Although early diagnosis and treatment are key factors in the effective control of human African trypanosomiasis (HAT), many cases of the disease delay taking appropriate action, leading to untold suffering. As a better understanding of treatment-seeking behaviour should help in identifying the obstacles to early diagnosis and effective treatment, the treatment pathways followed by 203 former HAT cases in western Kenya and eastern Uganda have recently been explored. About 86% of the HAT cases had utilized more than two different healthcare options before being correctly diagnosed for HAT, with about 70% each using more than three different health facilities. Only about 8% of the cases reported that they had been correctly diagnosed the first time they sought treatment. Just over half (51%) of the HAT cases had been symptomatic for >2 months before being correctly diagnosed for HAT, and such time lags in diagnosis contributed to 72% of the cases receiving their first appropriate treatment only in the late stage of the disease. The likelihood of a correct diagnosis increased with the time the case had been symptomatic. These observations indicate an urgent need to build the diagnostic capacity of the primary healthcare facilities in the study area, so that all HAT cases can be identified and treated in the early stage of the disease.
This paper focused on the early warning signs of climate variation as indicated by the Borana community of Isiolo County, Kenya. The objective of the study was to determine the indigenous early warning signs used by the Borana to predict the onset of rainfall, floods and droughts and their efficacy. The study was guided by cultural ecological theory, and data was collected through secondary sources, semi-structured interviews, focus group discussions and direct observation. The findings revealed that the Borana had many indigenous early warning signs to predict different weather changes. These included the behaviour of animals and birds, presence of insects, clouds, the colour of the intestines of slaughtered domestic animals, interpreting dreams, flowering of plants and the pattern of stars. The study also indicated that the indigenous early warning signs have been reliable since time immemorial; however, the increasing severity and frequency of drought over the last decade has rendered indigenous forecasting less reliable than it has been in the past. Early warning of weather changes is very important as it helps the community to apply the most appropriate coping strategy when faced with certain natural calamities. This study recommends a combination of the existing indigenous early warning indicators with modern forecasting methods, to make them more appropriate.
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