http://idl-bnc.idrc.ca:80/dspace/handle/10625/35555 2013-05-23T19:41:04Z http://idl-bnc.idrc.ca:80/dspace/handle/10625/50943 Title: Social and environmental determinants of Aedes aegypti infestation in Central Havana : results of a case–control study nested in an integrated dengue surveillance programme in Cuba Authors: Spiegel, Jerry M.; Bonet, Mariano; Ibarra, Ana-Maria; Pagliccia, Nino; Ouellette, Veronic; Yassi, Annalee Abstract: objective To characterize the social and environmental risk factors associated with the presence of Aedes aegypti in order to improve community dengue control. methods A case–control study with ‘cases’ being households with entomologically confirmed A. aegypti infestation; personal interviews in Central Havana, a densely populated inner city area characterized by overcrowded housing and irregular water service. The participants were residents of 278 houses with infestation and 556 houses without infestation. results Greater risk of infestation was associated with lack of preventive measures, such as no larvicide in the water tanks (OR ¼ 2.21) and use of flower vases for religious practice (1.93), not being economically active (1.64), vulnerable populations with higher risks in households with older people (1.52) and households with children (1.94). conclusions Efforts to reduce infestations should continue to focus on water tank sanitation and improving housing conditions, but also engage community religious leaders to help promote safe practices. Vulnerable populations should be especially targeted by prevention activities. A surveillance programme can produce evidence to guide interventions. 2007-04-01T00:00:00Z http://idl-bnc.idrc.ca:80/dspace/handle/10625/50257 Title: Trans-disciplinary study on the health risks of cryptosporidiosis from dairy systems in Dagoretti, Nairobi, Kenya : study background and farming system characteristics Authors: Kang’ethe, Erastus K.; Kimani, Violet N.; McDermott, Brigid; Grace, Delia; Lang’at, Alfred K. Abstract: This paper characterises the dairy farming system in Dagoretti, Nairobi. Characterisation was part of a broader ecohealth project to estimate the prevalence and risk of cryptosporidiosis and develop risk mitigation strategies. In the project a trans-disciplinary team addressed epidemiological, socioeconomic, environmental and policy aspects of cryptosporidiosis, an emerging zoonosis. This paper also provides background and describes sampling methods for the wider project. Three hundred dairy households were probabilistically sampled from a sampling frame of all dairy households in five of the six locations of Dagoretti, one of the eight districts of Nairobi Province. Randomly selected households identified 100 non-dairy-keeping households who also took part in the study. A household questionnaire was developed, pre-tested and administered in the dry and wet seasons of 2006. An additional study on livelihood and economic benefits of dairying took place with 100 dairy farmers randomly selected from the 300 farms (as well as 40 non-dairy neighbours as a control group), and a risktargeted survey of environmental contamination with Cryptosporidium was conducted with 20 farmers randomly selected from the 29 farmers in the wider survey who were considered at high risk because of farming system. We found that around 1 in 80 urban households kept dairy cattle with an average of three cattle per household. Cross-breeds of exotic and local cattle predominate. Heads of dairykeeping households were significantly less educated than the heads of non-dairy neighbours, had lived in Dagoretti for significantly longer and had significantly larger households. There was a high turnover of 10 % of the cattle population in the 3-month period of the study. Cattle were zero grazed, but productivity parameters were sub-optimal as were hygiene and husbandry practices. In conclusion, dairy keeping is a minor activity in urban Nairobi but important to households involved and their community. Ecohealth approaches are well suited to tackling the complex problem of assessing and managing emerging zoonoses in urban settings. Description: This paper is part of a special supplement on assessing and managing urban zoonoses and food-borne disease in two African cities (Nairobi, Kenya and Ibadan, Nigeria). 2012-08-11T00:00:00Z http://idl-bnc.idrc.ca:80/dspace/handle/10625/50256 Title: Social and gender determinants of risk of cryptosporidiosis, an emerging zoonosis, in Dagoretti, Nairobi, Kenya Authors: Kimani, Violet N.; Mitoko, Grace; McDermott, Brigid; Grace, Delia; Ambia, Julie Abstract: The aim of the study was to investigate the social and gender determinants of the risk of exposure to Cryptosporidium fromurban dairying in Dagoretti, Nairobi. Focus group discussions were held in six locations to obtain qualitative information on risk of exposure. A repeated cross-sectional descriptive study included participatory assessment and household questionnaires (300 randomly selected urban dairy farming households and 100 non-dairying neighbours). Onehundred dairy households randomly selected from the 300 dairy households participated in an additional economic survey along with 40 neighbouring non-dairy households. We found that exposure to Cryptosporidium was influenced by gender, age and role in the household. Farm workers and people aged 50 to 65 years had most contact with cattle, and women had greater contact with raw milk. However, children had relatively higher consumption of raw milk than other age groups. Adult women had more daily contact with cattle faeces than adult men, and older women had more contact than older men. Employees had greater contact with cattle than other groups and cattle faeces, and most (77 %) were male. Women took more care of sick people and were more at risk from exposure by this route. Poverty did not affect the level of exposure to cattle but did decrease consumption of milk. There was no significant difference between men and women as regards levels of knowledge on symptoms of cryptosporidiosis infections or other zoonotic diseases associated with dairy farming. Awareness of cryptosporidiosis and its transmission increased significantly with rising levels of education. Members of nondairy households and children under the age of 12 years had significantly higher odds of reporting diarrhoea: gender, season and contact with cattle or cattle dung were not significantly linked with diarrhoea. In conclusion, social and gender factors are important determinants of exposure to zoonotic disease in Nairobi. Description: This paper is part of a special supplement on assessing and managing urban zoonoses and food-borne disease in two African cities (Nairobi, Kenya and Ibadan, Nigeria). 2012-08-05T00:00:00Z http://idl-bnc.idrc.ca:80/dspace/handle/10625/50255 Title: Prevalence of cryptosporidiosis in dairy cattle, cattle-keeping families, their non-cattle-keeping neighbours and HIV-positive individuals in Dagoretti Division, Nairobi, Kenya Authors: Kange’the, Erastus; McDermott, Brigid; Grace, Delia; Mbae, Cecilia; Mulinge, Erastus Abstract: This paper reports a study estimating the prevalence of cryptosporidiosis, an emerging zoonosis, in people and cattle in Dagoretti, Nairobi. A repeated cross-sectional survey was carried out among randomly selected cattle keepers in Dagoretti, their dairy cattle and their non-cattle-keeping neighbours in the dry and wet seasons of 2006. A survey was also carried out among a group of people living with human immunodeficiency virus (HIV). Faecal samples were examined for Cryptosporidium oocysts using the modified Ziehl–Neelsen method; 16 % of the samples were also examined using immunofluorescence antibody (IFA) technique. Quality control consisted of blind reviews of slides, examining split samples and confirming slide results with IFA. We found that members of dairy households had a dry season cryptosporidiosis prevalence of 4 % and wet season prevalence of 0.3 %, and non-dairy households, a prevalence of 5 and 0 %, respectively. The cattle dry season prevalence was 15 %, and the wet season prevalence, 11 %. The prevalence in people living with HIV was 5 %. The laboratory quality control system showed some inconsistency within and between different tests, indicating challenges in obtaining consistent results under difficult field and working conditions. In conclusion, this is the first reported study to simultaneously survey livestock, livestock keepers and their neighbours for cryptosporidiosis. We failed to find evidence that zoonotic cryptosporidiosis is important overall in this community. This study also draws attention to the importance of quality control and its reporting in surveys in developing countries. Description: This paper is part of a special supplement on assessing and managing urban zoonoses and food-borne disease in two African cities (Nairobi, Kenya and Ibadan, Nigeria). 2012-08-10T00:00:00Z http://idl-bnc.idrc.ca:80/dspace/handle/10625/50254 Title: Outcome mapping for fostering and measuring change in risk management behaviour among urban dairy farmers in Nairobi, Kenya Authors: Nyangaga, Julius N.; Grace, Delia; Kimani, Violet; Kiragu, Monica W.; Langat, Alfred K. Abstract: A study was undertaken to investigate and mitigate the risk from zoonotic Cryptosporidium associated with dairy farming in Dagoretti division, Nairobi, Kenya. Outcome mapping (OM), a relatively new tool for planning and evaluation, was used to foster and then monitor changes in farmer management of health risks. Elements of the OM framework, including the vision, mission and expected progress markers, were developed in participatory sessions and a set of progress markers was used for monitoring behaviour change in farmers participating in the project (the boundary partners). Behaviour change (the outcome challenge) was supported by a range of awareness and educational campaigns, working with strategic partners (extension agents and administrative leaders). The farmers the project worked with made considerable progress according to the markers; they demonstrated an understanding of cryptosporidiosis, established or maintained clean and well drained cattle sheds, and took conscious effort to reduce possible infection. Farmers who did not participate in the project (non-contact farmers) were found to be less advanced on the progress marker indicators. Non-contact farmers who carried out risk-reducing practices had done so independently of the project team. The administration leaders, as strategic partners, had a positive attitude towards the project and confidence in their ability to support project objectives. The study demonstrates the utility of OM in helping to identify and support behavioural change. Description: This paper is part of a special supplement on assessing and managing urban zoonoses and food-borne disease in two African cities (Nairobi, Kenya and Ibadan, Nigeria). 2012-08-11T00:00:00Z