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Insecticide Resistance and Its Intensity in Urban Anopheles Arabiensis in Kisumu City, Western Kenya: Implications for Malaria Control in Urban Areas
(BMJPH, 2024-11) Ndiema, Dalphine Chebet; Abuom, Tom O.; Karia, Matthew
Introduction The complex, multifaceted nature of oropharyngeal dysphagia calls for all health professionals to be aware and involved in its management. Drawing on the WHO’s Interprofessional Collaboration model, this study assessed the implications of health professionals’ awareness and involvement in the management of oropharyngeal dysphagia among inpatients in the acute care facility of a national (level-six) hospital in Kenya. The research questions were (1) what roles do health professionals play in the management of oropharyngeal dysphagia among adult inpatients in the acute care facility of a Kenyan national hospital? (2) what implications do health professionals’ awareness and involvement in oropharyngeal dysphagia management have on the outcomes of inpatients in the acute care facility of a Kenyan national hospital diagnosed with this condition? Methods This study adopted a cross-sectional, descriptive design. Data collection involved semistructured interviews with 15 health professionals handling dysphagia inpatients in the facility. The resulting data were transcribed verbatim, analysed thematically and presented through narrations. Results The analysis revealed that health professionals perform several oropharyngeal dysphagia management roles that fall into two broad complementary categories: those contributing directly to oropharyngeal dysphagia management and those supporting patients with the condition. However, some participants were uncertain of their roles in dysphagia management. The analysis also identified several potential implications of health professionals’ awareness/non-awareness and involvement/non-involvement in oropharyngeal dysphagia management. The implications were grouped into three themes: patient outcomes, professionalism and the healthcare system. Conclusions Increased involvement of all health professionals in the facility in oropharyngeal dysphagia management may result in improved patient outcomes and professionalism. As a recommendation, the hospital’s management should implement programmes emphasising holistic collaboration among health professionals working in its acute care facility to facilitate oropharyngeal dysphagia management and enhance patient outcomes.
Insecticide Resistance and Its Intensity in Urban Anopheles Arabiensis in Kisumu City, Western Kenya: Implications for Malaria Control in Urban Areas
(PLoS ONE, 2024-11) MachaniI, Maxwell G.; Nzioki, Irene; Onyango, Shirley A.; Onyango, Brenda; Githure, John; Atieli, Harrysone; Wang, Chloe; Lee, Ming-Chieh; Githeko, Andrew K.
Background
The rise of insecticide resistance poses a growing challenge to the effectiveness of vector control tools, particularly in rural areas. However, the urban setting has received comparatively less focus despite its significance in attracting rural to urban migration. Unplanned urbanization, often overlooked, exacerbates insecticide resistance as Anopheles mosquitoes adapt to the polluted environments of rapidly expanding cities. This study aimed to assess the insecticide susceptibility status of malaria vectors and identify potential underlying mechanisms across three distinct ecological settings characterized by differing levels of urbanization in Kisumu County, Kenya.
Methods
The study was conducted in 2022–2023 in Kisumu County, western Kenya. Field-derived An. gambiae (s.l.) larvae collected from a long stretch of urban-to-rural continuum were phenotyped as either resistant or susceptible to six different insecticides using the World Health Organization (WHO) susceptibility test. Polymerase chain reaction (PCR) techniques were used to identify the species of the An. gambiae complex and screened for mutations at voltage-gated sodium channels (Vgsc-1014F, Vgsc-1014S, Vgsc-1575Y) and acetylcholinesterase (Ace1) target site mutation 119S. Metabolic enzyme activities (non-specific β-esterases and monooxygenases) were evaluated in mosquitoes not exposed to insecticides using microplate assays. Additionally, during larval sampling, a retrospective questionnaire survey was conducted to determine pesticide usage by the local inhabitants.
Results
Anopheles arabiensis dominated in urban (96.2%) and peri-urban (96.8%) areas, while An. gambiae (s.s.) was abundant in rural settings (82.7%). Urban mosquito populations showed high resistance intensity to deltamethrin (Mortality rate: 85.2% at 10x) and suspected resistance to Pirimiphos-methyl and bendiocarb while peri-urban and rural populations exhibited moderate resistance intensity to deltamethrin (mortality rate >98% at 10x). Preexposure of mosquitoes to a synergist piperonyl butoxide (PBO) significantly increased mortality rates: from 40.7% to 88.5% in urban, 51.9% to 90.3% in peri-urban, and 55.4% to 87.6% in rural populations for deltamethrin, and from 41.4% to 78.8% in urban, 43.7% to 90.7% in peri-urban, and 35% to 84.2% in rural populations for permethrin. In contrast, 100% mortality to chlorfenapyr and clothianidin was observed in all the populations tested. The prevalence of L1014F mutation was notably higher in urban An. arabiensis (0.22) unlike the peri-urban (0.11) and rural (0.14) populations while the L1014S mutation was more prevalent in rural An. gambiae (0.93). Additionally, urban An. arabiensis exhibited elevated levels of mixed function oxidases (0.8/mg protein) and non-specific esterases (2.12/mg protein) compared to peri-urban (0.57/mg protein and 1.5/mg protein, respectively) and rural populations (0.6/mg protein and 1.8/mg protein, respectively). Pyrethroids, apart from their use in public health through LLINs, were being highly used for agricultural purposes across all ecological settings (urban 38%, peri-urban 36% and rural 37%) followed by amidine group, with organophosphates, neonicotinoids and carbamates being of secondary importance.
Conclusion
These findings show high resistance of An. arabiensis to insecticides commonly used for vector control, linked with increased levels of detoxification enzymes. The observed intensity of resistance underscores the pressing issue of insecticide resistance in urban areas, potentially compromising the effectiveness of vector control measures, especially pyrethroid-treated LLINs. Given the species’ unique behavior and ecology compared to An. gambiae, tailored vector control strategies are needed to address this concern in urban settings.
Worklife Balance and Employee Performance in Jomo Kenyatta University of Agriculture and Technology Kiambu County, Kenya
(Journal of Social Sciences Management and Entrepreneurship, 2024-11) Ngugi, Joan Njeri; Muli, Jedidah
Relationship between Utilization of Physical Infrastructure and Students’ Academic Performance in Secondary Schools in Machakos County, Kenya
(IAJSSE, 2024-11) Kamuya, Naomi Mueni; Guantai, Hellen Kiende
In recent years, the performance of public secondary schools in Machakos County, Kenya, has shown signs of concern. Closer examination of the KCSE performance data from 2012 to 2020reveals a fluctuating pattern that warranted investigation. This study aimed at establishing the influence of utilizing physical infrastructure on the students ’academic performance in secondary schools in Machakos County. The study was guided by the following objectives: (i) To establish the influence of the utilization of computer laboratories on the performance of KCSE in secondary schools in Machakos County; (ii) To determine the influence of science laboratory utilization on students’ academic performance in secondary schools in Machakos County;(iii) To establish the influence of library utilization on students’ academic performance in secondary schools in Machakos County. The study was guided by the System Resource Theory by Yutchman and Seashores (1967) and employed a correlational research design. The target population was all 202 public secondary schools in Machakos County. The unit of observation was 43,688respondents comprising 202 principals, 3,030 teachers, and 40,456 students. Simple random sampling technique was employed to select the 20 public secondary schools which represents 10% of the schools. The study used a census to select 20 principals from the 20 schools because the number was very small. For the remaining respondents, 26 teachers and 338 students for the sample of 20 schools, this study used stratified sampling method. Data were collected through interviews with teachers and questionnaires from students. Pilot testing was conducted to identify potential issues or ambiguities in the instrumentsand1allows for necessary modifications. Content validity was ensured through consultation with specialists in education management, and reliability was assessed through a test-retest method. Data analysis was s done using descriptive statistics including mean, standard deviation, frequency, and percentages. Regression analysis was used to test the hypotheses at a significance level of 0.05 and to examine the relationship between one or more independent variables (predictors) and a dependent variable (outcome). This study might help policymakers at the Ministry of Education create a framework for how the money would be distributed to public secondary schools to upgrade infrastructure and increase students' and teachers' access to physical resources. The study found that majority of the secondary school students’ in Machakos County used the computer lab for academic purposes. Moreover, the study found that the science labs were used for experiments with an appropriate duration and frequency, and the science laboratories were available in their school. The study also found that it was uncertain whether the nature and quality of library facilities contributed to a positive learning environment, and the library facilities were user-friendly and promote effective research and study. The study concludes that utilization of science laboratories (β=0.843, p-value=0.025<0.05) had the greatest influence on student academic performance in secondary schools in Machakos County, followed by utilization of library (β=0.774, p-value=0.008<0.05), while utilization of computer laboratories (β=0.632, p-value=0.023<0.05) had the least influence on student academic performance in secondary schools in Machakos County. The study recommends that secondary schools in Machakos County should prioritize investment in upgrading and maintaining computer lab resources to ensure adequacy and functionality.
Dynamics of Ecohydrology, Governance, and Community Livelihoods of Migori River Watershed, Kenya
(Kenyatta University, 2023-06) Balaka, Stephen
This study investigated the dynamics of ecohydrological processes, watershed governance, and livelihood systems of Migori River watershed. The objectives of the study were to; examine the institutional arrangements in the Migori River watershed management and their influence on the nature and level of coordination among the actors, evaluate the impacts of land use and land cover (LULC) changes on the trends of stream flow and sediment yields in Migori River watershed from 1980 – 2020, assess the spatio-seasonal variations of water quality parameters of Migori River and associated household health risk implications in Migori River watershed, and assess the level of sustainability of community livelihoods in the Migori River watershed and its associated vulnerability to climate change impacts. The study adopted a mixed-method approach comprising case and cross-sectional study designs which enabled the collection of both qualitative and quantitative data from different sources. Governance assessment was based on semi-structured interview data qualitatively analyzed through content analysis in ATLAS.ti software. Simulation of hydrological changes due to LULC changes was performed using the Soil and Water Assessment Tool (SWAT) model embedded in QGIS, with analysis of LULC patterns from remote sensing data conducted based on maximum likelihood classifier algorithm. In assessing the water quality trends along with potential health risks, 18 physico-chemical and bacteriological variables were sampled and analyzed monthly for two seasons from six stations using standard procedures, and a health risk survey conducted with 90 households. ANOVA and T-test were used to test for the significant spatial and seasonal variations, respectively; whereas the overall water quality status was analyzed using the CCME water quality index (CCME-WQI). The community livelihoods‘ sustainability level in the watershed and its associated vulnerability to climate change impacts were analyzed using the Livelihood Sustainability Index (LSI) and Livelihood Vulnerability Index (LVI-IPCC), respectively, based on 318 households‘ survey data. The results on the structure and roles of institutions at various levels revealed adequate representation of the river basin management actors within the watershed; but the associations among these actors are weak due to conflicting and overlapping mandates, and gaps in the coordination processes. The watershed has undergone a substantial transformation between 1980 and 2020, with a considerable decline in shrub lands by 40.63%, grasslands by 84.86%, forests by 52.90%, water by 82.03%, and wetlands by 38.44%; whereas cultivated land, bare land and built-up areas have expanded over the same period by 34.25%, 132.28% and 461.20%, respectively. These LULC changes, majorly driven by population pressure and poverty, have contributed to the decline of actual evapotranspiration by 2.83%, potential evapotranspiration by 5.38%, and groundwater flow by 19.06%; and an increase in surface runoff by 32.57%, water yield by 4.82% and sediment by 84.58%. Water quality variables showed significant seasonal variability but no significant spatial differences at p < 0.05; with integrated analysis showing the river is polluted and potentially hazardous for human usage due to high bacteriological levels. The LSI and LVI-IPCC respectively categorized the watershed households as moderately sustainable and moderately vulnerable to climate risks, with no significant differences across the watershed zones (p < 0.05). The study concludes that the changes in land use practices and climate variability has negatively impacted hydrologic flows and has implications for watershed community livelihoods, which the existing governance framework may not effectively manage due to flaws in the institutional structure undermining coordination of stakeholders. The study recommends interventions in the institutional design of the governance system; and implementation of suitable land use zoning, multifaceted pollution control measures and rural development initiatives for enhancing household‘s adaptive capacity to climate change.