MST-Department of Public Health

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Browsing MST-Department of Public Health by Author "Augustine Afullo"

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    Community indigenous knowledge and its role on prediction of natural disasters of public health importance: a case of central division of Isiolo district Kenya
    (2011-08-18) Habane, Fayo Galgalo; Kabiru, Ephantus W.; Augustine Afullo
    Indigenous knowledge is the local knowledge that is unique to a given culture or society. It is the basis for local-level decision-making in agriculture, health care, food preparation, education, natural resource management, and a host of other activities. This study was to establish the existence of the indigenous knowledge in the community of central division in lsiolo District and its role in the prediction of natural disasters. The research design used in the study was survey. This design helps in seeking information for decision making and improvement of certain areas of weaknesses. Opinions are the major features in survey research. The study population was derived from the 10 settlements within Central location of Central division in the district and systematic sampling design was employed in selecting households in the settlements. Questionnaires, interview guides and focus group discussions were used to get the data from the respondents. Data from the questionnaires were analyzed using the statistical packages for social sciences (SPSS) soft ware. Inferential statistics by use of' chi-square was used to determine the significance of relationship between variables and non-parametric inferential statistics used in analyzing the data were percentages and frequencies where the findings were presented in tables, bar- charts, pie-charts and line graphs. All the tests on the relationship was done and level of significance determined. The role of IK technique in the predictions was that 77.3% can be used to predict floods, Drought at 94.3%, Famine at 83.9% among others. Correlation analysis was done using chi-square (x2) between different variables such us age, gender, educational level, marital and employment status. In the determination of the correlation between age and knowledge on the frequency of occurrence of disasters; the results was that x2 15.745, p- 0.399, df 15. The study found that there was no significant relationship between the age of the respondents and the knowledge on the frequency of occurrence of the disasters. Regarding the aspects of formal disaster management by the government with correlation to age, gender, marital status, and level of education, the study found that there was no significant relationship between the variables. Finally the null hypothesis for the study was rejected and it was therefore concluded that the communities living in Central division of Isiolo District uses IK in the prediction of natural occurrences. The study concluded that the major disasters in lsiolo include: famine, drought, floods and epidemic diseases. It was also concluded that the government was successful in managing disasters in Isiolo District. The study finally concluded that some of the indigenous knowledge used included the use of animal intestines, stars, clouds, crescent shape and croaking of the frogs. The study recommended that indigenous knowledge should be promoted through keeping of records, be recognized and policy framework instituted to safeguard and preserve it so that it can be an additional resource base in supplementing the formal Government techniques in natural disaster management and predictions. The researcher finally recommended that another study should be carried out in the study area to find out the use of IK on environmental sustainability and management.
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    Effect of water sanitation and health education interventions on diarrhoeal morbidility among children in Mandera District, Kenya
    (2011-12-29) Simiyu, Sheillah; Augustine Afullo; Keraka, M.
    Globally, more than 125 million children under five years live in households without access to quality drinking water, while more than 280 million children live in households without access to improved sanitation facilities. Therefore, more than 1.5 million children die from diarrhoea every year while many millions more have their development disrupted and their health undermined by diarrhoeal or water-related diseases. Today diarrhoea is the leading cause of mortality and morbidity, especially among young children in developing countries. The Ministry of Health estimates that it contributes to 12.8% of the under five deaths in Kenya. In Mandera, diarrhea is a problem especially among children under five years. It has been identified as a major factor contributing to various other health problems such as malnutrition and mortality. Various organizations have had Water, Sanitation and Health Education interventions in the district, all aimed at containing diarrhoeal diseases especially among the under fives. However, it is not known if these interventions have had any effect on diarrhoeal morbidity among the children. The main objective of this study was to assess the effects of water, sanitation and health education interventions on diarrhoeal morbidity among children under five years in Mandera district. This was a descriptive cross sectional study that mainly targeted the residents of Mandera District. Four divisions in the district were purposively selected, and the sample size, of 350 caregivers proportionately distributed to each of these divisions and the locations in each of them. Data was collected through an interview schedule, focus group discussions and observation. SPSS version 12 was used for analysis and chi square tests applied. Before the interventions, poor hygiene practices were identified to be the main factors in the spread of diarrhoeal diseases. The study found that there had been an increase in the number of people who had received health education. There had also been an increase in the number of water sources and sanitary facilities, though this increase did not reduce diarrhoel diseases. Just like before the interventions, the study found that hygiene practices at the household level were the main factors in the spread of diarrhoea, including storing drinking and water for other purposes in the same container (x2=8.471; df l;-p=0.004), scooping of drinking water by pouring from the container (x2=20.981; df 2; p=0.000), washing hands with water only (x2=15.471; df 4; p=0.004) open defecation among children (x2=34.815; df 4; p=0.047) and poor storage of kitchen utensils (x2=15.859; df 5; p=0.004). Other risk factors include using the river water in the dry season (x2=16.735; df--7; p=0.019), water transportation by rolling on the ground (x2=13.329; df--6; p=0.038), and poor disposal of the children's waste (x2=1 1.220; df 5; p=0.047). The study thus concludes that the interventions have led to an increase in water and sanitation facilities, and in health education, however, diarrhoeal diseases were mainly influenced by water, sanitation and hygiene risk factors at the household level. This study recommends that the organization in the district should continue with health education, but target the main household hygiene practices. Religious leaders should also use religion to promote hygiene and the ministry of Health should increase coverage of health centres in the district. A further study should be done to identify factors that hinder the residents from practicing what they have been taught
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    Etiology of diarrhea in children under 5 yrs in Mbagathi district hospital, Nairobi province
    (2013-02-04) Segecha, Shirley; Augustine Afullo; Keraka, M.; Willie Sang
    Diarrhea is a major public health problem with adverse effects on children's health. After acute respiratory illnesses, pediatric diarrhea is the most important cause of disability adjusted life years lost; it has the single greatest adverse effect on children's growth and development. Epidemiology of diarrheal illness in many areas remains poorly understood. Two hundred and forty six children who presented to Mbagathi district hospital in the months May-Aug 2007 were randomly selected and screened for bacterial agents causing diarrhea. Descriptive cross sectional survey design was used for this study. Main objective of study was to identify and characterize bacterial causes of diarrhea among children under 5years. Identification was done through stool culture, biochemical tests, serotyping and multiplex PCR. Demographic data were collected using a standardized questionnaire. Physical examination and clinical symptoms in patients were assessed to determine association with diarrheal illness. Main risk factors associated with diarrhea in children less than 5 years are: area of residence and water sources. Data management was by MS-Access(2003) and data analysis was done using STATA (StataCorp. 2005. Stata Statistical Software: Release 9. College Station, TX: StataCorp LP version 8.0) software. Dependent variable was bacterial pathogen and independent variables were: area of residence and water sources of study households. Seventy six patients (93.83%) harbored E.coli, 3 (3.7%) had Salmonella and 2 (2.46%) were positive for Shigella. E.coli was found to be the most common bacterial pathogen associated with acute diarrhea among children below 5 years of age. E. coli being the most isolated bacteria Chi-square tests of associations with the different areas of residence gave the following p-values: Kibera p=0.415, South B p=0.478,Kawangware p=0.209. Diarrheal illnesses in the hospital during the study period ranked third among the most common diseases. Chi-square tests of association for well as water source gave p value of 0.74 and a cross tabulation of municipal water source and isolated bacteria pathogen did not prove any interaction. Prevalence of acute diarrhea among children less than 5 years of age was 20%.There is need to create awareness on maintenance of hygiene among mothers/caretakers of children less than 5 years to control occurrence of E.coli infections. It is important for MoH to conduct continuous surveillance and reporting of diarrheal pathogens to promote better prevention and therapeutic measures for diarrheal illnesses among children under 5 years.