MST-Department of Environmental Health

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    Adherence to Pulmonary Tuberculosis Treatment in Murang’a County, Kenya
    (Kenyatta University, 2020-03) Gitonga, Charles Muthui
    Non-adherence to Tuberculosis treatment is a major barrier for TB control programs because incomplete treatment may result in prolonged infectiousness, drug resistance, relapse and death. Successful treatment of TB involves taking anti TB drugs for at least six months as per the doctors advise. Currently, Tuberculosis has become a resurgent public Health problem in developing countries and is the leading cause of death from any single infectious agent. The purpose of the study was to identify factors contributing to non-adherence to TB treatment amongst pulmonary TB patients in Maragua Sub-County of Murang’a County. The objectives included were to determine the social-economic related, healthcare-related, patient-related and disease and medicine related factors associated with non-adherence of TB treatment amongst patients in Murang’a County. The study was guided by the Health Belief model as the theoretical framework. A cross-sectional survey study design was used. Census method was used and all 270 people were considered. Data was collected using a mixed method approach of interview guides, questionnaires and Focus Group Discussions. A total of 270 adult Pulmonary TB patients, amongst whom 59 (47%) were adherents and 67(53%) non adherents with TB treatment, who received treatment in 2017 and had completed treatment, Community Health workers, and Health Personnel in the TB clinic participated in the study. Data was entered to EPI INFO version 3.5.3 and analysed using Statistical Package for Social Sciences (SPSS) version 22. Multiple logistic regressions was used to identify associations and to control potential confounding variables. Chi Square was used to test independence of categorical variables with p value of less than 0.05 at 95% confidence interval being considered significant. Data presentation was done using figures and tables. From the results of the study only the distance taken to collect drugs in the health facility was found to be associated with non-adherence to TB treatment (n=9 ,13%). The study recommends that measures should be undertaken so as to reduce the non-adherence level to TB treatment by ensuring anti-Tb treatment is accessible to patients at the nearest Health facility from their residence. Additionally, the study proposes that the patients should be sensitized on the importance of adherence to TB drug mediction. Interventions with Health promotion initiatives emphasizing the benefits of treatment adherence should be enhanced in the communities by further large scale multicentred studies and that an enabling environment which is conducive for good patient interactions should be created. The study concludes that there are challenges facing adherence of TB treatment which ought to be addressed. The study, suggests that measures to improve drug adherence such as improving health conditions, increasing the availability of drugs and conducting health educations to the patients is essential in minimizing the drug non-adherence to TB drugs.
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    Adoption Level of a Proactive Safety Program Within the Construction Phase of Olkaria’s Geothermal Power Stations of Nakuru County, Kenya
    (Kenyatta University, 2020-02) Nzioka, Luka Musembi
    Kenya is among the leading countries globally with significant geothermal resources. Geothermal energy provides reliable, cost-competitive, base load power with a small carbon footprint, and reduces vulnerability to changes in climate by diversifying power supply away from hydropower. Kenya has set out ambitious targets for geothermal power plants to meet an increasing power demand with significant impact to the safety and health of the workforce. This study focused mainly on this sector with a great emphasis to Olkaria’s geothermal power stations of Nakuru County that are under development. Olkaria domes has over 71% of Kenya’s potential to geothermal power capability. The overall objective of this study was to determine level of adoption of proactive safety program measures within construction phase of Olkaria’ s geothermal power stations of Nakuru County. Additionally, the study sought to identify the level of importance attached to each proactive safety measure, determines the strategies employed in ensuring that proactive safety program measures are adopted at construction phase and to establish the barriers and success factors to the adoption of this proactive safety program measures. Safety performance metrics and leading indicators from Institute for Work and Health Organisational performance metrics provided measure for the safety performance. Known safety performance indicators of this study were quantitative and qualitative. A descriptive cross-sectional and evaluative study design which uses both quantitative and qualitative methods in data collection has been applied in this study, with a study population being the workers working at the two Geothermal power plants that are currently under construction, a sample was drawn from all the Departments, data was collected using a self-administered questionnaires, observations through a structured checklist, document review and key informant interviews. The data collected was computer managed and analyzed by using the Statistical Package for the Social Sciences software version 20.0. Analysis was achieved by use of descriptive statistics which includes frequencies, percentages, and the mean. The overall result shows that there is partial adoption of the proactive safety measures with dismal performance in process safety measures and thus need for contractors to have policy statement by the top management in commitment to support proactive safety program adoption and implementation. The research pointed out that, employee competency assessment is of great importance to this challenging area, and management should consider their competencies before being hired. Barriers to the adoption of this program has been noted, the management has not provided adequate budget allocation to the provision of personal protective equipment and thus workers are vulnerable to injuries as a result, there is need for management to incorporate safety budget in their core project budget. The findings of this study when adopted, will provide a body of knowledge to all players within the construction phase to enforce a positive safety culture, help to prevent accidents from occurring, and improve health and safety of workers. By incorporating these proactive safety measures as a zero-harm strategy, management shall understand that accidents are preventable and zero accident is a realizable goal.
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    Adoption of Biomass Briquettes as Alternative Source of Energy in Maasai-Mau Region, Narok County, Kenya
    (Kenyatta University, 2020-11) Mokaya, Dennis Chweya
    Climate change phenomenal is a trend that impacts the local communities by affecting their way of life. High demand for wood products to meet the demand of energy supply in Maasai-Mau region has seen the depletion of the forest cover thus increasing carbon dioxide emission and other greenhouse gases into the atmosphere. However, there is no extensive research on the benefits of alternative sources of energy like solar, biogas and biomass briquette in mitigating these impacts. The study investigated the adoption of biomass briquettes as an alternative source of energy in Maasai-Mau, Narok County, Kenya. The study was guided with three objectives (i) to determine the level of adoption of biomass briquette in Maasai-Mau region, (ii) to evaluate the challenges and hindrances Maasai-Mau residents face in the adoption of biomass briquettes in Maasai-Mau region and (iii) to investigate the availability of biomass briquette making materials in Maasai-Mau region. The study used two sampling techniques; systematic and purposive sampling to get information from the key informants and households in the study area with a target sample of 100 respondents. The findings obtained were analysed through Excel and Statistical Package of Social Sciences. Data results were presented in graphs, pie-charts, and tables. From the results, the hypothesis was analysed by Chi-square (2). The study failed to reject the null hypothesis of a relatively low level of education hinders the adoption of biomass briquette, where (2=9.866, DF=6, P=0.13). The study concluded that the level of biomass adoption in Maasai-Mau region was relatively low with only 28% of the households using briquettes daily as compared to other sources of energy. The other conclusion from the study was that biomass briquette making materials were readily available with saw dust chippings and charcoal dusts ranking 84.61% and 79.49% respectively. Finally, the study found out that lack of funds and lack of briquette making skills were the highest challenge to adoption of briquette making technology in the region, being ranked as 88% and 77.6% respectively. The primary recommendations were that the Massai-Mau region residents be educated on biomass briquette making skills, and ensuring that their biomass briquette initiatives are funded to solve the challenges they face while adopting this clean energy mechanism as an alternative source of energy.
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    Anthropogenic Impacts on Land Use and Land Cover Change in Ombeyi Wetland, Kisumu County, Kenya
    (Kenyatta University, 2020-11) Odhiambo, Nicodemus Osoro
    Land use and land cover change dynamics and associated human-induced transitions studies are very critical in the formulation of sustainable land management strategies, land use systems and policies. The study aimed at generating a characterized area estimate of Ombeyi wetland’s land use and land cover change schema for the period between 1990 and 2017, examining the spatial and temporal characteristics of anthropogenic impacts and their relationship with land use and land cover change in Ombeyi wetland, and to evaluate the impact of existing plan/program used for sustainable management of Ombeyi wetland. The study adopted a mixed-method design consisting of remote sensing and GIS-based analysis, key informants interview, and a household survey of 384 households. Remote sensing analysis revealed that between 1990 and 2017, the area covered by papyrus vegetation has decreased from 1017.01 Ha to 4.04 Ha while agricultural land and built-up area increased from 2966.5 Ha to 3450.8 Ha and 52.46 Ha to 581.2 Ha, respectively. Key informants attributed the changes to population increase (29.2%) and their associated demand for land and natural resources. Analysis of household-survey results validated the observed patterns during the remotely sensed data analysis phase, as majority of the respondents (90.1%) own land within the wetland through inheritance. The respondents reported farming (92.2%) as their main occupation with 72.4% of the same respondents attaining primary level education and below. Most of the respondents (24.7%) are aged between 21 and 30 years with 88.3 %, earning Kshs >2,500 or more monthly from wetland utilization. Wetland conservation was not popular as 70.1% of the respondents were against conservation while 98.1% have never participated in any conservation efforts. Results from the evaluation of the integrated management plan 2014-2018 objectives were, afforestation and re-afforestation in catchment areas (50%), improve environmental education and awareness (50%), halt pollution and improve water quality (45.45%), improved food security and household income (41.67%), and enhancement of participatory monitoring and evaluation (50%). Hypothesis testing for; there is significant spatial and temporal change in Ombeyi wetlands’ land cover types using T-test resulted in a p-value of 0.999, while correlational test for hypothesis; anthropogenic impacts significantly correlate with changes in land use and land cover resulted in a r-value of 0.892. Both hypotheses were accepted. The respondents proposed land use zoning (30.2%) as the most suitable conservation measure. The current state of land cover and its dynamics have had negative impacts on the livelihoods of residents and resources management.
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    Assessment of Knowledge, Attitude and use of Insecticide-Treated Nets Among Students in Boarding Secondary Schools in Igembe District, Kenya
    (2014-08-18) Kinyua, Daniel M.
    Malaria is a major public health problem causing immeasurable human suffering in many countries particularly in the sub-Saharan Africa, which account for about 90% of malaria cases in the world. Many people live in countries with high risk of contracting malaria and 300-500 million cases of malaria are estimated to occur annually. Malaria is transmitted to people of all ages and an estimate of 80% of human-mosquito transmission comes from over-fives with young adolescents forming the peak age group. Over the years malaria has emerged as serious threat to poverty reduction and a contributor to poor socio-economic development. In Kenya, malaria remains the leading cause of morbidity and mortality followed by AIDS and TB. Efforts to control malaria are being challenged by emergence of drug and insecticide resistance among other factors. Hence, there is a need to focus on interventions which prevent human contact with the mosquito vector such as the use of ITNs. However, studies have shown that ITN is an effective tool for malaria control. Although, a lot of campaign is being made to promote the use of ITNs WHO has reported low usage of ITNs among students in boarding secondary schools in Ghana, Nigeria, Sudan and Kenya, even in malaria endemic areas. The primary beneficiaries of the donor-driven free distribution of ITNs have been pregnant women and children below five years. Thus failing to target older children, it means malaria transmission is likely to continue. The objective of this study was to access the students’ knowledge on malaria transmission and the use of ITNs for malaria prevention among students in boarding secondary schools. This study was a descriptive cross-section survey and it was carried out in randomly selected boarding secondary schools in Igembe district, Meru County, Kenya. The study focused only on boarders who are admitted or resident of the area for at least one month because naturally acquired malaria has an incubation period of 12-28 days. Three hundred and eighty four students were randomly selected from 5170 learners in ten schools out of 37 secondary schools in Igembe district. Pre-tested, structured self- administered questionnaires, observation checklist and interview guide to guide focused group discussion was used to collect information on demographic characteristics, knowledge, use of ITNs and reasons for non-use of ITNs. Only respondents willing to participate in the study were recruited. Data was analyzed using SPSS. Chi-square test was used to compare differences in proportions between groups. Most respondents 303(79%) were aware that mosquitoes transmit malaria but only a few could identify the causative agent of malaria. Respondents reporting ITN use experienced significantly less episodes of malaria [8(16.6%)] relative to those reporting non-use of ITNs [205(61%)]. This was statistically significant (p = 0.003). Cost [172(44.7%)] and availability [81(21.2%] were the main reasons cited 13 by most students for non-use of ITNs. Therefore, to protect our youth in boarding secondary schools from malaria attack, ITNs usage should be incorporated into the school health service. The result of this study was used to make recommendations to scale up ITNs usage among the students in boarding secondary schools. This would lead to reduced malaria morbidity and mortality and increase malaria prevention awareness among the students in boarding secondary schools.
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    Assessment of Physico-Chemical and Microbiological Properties of Shallow Well Water in Kawangware Location, Nairobi City County, Kenya
    (Kenyatta University, 2020-09) Njiraini, Beth Waithera
    Lack of access to clean drinking water adversely the public health. Kawangware location is undergoing rapid expansion in population, economic growth and urbanization. One of the challenges of this growth is pressure on public water supply. The inconsistent and inadequate water supply for the inhabitants has led to majority of the population relying on ground water for domestic and commercial uses more so, on shallow wells which seem to be relatively cheaper to construct. This has increased the vulnerability of underground water sources to sewage and waste water contamination and therefore exposing the population to infections by various water borne pathogens such as bacteria, viruses and protozoa. The aim of this study was to determine the quality of shallow well water used by households in Kawangware Location and compare it with the Kenya Bureau of Standards for drinking water. Water samples were from the three sub-location that is Kabiro, Gatina and Kawangware. Cross-sectional Survey research design was used and was accompanied by laboratory tests to analyze the level of each parameter from twenty eight shallow wells. A total of 112 samples were collected. Water samples were collected in the morning and evening in the month July and August 2017.The collected samples were analyzed for temperature using a mercury thermometer; pH, electrical conductivity, turbidity and Total dissolved solids was determined using portable meters. Zinc, iron, cadmium and lead were analyzed using Atomic Absorption Spectrophotometer, potassium and sodium using a flame photometer, total hardness was analyzed using titration, nitrates, phosphate, and bacteriological analysis were tested in accordance with the Standard methods for the Examination of water and waste waters. Derived values of tables and graphs were adopted for data presentation. The measurements physico-chemical parameters were as follows: in Gatina all parameters were within KEBs drinking water standards except for turbidity value which ranged from 0.6-78 μS/cm, NO3- value ranged from 17- 19.5 mg/L,PO32- ranged from 0.02-15.8mg/L, Cd ranged from 0.03-0.06 mg/L and Pb ranged from 0.01-1 mg/L. In Kawangware site all the parameters were within KEBs drinking water standards except for turbidity value which ranged from 0.0-50.1 μS/cm, NO3- value ranged from 17.5-19.7mg/L,PO32- ranged from 0.02-42.8 mg/L, Cd ranged from 0.03-0.05 mg/L and Pb ranged from 0.06-0.09 mg/L. In Kabiro site all the parameters were within KEBs drinking water standards except for turbidity value which ranged from 0.0-100.9 μS/cm ,NO3- value ranged from 14.3-20.1 mg/L,PO32- ranged from 0.04-14.0 mg/L and Cd ranged from 0.03-0.06 mg/L.The result obtained for the microbial analysis indicated that all the water samples analysed from the shallow wells in Kawangware location were contaminated with both total coliform and faecal coliforms. The highest counts of total coliform was 1637 MPN/100 ml and was recorded at Kabiro whilst the lowest counts of 1013 MPN/100 ml was recorded at Kawangware. At the same time, the water from all the sub-location had faecal coliforms with Gatina sub-location recording higher numbers (434 MPN/100 ml) followed by Kawangware (298 MPN/100) and finally Kabiro (271 MPN/100 ml). The results of the study also revealed that the physico-chemical parameters of ground water were significantly different (P≤0.05) from the recommended levels by the KEBS (2010).Parameters like Nitrates, phosphates, turbidity, lead, cadmium, coliforms levels and feacal coliforms exceeded the KEBS standards with the rest being within the acceptable levels. The difference was not significant (p≤ 0.05) between the levels of turbidity, Iron and phosphates and that of KEBS. The ground water in the area is not safe for drinking due to elevated levels of Nitrates, phosphates, turbidity, lead, cadmium, total coliforms levels and feacal coliforms which poses a great health risk to the public therefore there is need to supply safe water for domestic purposes.
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    Assessment of Water Quality in Aquaculture Ponds in Tigoni , Kiambu County, Kenya
    (Kenyatta University, 2020-01) Mbuthia, Milkah Gathoni
    Fisheries and aquaculture is an important source of food, income and livelihoods for hundreds of millions of people around the world. Aquaculture production has increased fro m 29.5million tonnes in 2010 to 37.5 million ton nes in 2014 in the world and 1.3 million tons in 2010 to 3.8 million tonnes in Africa. There is no sufficient information suitability of water quality in aquaculture ponds in Tigoni . The aim of the study was to determine the suitability of aquaculture ponds for fish farming based on their water quality The specific objective s of the study were; t o find out quality of water in aquaculture ponds , t o identify the type of algae in aquaculture ponds and t o evalu ate the relationship s between water quality and algae in the aquaculture ponds. The study area was Tigoni in Kiambu County. Stratified random sampling design was used to select 8 sample ponds which water samples were collected twice a mont h for four months . Parameters were temperatures, pH, conductivity, dissolved Oxygen (DO), secchi depth, Biochemical oxygen demand (BOD), nitrates, phosphate and algae identification was also done. The mean values for the physical parameters ranged from 19.69±0.48 0 C to 22 .54±0.57 0 C (water temperature), 7.57 ±0.52 (pH), 190.25±127.86 to 416.50±168.93 µS/cm (conductivity), 14.13±3.36 to 28.38±7.13cm (transparency) and 4.03±1.39 to 6.63±1.37 mg/l . Chemical parameter 1.99±0.52 to 2.82±0.48 mg/l (BOD), 5.06±1.05 to 57.57±15.84 mg/ l (phosphate) and 0.38±0.10 to 8.86±1.20 ( One Way ANOVA indicated significant difference between pond F and H (P=0.001) (temperature), pond A and G (P=0.001) (pH), pond A and C (p=002) (conductivity). Pond D from G (p=0.000) (Secchi depth), pon d C and G (P=0.001) (DO). Pond D and G (p=0.001) (BOD) Pond F and H (p=0.001) (phosphates) and pond A and H (0.000) (nitrates). Mean temperature were in the lower range with pond D and H bein g below optimum range. DO t test, pond G had a significant differ ence (t=7.500, α=0.05, p=0.00) and there was no significant difference in BOD in all ponds. A total of 12 genera of algae were identified. Composition per pond was; pond A, B, C, D, E, F, G and H recorded 6, 10, 7, 6, 6, 7, 10 and 11 genera respectively. Temperature, lowest Pond H 6 genera identified, highest mean pond 7 genera were identified. Phosphate, Pond H highest mean 11 genera pond F 7 genera. Nitrates highest in pond H 11 genera while lowest was in pond A 6 genera were identified. In conclusion , water quality in most aquaculture ponds did not vary signific antly from one pond to another and the quality in most aquaculture ponds met quality for fish farming . Ponds high in phosphates and nitrates had more genera of The study recommends wate r management intervention be practced to manage water quality and control algae growth also water and soil conservation to control nutrient load in water sources . R esearch on suitability of water used for aquaculture in the area , a comparative study for wa ter quality in liner and earthen ponds and the algae composition and abundance in the aquaculture ponds
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    Attitudes and Perceptions Among Issey and Masese Communities Towards Conservation of Forest Resources in Mau Forest Complex, Kenya
    (Kenyatta University, 2020-09) Nyangweso, Hyline Nyatichi
    Forests cover approximately 30% of the earth‘s land surface area and provide critical ecosystem goods and services to mankind. However, forest cover in Kenya is among the lowest in the world, currently at around 7.6%. The Mau Forest Complex is the largest water tower in Kenya, but is threatened because of land use change and rapid human population growth in the adjoining areas. The overall objective of this study was to assess community attitudes and perception towards conservation of the Mau Forest, and relate them to alternatives to forest resource use. Methodology for data collection involved a case study survey. Semi-structured and structured questionnaires were used to collect data from the local residents and Community Forest Association officials, respectively. The hypotheses tested were that communities living in the periphery of Mau Forest Complex have positive attitudes and perceptions towards the forest and alternatives to forest resources, and that proximity influences the community‘s attitudes towards the forest and people-wildlife conflicts. Pearson correlation was used to find relationships between variables, and Chi-square test was performed to determine statistical significance differences (p < 0.05) in responses between the study areas (Masese and Issey). A total of 200 residents from Issey and Masese areas of Bomet were interviewed. Men and female respondents interviewed were 86% (n = 172) and 14% (n = 28), respectively. There were positive attitudes towards the forest among most (89%) of the community members. As a result, respondents were practicing some form of conservation of resources on their farms, such as tree planting, and soil and water conservation. However, 60% of the respondents indicated that they have had a bad experience with the forest, and people wildlife-conflicts were causes of negative attitudes towards the forest. This study gives a number of recommendations that can be used to foster forest conservation in Kenya, such as training of residents about the environment, encouraging the use of alternatives to forest resources, fostering local decision making and participation in forest management, and compensation of losses as a result of wildlife invasion of farms and homes. As elsewhere, these recommendations have the potential to create positive attitudes towards the Mau Forest Complex and an apparent increase in positive forest interactions and behavior that will ultimately lead to forest conservation and well-being in Kenya.
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    Compliance to Occupational Safety and Health Practices among Workers in Flower Farms in Embu County, Kenya
    (kenyatta university, 2023) Barongo, Bevalyne Gechemba; Peterson Njogu Warutere; Isaac K. Makau
    The Kenyan flower sector has experienced significant growth since the early 1980s. However, limited studies have been conducted on the provision of occupational safety and health services to employees in this industry. This study aimed to assess the compliance level with occupational safety and health practices among workers in flower farms in Embu County, Kenya. Specifically, the research evaluated risk identification and assessment practices, compliance with workers' health surveillance, and the awareness of safety and health among flower farm workers in Embu County. The study was guided by the Systems Theory of Accident Causation and Domino Theory. A descriptive cross-sectional research design was employed, isolating dependent and independent variables to determine the extent and frequency of their relationships. The study population consisted of employees working at Fides Kenya Ltd farm in Embu County. The sample size was calculated using the Slovin's formula based on the study population, and respondents were selected through stratified random sampling. Structured questionnaires, an observational checklist, focus group discussions (FGDs), and key informant interviews (KIIs) were used to collect quantitative and qualitative data. Statistical Package for the Social Sciences (SPSS) was utilized for data analysis, employing percentages, means, standard deviations, and Pearson's Product Moment Correlation to assess the influence of independent and dependent variables. The study revealed a strong, significant positive correlation between risk identification and assessment practices and compliance with a safe work environment (r=0.799, P=0.001<0.01). Additionally, the surveillance of workers' health showed a strong, significant positive influence on compliance with occupational safety and health practices in flower farms in Embu County (r=0.711, P=0.021<0.05). Moreover, the degree of awareness of safety and health exhibited a strong, significant positive correlation with compliance of occupational safety and health practices (r=0.721, P=0.037<0.05). In conclusion, the study found a high level of risk identification and assessment practices, contributing to improved compliance with occupational safety and health practices among workers in flower farms in Embu County, Kenya. Additionally, the existence of a health surveillance program was identified, preventing diseases and illnesses and further enhancing compliance with occupational safety and health practices among workers. The results also indicated a high level of employee awareness of safety and health, leading to improved compliance with occupational safety and health practices. Based on the findings, it is recommended that management in flower farms in Embu County should ensure the participation of all employees in the application and review of OSH risk identification and assessment practices in accordance with Section 6 of the OSHA 2007. Additionally, implementing periodic and post-employment medical examinations for all workers is advised to comply with the Medical Examination Rules 2005. Furthermore, flower farm management should provide training programs that address new risks, such as changes in machinery or materials, to ensure compliance with Section 99 of the OSHA 2007.The results of this study are essential and can be utilized by policy makers, the county government, and the national government to streamline OSH implementation within the flower industry
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    Compliance with Occupational Safety Practice among Petrol Station Pump Attendants in Kaduna state, Nigeria
    (Kenyatta University, 2020) Kakwi, Josephine Daniel; Anthony W. Nyambura; Rosebella Iseme
    Petrol pump attendants in Kaduna encounter numerous hazards at the pump. This constitutes the most important threat to their survival at the workplace. Unfortunately, there are very few researches evaluating compliance with safe practices among pump attendants in Kaduna South, Nigeria. Therefore; the study objectives were to assess the compliance levels with safe practice, to establish pump attendant’s knowledge and attitude on safe practice and to determine the factors associated with the compliance rate. The study adopted a cross-sectional survey design. Two-stage cluster sampling technique was utilized to select 27 filling stations, of which, 212 petrol pump attendants were interviewed as respondents. Data were collected using an interviewer-administered questionnaire. Descriptive statistics including percentages and frequencies were utilised in summarizing the data. Findings of the study show that the level of compliance with safe practices in terms of fire extinguisher usage (76.9%) and use of PPE (77.8%) was good. However, other safe practices have been neglected. Knowledge was generally good, especially in terms of PPE usage (92%), fire extinguisher (99.1%), and the use of spill kits (64.6%). Pump attendant's also had a positive attitude towards compliance. Inferential analysis revealed that level of education (AOR 3.331, CI 95% 1.771-6.264), work experience (AOR 1.905, CI 95% 1.028-3.529) and attitude (AOR 5.216, CI 95% 1.458- 18.665) are the best predictors for compliance with safe practice. Therefore, the study concludes that pump attendants have a good knowledge and a positive attitude regarding safe practices, but recommends that education and training of pump attendants should be prioritized in order to boost compliance rate which was found to be poor. Department of Petroleum Resources (DPR) should enforce the adoption of safety regulations in order to improve compliance by both managers and pump attendants.
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    Cyanotoxins Exposure and Attributable Health Effects among Residents of Tharaka-Nithi County, Kenya
    (Kenyatta University, 2022) Wakhungu, Dickson Wekesa; Daniel Akunga; Peterson Warutere
    Access to safe domestic water remains a challenge in many rural community and water scarce areas. One key challenge is cyanotoxins in surface water that has been known to cause serious health effects among people using these sources. The main objective of the study was to determine health effects attributable to cyanotoxin exposure among residents of Tharaka-Nithi County. The study employed Analytical cross-sectional study design in which quantitative data was collected. Interview schedules were main subject ways of data collection from the household heads while water samples for cyanotoxins and physicochemical characteristics were subjected to laboratory analysis. Simple random sampling was used to select 6 water sources. Treated pipe water and residents using it were the control point. The number of households sampled was proportionate to the number of the households in the particular area which were subjected to systematic random sampling technique during data collection. Household heads or any other dependable adult present in the household at the time of interview and were willing to participate were illegible for participation. Those excluded in the study are those who met the inclusion criteria but were absent during the sampling or unwilling to participate. A household to start with was randomly picked and the calculated interval followed in a chosen direction until the required number of households was reached. Data was analyzed using SPSS version 21 and presented using tables and bar graphs. Majority (54.40%) of the respondents were of age 46 and above years. Majority (54.93%) of respondents had primary level of education. Majority (48.53%) of respondents earn less than KShs 10000 per month. Majority (36.59%) of the respondents with more than one disease symptoms related to cyanotoxins use water with high level of cyanotoxins (3.6μg/L). Two sources of water were found to have significant level of cyanotoxin (3.6μg/L and 2.3μg/L) above WHO recommended value (1μg/L). The physicochemical characteristics were found to be high in sources with detected cyanotoxins: -Total nitrogen (7.01mg/l); total phosphorous (2.16 mg/l); pH (9.8); turbidity (21.2 NTU) and temperature (27.6oC). Chi-square test showed that the level of income had significant influence on the selection of the water source while the age and level of education had no significant influence on selection of water source. Pearson correlation found that cyanotoxin levels in the water source influenced the disease symptoms related to cyanotoxins and physicochemical characteristics influenced the cyanotoxin levels in water source. The findings of this study exposed the situation on the ground on health effects related to cyanotoxins and cyanotoxins levels in water sources and hence a wake-up call to the Public Health Officer and other Sub-County authorities on safety of the water sources. It also alerts the residents on the level of cyanotoxins in water they use and effects of using such water sources.
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    Determinants of Dehydration among Children Under Five Years with Acute Diarrhea Attending Mbagathi Hospital in Nairobi City County, Kenya
    (Kenyatta University, 2023-11) Muriu, Mary Wanjeri; Judy Mugo; Redempta Mutisya
    Diarrhea in the developing countries is the second death causing infection among children below five years of age. Millions of these deaths are caused by dehydration which is the most frequent and dangerous complication of diarrhea. Identification of determinants of dehydration among under five years old would help in predicting the children with acute diarrhea who are likely to die due to dehydration. The aim of the study was to establish predictors of dehydration among under five years old seeking treatment for acute diarrhea at Mbagathi County hospital in Nairobi county, Kenya. The specific objectives were to determine the socio- demographic characteristics of primary care givers (PCGs) and child associated with dehydration in under five years old with acute diarrhea attending Mbagathi county hospital, to identify the social- cultural beliefs of PCGs which are associated with dehydration in under five years old with acute diarrhea attending Mbagathi county hospital, to establish whether there was an association between the PCGs level of knowledge in diarrhea management and dehydration in under five years old with acute diarrhea at Mbagathi county hospital and to determine whether there was an association between the prior actions taken by PCGs to manage the acute diarrhea at home and dehydration in children under five years at Mbagathi county hospital. The study applied a hospital based unmatched case- control analytical design with mixed method approach. Purposive sampling was used to select 110 cases and 110 controls who met the inclusion criteria at a ratio of 1:1. The study participants were interviewed using a structured questionnaire. The same sampling method was used to select PCGs to participate in focus group discussions (FGDs). Qualitative data was thematically analyzed by Nvivo software then transcribed and coded into themes. Quantitative data was analyzed using SPSS Version 25. A mixed effect logistic regression model was used to evaluate the association between the predictors of dehydration. The results of the logistics regression analysis are presented in terms of odd ratios (OR) and the corresponding 95% confidence intervals (CIs). The socio demographics characteristics of PCGs in cases and controls were almost similar in terms of proportion in both groups. The characteristics of child demographics were also almost similar in both groups. In univariate analysis the variables that were statistically significant at cut off p< 0.2 were then offered to the multivariable model. Findings from the adjusted multivariate model the variables that were statistically significant were highest level of education at p< 0.05 and initiation of zinc supplement at home immediately diarrhea started p<0.05. After adjusting for duration of diarrhea, results of the logistic regression showed that the variables median age of the PCGs at p<0.01 and initiating zinc supplement at home immediately diarrhea started at p< 0.02 were significant predictors of dehydration among children below five years. In conclusion there is risk of developing diarrhea- associated dehydration among children under five years with acute diarrhea attending Mbagathi hospital mainly in young mothers with low education and also due to delay in initiating zinc supplement when children develop diarrhea. Recommendation was that there is need for more focused health education on diarrhea management in young mothers and health promotion activities at the community level so as to sensitize the community and dispel myths and misconceptions on causes and management of diarrhea.
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    Determinants of Occupational Injuries among Workers in Artisanal and Small-Scale Gold Mining Activities in Ka-Kamega County, Kenya
    (Kenyatta University, 2021) Makokha, Winnie Rabera; Jackim Nyamari; Isaac K. Makau
    Occupational injury is any bodily damage, that may be fatal or non-fatal in nature, resulting from a work-related accident. Though preventable, these injuries have resulted in serious socio-economic consequences that have been described as a major public health problem. In artisanal and small-scale gold mining (ASGM), occupational injuries are one of the many health concerns. Indeed, ASGM has been in existence in various parts of Kenya for decades including in Rosterman, Kakamega County. Despite ASGM being a common eco-nomic activity, health and safety concerns, such as occupational injuries have yet to be documented and addressed adequately. The objectives of this study were to determine the prevalence of occupational injuries, assess the level of knowledge on health and safety among workers in ASGM, assess the application of organizational and regulatory frame-works in health and safety in ASGM and to determine risk factors associated with the in-juries among workers engaging in ASGM in Rosterman, Kakamega County, Kenya. This study employed a descriptive cross-sectional study design and stratified proportionate sam-pling was used as a sampling technique. A total of 313 ASGM workers were interviewed alongside six key informants. Interviewer-administered electronic based questionnaires, interview guides, observation checklists and photography, were used to collect the data. The questionnaires were administered through the Open Data Kit platform. The data anal-ysis was done using the Statistical Package for Social Scientists (SPSS) version 22. The relationship between independent and dependent variables was determined using chi-squared tests. Significant factors were analyzed further using logistic regression and ex-pressed as odds ratio. The study found that prevalence of occupational injuries was 44.73 % with the most affected body parts being hands and upper and lower limbs at 62.14% and 30% respectively. Hand injuries were reported to be the most severe at 45%. Occupational injuries were significantly associated with having an alternative source of income (p=0.019), alcohol consumption (p=0.027), personal safety culture (p=0.007), using ham-mer or mallet (p=0.002), using pick axe (p=0.036), excavating (p=0.042) and wearing pro-tective boots (p=0.023). The significant risk factors that predicted injuries included, alter-native source of income (p=0.027), personal safety culture (p=0.021) and use of hammer or mallet (p=0.022). Respondents who had an alternative source of income were 1.79 times more likely to experience injuries. Key informants reported two fatalities to have occurred at the Rosterman mines as a result of tunnel cave-in, asphyxiation, and electrocution. The respondents had varied knowledge on health and safety practices in ASGM including the importance of PPE and training on the prevention of injuries. It was observed that machin-ery such as the ore crusher does not undergo preventive inspection. In conclusion, the study revealed that injuries are prevalent in ASGM with the most affected body parts being hands. Various risk factors were associated with injuries including having an alternative source of income, using a mallet or hammer. The study recommended having workers sen-sitized on the kind of injuries they are exposed to. Also, relevant stakeholders should create awareness on the risk factors to injuries and initiate strategies to reduce the burden of inju-ries among ASGM workers.
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    Determinants of Utilization of Youth Friendly Reproductive Health Services among School and College Youth in Thika west district, Kiambu county, Kenya
    (2013-08-14) Akinyi, Obonyo Perez
    This study was on Determinants of Utilization of Youth friendly Reproductive Health services (YFRHS) among school and college youth in Thika West District of Kiambu County, Kenya. The reproductive and sexual health of the youth remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services. Sex and sexuality among the young people have remained a sacred area and few structures were in place to address it. After International Conference on Population and Development in 1994 countries started implementing adolescent reproductive health issues. The Government of Kenya together with partners in an attempt to address the reproductive health challenges came up with the Adolescent Reproductive Health and Development Policy (ARH&D) in 2003 whose guidelines were finalized in July 2005 and released for use by service providers. Despite these guidelines, the access and utilization of YFRHS among the school youth are dependent on many factors which include demographic, economic, school, socio-cultural and health system factors. The study examined how those factors determined or affected the utilization patterns of YFRHS by the youth. The study further explored ways of mitigating or addressing the barriers to scale up utilization of those services. The study used both quantitative and qualitative approaches to collect data. The study utilized survey research adapting descriptive cross sectional design and semi-structured questionnaire to interview 390 school and college youth in Thika West District from 9th January 2012 to 17thFebruary 2012.The key informants were mainly nurses who were working at the reproductive health service delivery area at the time of study and were interviewed using an interview guide. Quantitative data was analyzed using Statistical Package for Social Sciences (SPSS) Version 18.0.Descriptive statistics and chi-square tests were performed to determine significant associations. The study established that sex, age, level of education, type of school and youth’s awareness about existence of reproductive health facility and services offered were significantly associated with utilization at p<0.05 while religion and parental employment status had association only to a few services. Ethnicity had no association to utilization of all YFRHS, p>0.05. Long queues, unfavorable working hours, mixing out of school youth and the school going youth and lack of money negatively affected utilization of YFRHS. Parents and teachers‟ involvement in passing RH information was found to be low as majority of the youth reported that they got information of these services from friends. The study concluded that the utilization of reproductive health services among the school and college youth was low largely due to unfriendliness of the reproductive health facilities to the youth and lack of awareness of RH services. In view of the findings, this study recommends need for the Government through the Ministry of Health and partners in health service provision to increase the number of YFRHS and ensure that the recommendations of Adolescent Health Policy guidelines are implemented fully with good evaluation strategies in place. Rigorous awareness drives to sensitize the youth about the available RHS through rigorous health education and increased involvement of both parents/guardians and teachers to scale up utilization are also recommended.
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    Determination of Fecal Contamination Status of Shallow Wells in Dede Division, Migori County, Kenya
    (Kenyatta University, 2018-11) Odiwuor, Oluoch Evance
    A shallow well is a hole dug, bored or drilled less than 50M deep to extract water. Contamination of shallow wells with fecal matter presents a grave public health threat in developing countries, such as Kenya, where large numbers of households lack access to clean and safe water supplies and rely on untreated surface water sources or shallow unprotected groundwater for domestic utilization. A report by WHO shows that 1 billion people practice open defecation with nine out of ten of them in rural areas and it is estimated that 1.8 billion people use a source of drinking water that is fecally contaminated. In Kenya unsafe water, sanitation and hygiene are the 2nd leading risk factors causing morbidity and mortality at the national and county levels respectively. In Dede Division, 65.5% of households depend on shallow wells for domestic needs and there are rising trends of confirmed cases of fecal-related diseases. The study sought to assess human and technical determinants of fecal contamination status of shallow wells in Dede Division. A cross-sectional study of households using the wells was conducted. Fisher’s formula was then used to calculate the sample size of the heads of households. Since the approximated number of households using shallow wells was <10,000 (4008), the two stages of the formula were adopted, giving a sample size of 386 heads of households. Out of the 180 shallow wells, 54 (30% of 180) were proportionately sampled and grab sampling technique adopted while sampling water from each of the sampled shallow wells. Basic physical parameters like temperature, turbidity and pH were analysed by a portable turbidity meter and pH meter while H2S rapid field test was employed for total corliforms analysis of grab samples in the field. Fecal contamination status of each well was determined by Membrane Filter Technique in kisumu government labaratory. Chi-square test was used to measure associations between variables while Multi-variate logistic regression analysis applied to test the hypotheses. The study reported significant relationship between level of knowledge of respondents on a well being too close to a latrine as a potential route (risk factor), a well located downhill a latrine, an open/uncovered well, surface run-offs into wells, dropping objects in shallow wells, using a dirty drawer, people/animals dropping in wells, doing laundry next to a well, and human/animal feces dropping in the well as potential routes of fecal contamination. It further revealed significant associations between several technical determinants and fecal contamination status of shallow wells e.g distance (M) from a latrine to a well, with majority of wells within safe distances of contamination (>10M) but still tested positive for fecal corliforms, distance (M) from the nearest cattle pen if any with a significant majority of shallow wells testing positive for fecal corliforms, damage or lack of concrete plinth, breaks/cracks on the parapet walls, breaks/cracks in the cover/top slab, breaks in the drainage channels, shallow well covered while not in use and shallow well fenced out respectively. Majority of shallow wells (69%) tested positive for E. Coli, a strong indicator for presence of fecal matter in water, with only 31% testing negative. Common human and technical determinants (risk factors) by and large are functions of fecal contamination status of shallow wells in Dede Division. Efficient protection of shallow wells is a critical pointer to their ground water quality. Households in Dede Division should ensure adequate treatment of shallow wells for fecal contamination before utilization of water from these sources. This can be both at source or household level. They should be sensitized by the relevant authorities on common routes of fecal contamination of shallow well water and safe hygiene and sanitation practices around shallow wells to prevent fecal contamination of the wells. Households using shallow wells in Dede Division should ensure proper sighting and location of latrines in relation to shallow wells to avoid fecal contamination of the wells through leaching. The pit latrines should be sighted down hill the shallow wells and located atleast 10 meters apart.
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    Determination of the Prevalence of Bovine Cryptosporidiosis and aflatoxin M1 among urban small holder dairy households in Dagoretti Division, Nairobi Kenya.
    (2014-05-05) M'Ibui, Gervase Miriti
    Cryptosporidium is a coccidian parasite belonging to the phylum apicomplexa. It causes human and animal cryptosporidiosis a disease characterized by severe gastroenteritis and watery diarrhea. The disease occurs after ingestion of Cryptosporidium oocysts, shed in human or animal feces. The prevalence of bovine cryptosporidiosis was investigated alongside that of aflatoxin Ml in milk. Aflatoxin Ml is a major metabolite of Aflatoxin Bland is found in milk of animals that have consumed feed contaminated with aflatoxins. Aflatoxins are potent toxic carcinogenic, mutagenic and immunosuppressive agents harmful to the health of the people. The prevalence and knowledge of bovine cryptosporidiosis and detection of Aflatoxin Ml (AFMl) were studied between smallholder dairy and non-dairy farming households in Dagoretti Division Nairobi Kenya, between January and June 2005. The purpose of the study was to establish the prevalence of the two hazards in order to enable the small holder dairy producers, traders, consumers and policy makers to adopt mitigation strategies to the problem. Three hundred (300) and 150 dairy and non-dairy households respectively, were randomly selected for the cross sectional study and mapped using GPS for future follow-up. Focus group discussions and household questionnaire administration were used to collect qualitative data. Cryptosporidium oocysts were identified using Ziehl Nelsen method, while Aflatoxin Ml in milk was determined using aflatoxin kit purchased from Charm Sciences which is a rapid receptor lateral flow assay that detects Aflatoxin Ml at 500ppt USA action level. In the study, three hundred and ninety six (396) milk samples comprising 260 and 136 from dairy and non dairy households respectively were analyzed for AFM1. For identification of Cryptosporidium oocysts, 278 adult cattle and 150 calves' pooled fecal samples were microscopically examined using Ziehl Nelsen method. Of the calf fecal samples, 11.3% (17/150) were positive for Cryptosporidium oocysts, while 12 %( 33/278) of the adult fecal samples were also positive for the same. There were 50 positive samples from 286 households where at least one fecal specimen was taken giving an apparent prevalence rate of 17%. A household was considered positive for bovine cryptosporidiosis if Cryptosporidium oocysts were found in at least one pooled sample (adult, calf or both) from that household. Positive status for households were associated with numbers of animals, feeding the cattle with water from the household well, and cementing the cattle shed floor (p<0.05). More dairy respondents, 20% (55/280) were aware of the disease cryptosporidiosis than their non-dairy neighbors, 4% (5/132). However, knowledge on transmission and symptoms of the disease was low for both groups. The prevalence of Aflatoxin Ml in the tested households was 45% (178/396). The prevalence of Aflatoxin Ml in the farming households was 43% as compared to 49% in the non-farming households. Nevertheless, this difference was not statistically significant I.P= 0.35]. Although there was a 17% prevalence rate of cryptosporidiosis, it does not constitute a human health risk unless Cryptospofidium parvum is present. The AFMl prevalence of 45% exceeds the WHO/F AO tolerance limit for milk. It points to an underlying problem that requires the action by policy makers. Awareness on the two hazards was low, and needs to be created. Further" research is needed to identify the Cryptosporidium genotypes, and quantify AFMl in milk in order to provide further information for guided health education and policy formulation.
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    Evaluation of Work-Related Health and Safety Risks Associated with Hairdressers in Nairobi City County, Kenya.
    (Kenyatta University, 2022) Chebet, Koskei Winnie; Peterson Warutere; Bernard B. O. Awuonda
    Hairdressers work towards changing or maintaining a person’s image. They are exposed to awkward posture, prolonged standing, long working hours and chemical hazards capable of causing adverse health effects. They are at high risk for safety and health risks which have not been well elucidated. This study sought to evaluate the safety and health risks associated with hairdressers. Specifically, it investigated whether salon designs, ergonomic risk factor and hairdressing tasks have impact on hairdressers’ health and safety. The study used descriptive cross-sectional and analytical design. Systematic random sampling was used to select salons and hairdressers. Closed and open-ended questionnaires were distributed to 286 hairdressers who consented to participate in the study. Observation checklist, WISHA caution checklist, thermometer, light meter and noise level meter were used to collect data in the sampled salon. To determine the impacts of salon deigns, ergonomic risk factors and hairdressing tasks on the health and safety of hairdresser, data were analyzed descriptively and with regression analysis. The findings indicate that the space in most salons in inadequate. The average space for salons is 7.22M² and that most (68.5%) hairdressers work for long hours (11-12 hours). It was also established that few salons (5.48%) have adequate amount of light and that 8.22% salons have high temperatures. Results also showed that aprons are the most used PPEs by hairdressers. It was revealed that manual handling of salon equipment and awkward posture cause musculoskeletal disorders among the hairdressers. Their odd ratios impacting health and safety of hairdressers were 2.706 and 2.728 respectively. All hairdressing tasks were done on awkward positions. The study revealed that hairdressing salon designs; space, affect the lighting and temperatures affect the health and safety of hairdressers. The hours off work and minimal or no breaks also have negative impacts on the health and safety of hairdressers. The study recommends the enforcement of the enacted legislation by the ministry of health and regular provision of hairdresser-based information on ergonomic risks to minimize the health and safety risks in the industry.
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    Household Hazardous Waste Management Practices among Pastoral Community of Mandera County, Kenya
    (Kenyatta University, 2018) Abukar, Abdi Sheikh
    Household hazardous waste possess physical, chemical or biological characteristics, which requires special handling and disposal procedures to avoid risk to health and/or environmental effects. The pastoral population of Mandera county has been treated in health facilities with complains of poisoning or reaction resulting from hazardous substances. Health effects of exposure to household hazardous waste could also take time to manifest in people who are exposed to it, such as development of cancers and effects on unborn babies. The pastoral population is unaware of the potential hazards caused by the many household hazardous waste in their homes therefore the options of safe disposal and storage are unexplored. The main objective of this study was to establish household hazardous waste management practices among pastoral community of Mandera County, Kenya. The specific objectives were; to identify the type of household hazardous waste generated and their disposal methods; to determine the occurrence of accidents related to household hazardous waste and to determine the level of knowledge on household hazardous waste management among household heads in the pastoral community. The study employed a descriptive cross sectional design. The sample size for this study was 415 household heads and 17 key informants from Mandera East Sub-County. The study used a multistage sampling technique that comprised of three steps: simple random sampling, systematic simple random sampling and purposive sampling. Data was collected by use of both qualitative and quantitative methods. Questionnaires, focus group discussions and key informant interviews tools were used to collect data. A pre test was conducted to assess the validity and reliability of the research instruments. Clean coded data was entered into SPSS version 20, frequencies and percentages were used for descriptive statistics while Chi square was used for inferential analysis. Quantitative data was presented in frequencies and percentages. The study found that almost half (48%) of the household heads in Mandera County had moderate knowledge on household hazardous waste while (32%) had good knowledge which had been obtained from radio and health workers. The study also found that almost all of the households at (99.5%) in Mandera County were generating used batteries and electronic items; unused drugs and pharmaceuticals for either human or animal use; remains of pesticides, herbicides, fungicides and accaracides; and used needles and syringes from animal treatment. The study found out that open dumping and incineration were the most common methods of waste disposal by all the study research participants. Further, to this, 8.3 per cent of the households in Mandera County had members who were victims of household hazardous waste related accidents. Most of these household members affected were aged between 0 and 5 years. The study established that there was a significant association between the level of education of research participants and segregation of household hazardous waste (p<0.05), the study also found that movement of households influences storage of HHW. Finally the size of land occupied by households had a significant association with the storage of HHW. This study recommends that the county government, national government and NGOs should initiate training and awareness creation programmes aimed at increasing knowledge on household hazardous waste in the pastoral population
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    Implementation of Community Led Total Sanitation Program in Kajiado County, Kenya
    (Kenyatta University, 2020-11) Bokea, John Ombongi
    Open defecation refers to defecating in bushes, fields, water bodies and other places that are open. Across the world, approximately 1 billion people are practicing open defecation. This is worse in sub-Saharan Africa where about 215 million people defecate in the open. In Kenya, an estimated 5.6 million people practice defecation in the open. The introduction of Community Led Total Sanitation strategy by the Ministry of Health has not achieved its goal of improved sanitation and hygiene due to poor implementation. The study sought to assess implementation of Community Led Total Sanitation in Kajiado County, Kenya. The specific objectives of this study included determining socio-cultural factors, functional pit-latrine to household ratio, knowledge level and attitude towards community led total sanitation in Kajiado County. The study used a descriptive cross-sectional study design adopting both quantitative and qualitative data collection methods. Quantitative data was collected using semi-structured questionnaires from selected household heads while qualitative data was collected using key informant interview schedules with 8 selected Key Informants. Additional qualitative data was obtained through Focused Group Discussion sessions with selected primary respondents. The study interviewed 303 household heads selected using systematic random sampling with a predetermined interval of 3. Descriptive statistics were calculated using Statistical Package for Social Sciences version 20.0 with the aid of Microsoft Excel program to generate frequency tables, graphs and pie-charts. Qualitative data was analyzed using thematic analysis and results triangulated with quantitative data as direct quotes or narrations. To test the relationship between study variables, Chi-Square tests done at 95% confidence interval (p<0.05) were used. The study results revealed that 27% of respondents had fully implemented community led total sanitation. Socio-cultural factors such as embracing use of latrines (p=0.001), involving community in planning health programs (p=0.023), disposal of child excreta (p=0.001), responsibility for pit-latrine construction and herdsmen using pit-latrines (p=0.032) were significantly associated with implementation of Community Led Total Sanitation. The study results further revealed that 68.3% of respondents had low knowledge levels with 61.0% having negative attitude towards community led total sanitation implementation. Knowledge level (p=0.001) and attitude level (p=0.019) were significantly associated with implementation of community led total sanitation among respondents. The study concludes that the implementation level of community led total sanitation status in Kajiado County was low. This may be due to low knowledge levels and negative attitude towards its implementation. The study generated data on the implementation status of Community Led Total Sanitation in Magadi Ward, Kajiado County. These results would also be of use to the Ministry of Health for purposes of health education and policy formulation towards improved implementation rates of community led total sanitation to increase latrine coverage thus reduced negative health implications as a result of open defecation.
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    Levels of environmental noise and perceived health implications in bus termini in Nairobi Central Business District, Nairobi City County, Kenya
    (Kenyatta University, 2018-07) Kogutu, Nyaranga Caleb
    Environmental noise is noise emanating from all other sources except the industrial workplace, main sources include road, rail and air traffic, industries, construction, public works and social activities. WHO and NEMA provides permissible environmental noise level standard to be 75 and 60 dB (A) respectively. Noise pollution has been linked to many adverse health effects and there is limited documentation to this effect within the CBD termini of Nairobi.The aim of this study was to assess noise levels and it’s perceived health effects across bus termini in Central Business District of Nairobi City. Using a cross-sectional study design and fishers et al (1983) to determine the sample size, a random sample of 422 community members working within nine bus termini for more than 8 hours a day were approached and recruited in the study. Noise levels were measured using Calibrated sound level meter (Model # 8926). A self-administered semi-structured questionnaire was used to collect data to identify perceived health risks of noise and safety practices across bus termini. Univariate Chi-square test of independence was used to test the association between noise levels and reported health implications. The response rate was 94.7% (n= 397). The study revealed that 66.8% of respondents (n=265) had awareness on effects of excessive noise exposure as compared to 33.2% (n=132).This study revealed that a higher proportion of respondents spending more than 3 days a week working at the bus termini visited the doctor for a perceived noise induced hearing problem. As such there was a significant association between the number of days spend working at the bus termini in a week and visiting a doctor for a noise induced hearing problem (χ2=16.52, df=2; p<0.001). In this study, the leading acute perceived health effects of excessive noise were reported to be sleep disturbance at 24.17% (n=152), hearing impairment at 23.05% (n=145), exhaustion at 13.04% (n=82), high blood pressure at 12.72% (n=80) and annoyance at 10.18% (n=64). This study revealed a high concentration of noise levels ranging between 88.14 to115.04dB(A) at Tuskys, St Peters Clavers, Central, Latema and Ronald Ngala bus termini as compared to Ngara and Railways bus termini which reported low concentration of noise levels ranging 85.45 to 93.63dB(A). There was a variation in maximum mean noise levels across the day, in the morning the maximum noise level was 93.65dB recorded at Old Nation Bus Terminus, at midday the maximum noise level was 94.28 dB recorded at Tuskys Bus Terminus while in the evening maximum mean noise level was 118.44 dB as recorded at Moi Lane Bus Terminus. This study revealed a significant association (χ2=27.663; df=8; p<0.001) between a respondent visiting a doctor for a perceived noise induced hearing problem and bus termini in which they are located. Hence a high proportion of respondents who visited the doctor for a perceived noise induced hearing problem were from bus termini that recorded high noise levels. This study revealed that safety practices most likely to be utilized across all occupational groups include; working few hours in the noisy environment (χ2=7.746; df=2; p<0.021); closing windows and doors to eliminate noise (χ2=3.89; df=2; p<0.05) and walking away from noise (χ2=5.29; df=2; p<0.024). However, a higher proportion of respondents across all the occupational groups reported not using personal protective equipment. In conclusion, this study has demonstrated that noise levels in Nairobi are beyond the permissible levels as per NEMA standards 60 dB(A) and WHO ( 75dB(A) standards. Location of bus termini close to each other contributes to the significant generation of noise. Consequently, the authorities should spread out bus termini to reduce high concentration of noise levels at single hotspots in the city. In addition, the public transport routes should be designed in a manner such that they do not terminate at one point in the city.