Publications by authors named "Stephen Munga"

Article Synopsis
  • * A machine learning approach was applied using data from the VIDA and EFGH-Shigella studies in rural Kenya to create predictive models for LGF among children aged 6-35 months, encompassing 65 potential predictors including demographic and health-related factors.
  • * The models showed a prevalence of LGF at 16.9% and 22.4% in different cohorts, with the gradient boosting model providing the best prediction accuracy, demonstrating its usefulness in identifying at-risk children for targeted healthcare interventions
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Objective: This scoping review aims to identify risk factors for COPD and asthma, examine the burden and intervention measures, and clarify the findings in the context of climate change, with a particular focus on LMICs.

Methods: Following the PRISMA-ScR guidelines, we conducted a scoping review using PubMed, Embase, and Scopus, focusing on studies published from 2011 to 2024.

Results: Our review included 52 studies that encompassed 244,004 participants.

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Background: The burden of malaria in Kenya was showing a declining trend, but appears to have reached a plateau in recent years. This study estimated changes in the geographical distribution of malaria parasite risk in the country between the years 2015 and 2020, and quantified the contribution of malaria control interventions and climatic/ environmental factors to these changes.

Methods: Bayesian geostatistical models were used to analyse the Kenyan 2015 and 2020 Malaria Indicator Survey (MIS) data.

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Article Synopsis
  • Malaria is a significant health threat, especially to young children in sub-Saharan Africa, and developing predictive models using empirical dynamic modeling (EDM) can help address resource allocation and planning challenges.
  • The study utilized data from 2008 to 2022, applying convergent cross-mapping to analyze the effects of climatic factors and intervention strategies (like bed net use) on malaria incidence at a hospital in Kenya.
  • Results showed that higher land surface temperature and wind speed, along with increased bed net usage, were linked to lower malaria cases, while higher rainfall and humidity contributed to increased incidence, demonstrating the importance of specific climatic conditions in forecasting malaria outbreaks.
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Background: Malaria mortality is influenced by several factors including climatic and environmental factors, interventions, socioeconomic status (SES) and access to health systems. Here, we investigated the joint effects of climatic and non-climatic factors on under-five malaria mortality at different spatial scales using data from a Health and Demographic Surveillance System (HDSS) in western Kenya.

Methods: We fitted Bayesian spatiotemporal (zero-inflated) negative binomial models to monthly mortality data aggregated at the village scale and over the catchment areas of the health facilities within the HDSS, between 2008 and 2019.

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Background: Climate change increasingly impacts health, particularly of rural populations in sub-Saharan Africa due to their limited resources for adaptation. Understanding these impacts remains a challenge, as continuous monitoring of vital signs in such populations is limited. Wearable devices (wearables) present a viable approach to studying these impacts on human health in real time.

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Article Synopsis
  • qPCR is a more efficient method for detecting pathogens in clinical samples than traditional culture methods, which often miss cases, leading to underestimation of disease burden by 2- to 3-fold.
  • The Enterics for Global Health (EFGH) study will use a TaqMan Array Card (TAC) to detect and differentiate various pathogens and antimicrobial resistance genes, analyzing samples from rectal swabs or stool.
  • The high sensitivity of TAC allows for better estimation of disease burden caused by specific pathogens, which is important for influencing health policy and designing future clinical trials.
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Article Synopsis
  • Molecular diagnostics have revealed a higher prevalence of shigellosis from human fecal samples than traditional culture methods, highlighting the need for improved identification of its causes.* -
  • The study involves testing dried blood spots for specific antibodies to determine immune responses in individuals with shigellosis and comparing these responses among various case types to identify patterns.* -
  • The findings aim to enhance our understanding of shigellosis, establish baseline immunity, and ultimately aid in the development of effective vaccines against diarrhea.*
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Article Synopsis
  • The study aims to improve the detection of bacterial diarrhea episodes by using fecal inflammatory biomarkers, which could help in deciding when antibiotics are needed.
  • A systematic review was conducted to analyze previous research on the effectiveness of these biomarkers, focusing on their sensitivity and specificity in identifying different bacteria associated with diarrhea.
  • The Enterics for Global Health (EFGH) study plans to test specific biomarkers in stool samples from various countries and develop prediction scores to better categorize diarrhea types using advanced detection methods like qPCR.
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Background: Although is an important cause of diarrhea in Kenyan children, robust research platforms capable of conducting incidence-based estimates and eventual targeted clinical trials are needed to improve -related outcomes in children. Here, we describe characteristics of a disease surveillance platform whose goal is to support incidence and consequences of diarrhea as part of multicounty surveillance aimed at preparing sites and assembling expertise for future vaccine trials.

Methods: We mobilized our preexisting expertise in shigellosis, vaccinology, and diarrheal disease epidemiology, which we combined with our experience conducting population-based sampling, clinical trials with high (97%-98%) retention rates, and healthcare utilization surveys.

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Introduction: as a public health policy, the ongoing global coronavirus disease 2019 vaccination drives require continuous tracking, tracing, and testing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Diagnostic testing is important in virus detection and understanding its spread for timely intervention. This is especially important for low-income settings where the majority of the population remains untested.

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Background: Entomological surveillance is traditionally conducted by supervised teams of trained technicians. However, it is expensive and limiting in the number of sites visited. Surveillance through community-based collectors (CBC) may be more cost-effective and sustainable for longitudinal entomological monitoring.

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Background: Climate change significantly impacts health in low-and middle-income countries (LMICs), exacerbating vulnerabilities. Comprehensive data for evidence-based research and decision-making is crucial but scarce. Health and Demographic Surveillance Sites (HDSSs) in Africa and Asia provide a robust infrastructure with longitudinal population cohort data, yet they lack climate-health specific data.

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Assessment of the relative impact of climate change on malaria dynamics is a complex problem. Climate is a well-known factor that plays a crucial role in driving malaria outbreaks in epidemic transmission areas. However, its influence in endemic environments with intensive malaria control interventions is not fully understood, mainly due to the scarcity of high-quality, long-term malaria data.

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Background: Malaria remains a public health problem in Kenya despite several concerted control efforts. Empirical evidence regarding malaria effects in Kenya suggests that the disease imposes substantial economic costs, jeopardizing the achievement of sustainable development goals. The Kenya Malaria Strategy (2019-2023), which is currently being implemented, is one of several sequential malaria control and elimination strategies.

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Background: Despite considerable progress made over the past 20 years in reducing the global burden of malaria, the disease remains a major public health problem and there is concern that climate change might expand suitable areas for transmission. This study investigated the relative effect of climate variability on malaria incidence after scale-up of interventions in western Kenya.

Methods: Bayesian negative binomial models were fitted to monthly malaria incidence data, extracted from records of patients with febrile illnesses visiting the Lwak Mission Hospital between 2008 and 2019.

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Using data from Ontario Canada, we previously developed machine learning-based algorithms incorporating newborn screening metabolites to estimate gestational age (GA). The objective of this study was to evaluate the use of these algorithms in a population of infants born in Siaya county, Kenya. Cord and heel prick samples were collected from newborns in Kenya and metabolic analysis was carried out by Newborn Screening Ontario in Ottawa, Canada.

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The population's antibody response is a key factor in comprehending SARS-CoV-2 epidemiology. This is especially important in African settings where COVID-19 impact, and vaccination rates are relatively low. This study aimed at characterizing the Immunoglobulin G (IgG) and Immunoglobulin M (IgM) in both SARS-CoV-2 asymptomatic and symptomatic individuals in Kisumu and Siaya counties in western Kenya using enzyme linked immunosorbent assays.

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Timely treatment-seeking behavior can reduce morbidity and mortality due to infectious diseases. Patterns of treatment-seeking behavior can differ by access to health care, and perceptions of disease severity and symptoms. We evaluated the association between self-reported symptoms at last illness and the level of treatment-seeking behaviors.

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Background: Although climate change is one of the biggest global health threats, individual-level and short-term data on direct exposure and health impacts are still scarce. Wearable electronic devices (wearables) present a potential solution to this research gap. Wearables have become widely accepted in various areas of health research for ecological momentary assessment, and some studies have used wearables in the field of climate change and health.

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Background: Spatial repellents are widely used for prevention of mosquito bites and evidence is building on their public health value, but their efficacy against malaria incidence has never been evaluated in Africa. To address this knowledge gap, a trial to evaluate the efficacy of Mosquito Shield™, a spatial repellent incorporating transfluthrin, was developed for implementation in Busia County, western Kenya where long-lasting insecticidal net coverage is high and baseline malaria transmission is moderate to high year-round.

Methods: This trial is designed as a cluster-randomized, placebo-controlled, double-blinded clinical trial.

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Background: Overnight travel predicts increased likelihood of Plasmodium infection and may introduce parasite strains to new areas, but deviations from routine at-home use of long-lasting insecticidal nets (LLINs) during travel are not well studied.

Methods: Cross-sectional data were taken in 2015 from the western Kenyan highlands and lowlands. Household surveys assessed individual travel activity during the previous month, LLIN use (at home and away), and current Plasmodium infection status.

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Background: Wearable devices hold great promise, particularly for data generation for cutting-edge health research, and their demand has risen substantially in recent years. However, there is a shortage of aggregated insights into how wearables have been used in health research.

Objective: In this review, we aim to broadly overview and categorize the current research conducted with affordable wearable devices for health research.

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As the epidemiological transition progresses throughout sub-Saharan Africa, life lived with diseases is an increasingly important part of a population's burden of disease. The burden of disease of climate-sensitive health outcomes is projected to increase considerably within the next decades. Objectively measured, reliable population health data is still limited and is primarily based on perceived illness from recall.

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