uptake and unwanted pregnancies in the study populations, and to examine the potential role that different factors play in meeting related family planning targets.

The Prevalence of Interpersonal Violence (IPV) Against Women and its Associated Variables: An Exploratory Study in the Rongo Sub-County of Migori County, Kenya.

Interpersonal violence (IPV) within intimate partner relationships and gender-based violence remain major public health problems worldwide; 44.8% of Kenyan women have reported experiencing IPV beginning after the age of 15 years (National Bureau of Statistics Nairobi, Kenya, 2015). Combatting IPV and its sequelae is integral to promoting gender equality, a key target of the Sustainable Development Goals.

Under-five mortality in the Rongo Sub-County of Migori County, Kenya: Experience of the Lwala Community Alliance 2007-2017 with evidence from a cross-sectional survey.

Introduction: Childhood mortality remains a pressing problem in rural Kenya, and reducing under-five deaths is a key target of the Sustainable Development Goals. We aim to describe the reduction in under-five mortality in a rural Kenyan community served by the Lwala Community Alliance and factors associated with under-five mortality in this community.

Methods: A cross-sectional survey containing a complete birth history was administered to a representative sample of the catchment area of the Lwala Community Alliance.

Antenatal care attendance and uptake of skilled delivery, Lokitaung Sub-County Hospital, Turkana County, Kenya.

Globally, nearly 500,000 women die annually from pregnancy- and childbirth-related complications. Antenatal care (ANC) is one of the most important factors in preventing maternal and infant mortality. This study investigated whether ANC attendance and sociodemographic characteristics of pregnant women influence uptake of skilled delivery at Lokitaung Sub-County Hospital, Turkana County, Kenya.

Progress Toward Eliminating Mother to Child Transmission of HIV in Kenya: Review of Treatment Guideline Uptake and Pediatric Transmission at Four Government Hospitals Between 2010 and 2012.

We analyzed prevention of mother-to-child transmission (PMTCT) data from a retrospective cohort of n = 1365 HIV+ mothers who enrolled their HIV-exposed infants in early infant diagnosis services in four Kenyan government hospitals from 2010 to 2012. Less than 15 and 20 % of mother-infant pairs were provided with regimens that met WHO Option A and B/B+ guidelines, respectively. Annually, the gestational age at treatment initiation decreased, while uptake of Option B/B+ increased (all p's < 0.

Predictors of Infant Age at Enrollment in Early Infant Diagnosis Services in Kenya.

Despite the importance of early detection to signal lifesaving treatment initiation for HIV+ infants, early infant diagnosis (EID) services have received considerably less attention than other aspects of prevention of mother to child transmission care. This study draws on baseline data from an on-going cluster randomized study of an intervention to improve EID services at six government hospitals across Kenya. Two logistic regressions examined potential predictors of "on time" (infant ≤6 weeks of age) vs.

Lessons learned from implementing the HIV infant tracking system (HITSystem): A web-based intervention to improve early infant diagnosis in Kenya.

Objectives: Guided by the RE-AIM model, we describe preliminary data and lessons learned from multiple serial implementations of an eHealth intervention to improve early infant diagnosis (EID) of HIV in Kenya.

Methods: We describe the reach, effectiveness, adoption, implementation and maintenance of the HITSystem, an eHealth intervention that links key stakeholders to improve retention and outcomes in EID. Our target community includes mother-infant pairs utilizing EID services and government health care providers and lab personnel.

Chemokine Coreceptor-2 Gene Polymorphisms among HIV-1 Infected Individuals in Kenya.

Chemokine Coreceptor-2 (CCR2) is an entry coreceptor for HIV-1. A mutation in the coding gene for this coreceptor, CCR2-64I, has been shown to be an important factor for delaying disease progression. In Kenya no studies have been done to determine the status of CCR2 gene polymorphisms among HIV-1 infected individuals.

Improving early infant HIV diagnosis in Kenya: study protocol of a cluster-randomized efficacy trial of the HITSystem.

Background: Early infant diagnosis among human immunodeficiency virus (HIV)-exposed infants is a critical component of prevention of mother-to-child transmission programs. Barriers to early infant diagnosis include poor uptake, low retention at designated re-testing intervals, delayed test results, passive systems of communication, and poor linkage to treatment. This study will evaluate the HIV Infant Tracking System (HITSystem), an eHealth intervention that streamlines communication and accountability between the key early infant diagnosis stakeholders: HIV+ mothers and their HIV-exposed infants, healthcare providers, and central laboratory personnel.

Hepatitis B, Hepatitis C and HIV-1 Coinfection in Two Informal Urban Settlements in Nairobi, Kenya.

Background: HIV-1 and Hepatitis B and C viruses coinfection is common in Sub-Saharan Africa due to similar routes of transmission and high levels of poverty. Most studies on HIV-1 and Hepatitis B and C viruses have occurred in hospital settings and blood transfusion units. Data on Hepatitis B and C viruses and HIV-1 coinfection in informal urban settlements in Kenya are scanty, yet they could partly explain the disproportionately high morbidity and mortality associated with HIV-1 infections in these slums.

If you text them, they will come: using the HIV infant tracking system to improve early infant diagnosis quality and retention in Kenya.

Objective: The objective of this study is to evaluate the impact of the HIV Infant Tracking System (HITSystem) for quality improvement of early infant diagnosis (EID) of HIV services.

Design And Setting: This observational pilot study compared 12 months of historical preintervention EID outcomes at one urban and one peri-urban government hospital in Kenya to 12 months of intervention data to assess retention and time throughout the EID cascade of care.

Participants: Mother-infant pairs enrolled in EID at participating hospitals before (n = 320) and during (n = 523) the HITSystem pilot were eligible to participate.

Population specific reference ranges of CD3, CD4 and CD8 lymphocyte subsets among healthy Kenyans.

Background: The enumeration of absolute CD4 counts is of primary importance for many medical conditions especially HIV infection where therapeutic initiation depends on the count. These ranges tend to vary across populations. However, these ranges have not been comprehensively established in the Kenyan population.

Are slum dwellers at heightened risk of HIV infection than other urban residents? Evidence from population-based HIV prevalence surveys in Kenya.

In 2008, the global urban population surpassed the rural population and by 2050 more than 6 billion will be living in urban centres. A growing body of research has reported on poor health outcomes among the urban poor but not much is known about HIV prevalence among this group. A survey of nearly 3000 men and women was conducted in two Nairobi slums in Kenya between 2006 and 2007, where respondents were tested for HIV status.

Discrepant test findings in early infant diagnosis of HIV in a national reference laboratory in Kenya: challenges and opportunities for programs.

Background: In Kenya, the availability of a cheap diagnostic service for HIV-exposed infants has helped scale-up access to treatment, and provided a means by which programs that support Prevention of Mother to Child Transmission of HIV can be evaluated. As expected for any large testing program, discrepant and indeterminate results present a significant challenge.

Methods: Dried Blood Spots were collected from health centers countrywide and couriered to four laboratories for tests.

HIV type 1 gag genetic diversity among antenatal clinic attendees in North Rift Valley, Kenya.

HIV genetic recombination and high mutation rate increase diversity allowing it to escape from host immune response or antiretroviral drugs. This diversity has enabled specific viral subtypes to be predominant in specific regions. To determine HIV-1 subtypes among seropositive antenatal clinic attendees in Kenya's North Rift Valley, a cross-sectional study was carried out on 116 HIV-1-positive blood samples.