We sought to determine the knowledge and attitude of public health workers (PHWs) with respect to emerging and re-emerging zoonotic diseases and the practice of one health approach in the surveillance of zoonoses in the community. A cross-sectional study was conducted in 12 randomly selected districts of Nyanza province, Kenya. One hundred and ten randomly-selected PHWs were assessed using a structured questionnaire. Data were collected on their knowledge, attitudes and practices about common zoonotic diseases. Eighty-nine (81%) questionnaires were received back. Eighty-seven (98%) said they discuss zoonotic diseases with the local villagers during their community health work. The most commonly discussed disease was rabies (n=39). Seventy-six (85%) respondents reported ever discussing zoonoses with their veterinary colleagues. Over 85% of the PHWs asked for refresher training on H1N1, and 51% require training on highly pathogenic avian influenza (H5N1). Despite fair knowledge of rabies among the PHWs in Nyanza province, there is need for improving their attitude of the emerging and reemerging zoonoses. There is also need to improve their practice in terms of collaboration with the veterinarians in zoonoses surveillance in the community.
Background.Lead exposure is linked to intellectual disability and anemia in children. The United States Centers for Disease Control and Prevention (CDC) recommends biomonitoring of blood lead levels (BLLs) in children with BLL ≥5 μg/dL and chelation therapy for those with BLL ≥45 μg/dL.Objectives.This study aimed to determine blood and environmental lead levels and risk factors associated with elevated BLL among children from Owino Uhuru and Bangladesh settlements in Mombasa County, Kenya.Methods.The present study is a population-based, cross-sectional study of children aged 12–59 months randomly selected from households in two neighboring settlements, Owino Uhuru, which has a lead smelter, and Bangladesh settlement (no smelter). Structured questionnaires were administered to parents and 1–3 ml venous blood drawn from each child was tested for lead using a LeadCare ® II portable analyzer. Environmental samples collected from half of the sampled households were tested for lead using graphite furnace atomic absorption spectroscopy.Results:We enrolled 130 children, 65 from each settlement. Fifty-nine (45%) were males and the median age was 39 months (interquartile range (IQR): 30–52 months). BLLs ranged from 1 μg/dL to 31 μg/dL, with 45 (69%) children from Owino Uhuru and 18 (28%) children from Bangladesh settlement with BLLs >5 μg/dL. For Owino Uhuru, the geometric mean BLL in children was 7.4 μg/dL (geometric standard deviation (GSD); 1.9) compared to 3.7 μg/dL (GSD: 1.9) in Bangladesh settlement (p<0.05). The geometric mean lead concentration of soil samples from Owino Uhuru was 146.5 mg/Kg (GSD: 5.2) and 11.5 mg/Kg (GSD: 3.9) (p<0.001) in Bangladesh settlement. Children who resided <200 m from the lead smelter were more likely to have a BLL ≥5 μg/dL than children residing ≥200 m from the lead smelter (adjusted odds ratio (aOR): 33.6 (95% confidence interval (CI): 7.4–153.3). Males were also more likely than females to have a BLL ≥5 μg/dL (39, 62%) compared to a BLL<5 μg/dL [aOR: 2.4 (95% CI: 1.0–5.5)].Conclusions.Children in Owino Uhuru had significantly higher BLLs compared with children in Bangladesh settlement. Interventions to diminish continued exposure to lead in the settlement should be undertaken. Continued monitoring of levels in children with detectable levels can evaluate whether interventions to reduce exposure are effective.Participant Consent.ObtainedEthics Approval.Scientific approval for the study was obtained from the Ministry of Health, lead poisoning technical working group. Since this investigation was considered a public health response of immediate concern, expedited ethical approval was obtained from the Kenya Medical Research Institute and further approval from the Mombasa County Department of Health Services. The investigation was considered a non-research public health response activity by the CDC.Competing Interests.The authors declare no competing financial interests.
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