Publications by authors named "Zeinab Gura"

Background: Cervical cancer is the leading cause of cancer mortality among women in Kenya. Two thirds of cervical cancer cases in Kenya are diagnosed in advanced stages. We aimed to identify factors associated with late diagnosis of cervical cancer, to guide policy interventions.

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Background: Kenya's estimated road traffic injury (RTI) death rate is 27.8/100,000 population, which is 1.5 times the global rate.

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Investing in the health workforce to ensure universal access to qualified, skilled and motivated health workers is pertinent in achieving the Sustainable Development Goals (SDGs). The policy thrust in Kenya is to improve the quality of life of the population by investing to improve health service provision and achieving universal health coverage. To realise this, the Ministry of Health undertook a Health Labour Market Analysis with to generate evidence on the relationship between supply, demand and need of the health labour force.

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Background: Long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) are the main malaria vector control measures deployed in Kenya. Widespread pyrethroid resistance among the primary vectors in Western Kenya has necessitated the re-introduction of IRS using an organophosphate insecticide, pirimiphos-methyl (Actellic® 300CS), as a pyrethroid resistance management strategy. Evaluation of the effectiveness of the combined use of non-pyrethroid IRS and LLINs has yielded varied results.

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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.

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Introduction: anthrax is endemic in some parts of Kenya causing mortalities in livestock and morbidity in humans. On January 20, 2018, news media reported suspected anthrax in a remote southern Kenyan village after villagers became ill following consumption of meat from a dead cow that was confirmed, by microscopy, to have died of anthrax. We assessed community knowledge, attitude and practices (KAP) to identify intervention gaps for anthrax prevention.

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Introduction: 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.

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On the last week of May of 2018, a community-based syndromic surveillance system detected mass abortions and deaths of young livestock in northeastern Kenya. Two weeks later, Rift Valley fever (RVF) was confirmed in humans presenting with febrile illness and hemorrhagic syndrome in the same region. A joint animal and human response team carried out an investigation to characterize the outbreak and identify drivers of disease transmission.

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Background: Globally, under-nutrition accounts for > 3 million deaths annually among children < 5 years, with Kenya having ~ 35,000 deaths. This study aimed to identify factors associated with malnutrition in children aged < 5 years in western Kenya.

Methods: We conducted a hospital-based unmatched case-control study between May and June 2017.

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Article Synopsis
  • Cholera is still a significant health issue in Kenya, particularly in Isiolo County, despite public awareness efforts; understanding the community's knowledge, attitudes, and practices (KAP) is crucial for effective prevention.
  • A mixed-methods study was conducted with 428 participants, revealing that while most had heard of cholera and understood its communicability, many were not treating their drinking water or practicing good sanitation.
  • Factors associated with higher knowledge scores included having a positive attitude, treating drinking water, being younger than 36, and having formal education, while focus group discussions identified poor latrine access and cultural beliefs as challenges to cholera prevention.
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Background: Cutaneous leishmaniasis is a neglected disease known to cause significant morbidity among the poor. We investigated a suspected outbreak to determine the magnitude of cases, characterize the cases and identify risk factors of cutaneous leishmaniasis in Gilgil, a peri-urban settlement in Central Kenya.

Methods: Hospital records for the period 2010-2016 were reviewed and additional cases were identified through active case search.

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Background: Cholera globally affects 1.3-4.0 million people and causes 21 000-143 000 deaths annually.

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Background: Lead exposure is linked to intellectual disability and anemia in children. The United States Centers for Disease Control and Prevention (CDC) recommends biomonitoring of blood lead levels (BLLs) in children with BLL ≥5 μg/dL and chelation therapy for those with BLL ≥45 μg/dL.

Objectives: This study aimed to determine blood and environmental lead levels and risk factors associated with elevated BLL among children from Owino Uhuru and Bangladesh settlements in Mombasa County, Kenya.

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Objective: Brucellosis is one of the top five priority zoonosis in Kenya because of the socio-economic burden of the disease, especially among traditional, livestock keeping communities. We conducted a 1 year, hospital based, unmatched case-control study to determine risk factors for brucellosis among Maasai pastoralists of Kajiado County in 2016. A case was defined by a clinical criteria; fever or history of fever and two clinical signs suggestive of brucellosis and a positive competitive enzyme-linked immunosorbent assay test (c-ELISA).

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Introduction: HIV-exposed infants (HEI) lost-to-follow-up (LTFU) remains a problem in sub Saharan Africa (SSA). In 2015, SSA accounted >90% of the 150,000 new infant HIV infections, with an estimated 13,000 reported in Kenya. Despite proven and effective HIV interventions, many HEI fail to benefit because of LTFU.

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Introduction: in 2012, the Government of Kenya amended the Food, Drug and Chemical Substances Act to make the fortification of maize and wheat flour with folic acid mandatory. We assessed folate deficiency, awareness and use of folic acid fortified flour among pregnant women receiving antenatal care (ANC) at a clinic at Pumwani Maternity Hospital, Kenya, 2015.

Methods: we conducted a cross-sectional survey at Pumwani Maternity Hospital between October and November 2014.

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Article Synopsis
  • Unadulterated milk is crucial for both health and industrial purposes, as antimicrobial residues can lead to drug resistance and allergies, especially in raw milk sold in Lamu West Sub-County, Kenya.
  • A study involving 152 vendors and 207 farmers revealed that a significant percentage of raw milk samples tested positive for antimicrobial residues (15.5% from farmers and 18.4% from vendors) and were often adulterated with water.
  • Increased awareness among farmers about the risks of antimicrobial residues and training on proper milking practices significantly reduced the likelihood of selling contaminated milk, highlighting the need for regular milk testing and education.
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Introduction: in February 2015, an outbreak of acute watery diarrhea was reported in two sub counties in western Kenya. e 01 serotype Ogawa was isolated from 26 cases and from water samples collected from a river mainly used by residents of the two sub-counties for domestic purposes. We carried out an investigation to determine factors associated with the outbreak.

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Introduction: rates of caesarean sections (CS) have been rising globally over time. Our study sought to identify factors associated with CS among mothers delivering at Mama Lucy Kibaki Hospital in Nairobi city county, Kenya.

Methods: we conducted an unmatched case-control study using a 1:2 case-to-control ratio.

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Introduction: male partner involvement in elimination of mother-to-child transmission (eMTCT) of HIV activities remains low in Western Kenya, despite its importance in reducing rates of child HIV transmission. We sought to identify factors associated with male partner involvement in eMTCT in Kisumu East sub-County, Western Kenya.

Methods: we conducted a cross-sectional study among women aged ≥ 18 years who had children aged ≤ 12 months and were attending a child health clinic for immunization services in one of four Western Kenya health centers between February and April, 2015.

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Introduction: dual contraception, the use of non-barrier contraceptive method in combination with condoms, is an effective strategy in the elimination of mother-to-child transmission (eMTCT) of human immunodeficiency virus (HIV) and the achievement of zero new HIV infections. Despite its effectiveness, dual contraception use among HIV-infected women in Kenya remains low. We identified factors associated with dual contraceptive uptake in Bungoma County, Kenya.

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Article Synopsis
  • The recent Zika outbreak and Ebola epidemic have underscored the need for improved preparedness in detecting and responding to public health threats, particularly those from animal origins.
  • One-Health approaches, which facilitate collaboration between human, animal, and environmental health sectors, are seen as essential for preventing and managing disease outbreaks.
  • This text discusses three significant initiatives in Kenya that are advancing the implementation of the One Health strategy.
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Article Synopsis
  • - Dadaab Refugee Camp in Kenya is home to approximately 340,000 refugees and faced a cholera outbreak starting in November 2015, when two residents showed symptoms of acute watery diarrhea linked to Vibrio cholerae.
  • - Following the initial cases, there was a swift escalation, with 45 more confirmed cases reported within a week, prompting a coordinated response from various health organizations, including the UN, Médecins Sans Frontières, and local health authorities.
  • - To mitigate future cholera risks, it's crucial to enhance water, sanitation, and hygiene facilities, as well as to improve disease surveillance systems in the camp and its surrounding areas.
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Background: 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.

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