Abstract. In 2008, a cholera outbreak with unusually high mortality occurred in western Kenya during civil unrest after disputed presidential elections. Through active case finding, we found a 200% increase in fatal cases and a 37% increase in surviving cases over passively reported cases; the case-fatality ratio increased from 5.5% to 11.4%. In conditional logistic regression of a matched case-control study of fatal versus non-fatal cholera infection, home antibiotic treatment (odds ratio [OR] 0.049; 95% CI: < 0.001-0.43), hospitalization (OR, 0.066; 95% CI, 0.001-0.54), treatment in government-operated health facilities (OR, 0.15; 95% CI, 0.015-0.73), and receiving education about cholera by health workers (OR, 0.19; 95% CI, 0.018-0.96) were protective against death. Among 13 hospitalized fatal cases, chart review showed inadequate intravenous and oral hydration and substantial staff and supply shortages at the time of admission. Cholera mortality was under-reported and very high, in part because of factors exacerbated by widespread post-election violence.

Background: Coronavirus is a major public health crisis that has adverse consequences on health systems globally. Considering the key role that mothers play in their children's life, their knowledge and practice regarding the protection against COVID-19 is paramount in mitigating its spread. The study aims to identify mothers' precautions for their children's protection from COVID-19 pandemic. Setting:The study was conducted in the Pediatric Outpatient Clinic, Shoe for Africa Children Hospital at Moi Teaching and Referral Hospital in Eldoret, Kenya. Subjects: A convenient sample of 400 mothers having children from birth to 12 years were included in the study. Tool: One tool named Mothers' Precautions for Their Children's protection from COVID-19 Pandemic Interview Schedule was used for data collection. Results: Cleaning and disinfection of surface areas were the most precaution measures used by mothers (65.55±32.45) followed by personal protective equipment (61.38±18.96). However, adequate rest and sleep as well as types and elements of nutrition were the least category of protective measures used by them (18.06±4.62 and 28.84±9.13). Conclusion: It was concluded from this study that mothers were highly caring for their children's protection from COVID-19 pandemic through cleaning and disinfection of surface areas precaution measures followed by the use of personal protective equipment, physical activity and hygienic measures. While, they were caring least regarding adequate rest and sleep, nutrition, adherence to social distancing and proper indoor ventilation. Recommendations: Governmental and non-governmental organizations efforts should be integrated to enhance the awareness of the mothers regarding the preventive measures for protection from COVID-19 pandemic.

(1) Background: Emergencies confront civilian and military healthcare providers with medical and hygienic challenges due to the lack of potable water. This pilot study aimed to describe the application of two different methods for microbiological monitoring of water in a harsh environment in terms of performance, ease of use, availability, and the possibility of using the results to evaluate water quality. (2) Methods: Samples from raw water, Potable water, and water for consumers were taken from two different camps with the same raw water source. The samples were analyzed by using IDEXX industry-standard methods (Colilert and Enterolert enzymatic test kits) and a combination of membrane filtration and 3M-Petrifilm. (3) Results: The IDEXX method used at the Norwegian Camp are easier to utilize and has a broader range of analyzing kits for drinking water analysis. In addition, IDEXX is better adapted to the requirements of the national legislation. However, the combination of membrane filtration followed by incubation on 3M-Petrifilm &trade;, as used at the Swedish camp, is a better field alternative compared to traditional bacteriology, as it eliminates the need to produce and store agar plates. (4) Conclusions: This pilot study highlights the need for adapted technical equipment and tools for internal microbiological control of water production in a harsh field environment and may facilitate the use of a relatively simple method for water control and ensure the safety of deployed staff in both civilian and military settings.

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