Background: WHO places health information as a key pillar of an effective health system (HS). HS strengthening has become a key focus of many nations. A paradigm shift from being disease specific focus to holistic strengthening of pillars of a HS. Kenya’s functionality of CbHMIS (community based health information systems)                                 stands at 55% down from 64% in year 2015, majorly contributed to by organization of community health volunteers (CHVs) work. The aim was to establish influence of organizational factors of CHVs on CbHMIS use in Kenya.Methods: A cross-sectional design which employed both quantitative and qualitative approaches was used. Kiambu, Kajiado and Nairobi counties formed the study location. A systematic random sample of 366 respondents was drawn. Multistage sampling was used to identify the community units (CUs). Ethical clearance was obtained from KEMU, ethics and research committee (SERC), national commission for science, technology and innovation (NACOSTI) gave a research permit. 3 FGDs and 6 KIIs were conducted. Quantitative data was analyzed using SPSS version 23 to generate univariate and bivariate analysis at p<0.05 significance level. Qualitative data was analyzed using content analysis. Results were presented in form of graphs, tables, figures and narration.Results: Use of CbHMIS stood at 56.6%. Organizational factor explains 39.9% (R2=0.399) of total variations in the use of CbHMIS. Organizational factors of the CHVs were found to positively and significantly influence use of CbHMIS.Conclusions: Organizational factors influences use of CbHMIS by CHV. Government/partners to build CUs capacity on sustainable resource mobilization strategies.

Background: Data-driven population studies focusing on clinical symptoms and syndromes with the potential to improve diagnostic strategies are rare in Africa. The objective of the study was to determine the prevalence of influenza-like illness (ILI) and gastrointestinal (GI) syndromes in a rural community in western Kenya.Methods: Using a cross-sectional study design, we collected data on self-reported symptoms experienced during the week preceding the study and clustered them into syndromes using case definitions in western Kenya. The study randomly enrolled 92 households and recruited 390 subjects aged between 5 and 83 years. On one hand, reporting at least any four prespecified respiratory-related symptoms attained influenza-like illness (ILI) syndrome while on the other, gastrointestinal (GI) syndrome constituted the reporting of at least any three of prespecified GI system symptoms. Data on individual and household-level independent variables were collected using interviewer-administered questionnaires. Using multivariable logistic regression models, we assessed relationships between the occurrence of these syndromes and the independent variables at a significance level of p≤0.05.Results: Respectively, 27% and 9% of subjects attained ILI and GI syndromes. Twenty-four subjects attained both syndromes. Visiting outside the local sub-county of residence was associated with attaining ILI (OR=2.3, 95% CI 1.4, 3.7) and GI syndromes (OR=3.4, 95% CI 1.6, 6.9). Besides, the absence of active medical insurance was independently associated with attaining GI syndrome (OR=0.12, 95% CI 0.02, 0.94).Conclusions: Study findings suggested the existence of a higher burden of ILI relative to GI syndrome making the study area critical for investigating disease exposures related to visiting outside the study area and the link between medical insurance and ill health occurrence.

Introduction delayed diagnosis of Mycobacterium tuberculosis infection leads to accelerated individual to individual transmission. This study evaluated this aspect of delayed diagnosis among patients visiting Isiolo level four hospital in northern Kenya. Methods this was a cross-sectional cohort study conducted during January, 2018-January, 2019 with systematically sampled 172 tuberculosis (TB) patients. Epidemiological and clinical characteristics were abstracted from records to serve as independent variables. Outcome variable was delayed diagnosis dichotomised into < 21 or > 21 days and treated as a binary outcome. Pre-tested interviewer-administered questionnaires, focused group discussions, and key informant interview guides were used to collect relevant information. Results most (n=89, 57.8%) of the TB diagnosis fell in the category of > 21 day delay. Overall, among all patients, delay in days constituted a median of 27.6, a mean of 37.3 ± 57 days (range 0-414 days). Factors associated with delayed diagnosis (happening > 21 days) included (i) use of dispensary and private health facilities, (OR=4.3, 95% CI: 1.44,13.14; P=0.009) and (OR= 4.9, 95% CI: 1.64, 14.73; P=0.004), respectively (ii) Self-employed individuals (OR=21.7, 95% CI: 2.47,190.93; P=0.006) and employed individuals (OR=9.9, 95% CI: 1.14, 85.80; P=0.038) (iii) secondary-level education (OR=0.03, 95% CI: 0.01,0.21; P=0.000) and tertiary education (OR=0.033, 95% CI: 0.01, 0.23; P=0.001). Conclusion delayed diagnosis of TB was found to be associated with health-seeking behaviour of TB patients, proxied by diagnosis facility, occupation, and education levels in our study area. Curtailment of local transmission of M. tuberculosis needs intensified health promotion and education in affected communities complemented with active case findings.

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Background: Often, long-distance truck drivers' (LDTDs') work predisposes them to sexually transmitted infections (STIs) whose outcomes are influenced by access and behavior of seeking sexual health care. Methodology: In this study, we assessed the utilization of HIV/STI preventive services and associated factors among 296 LDTDs operating along the northern corridor highway using an interviewer-administered questionnaire for data collection at Mlolongo stopover in Machakos, Kenya. Responses for the investigated variables, including condom use, history of HIV testing, frequency of HIV testing, antiretroviral therapy (ART) use and follow-up for the HIV positive and STI treatment, were assigned a score of either 1 or 0 depending on the question's dimension. Following summing up for each participant, we computed a weighted score ranging between 0 and 1 by dividing the summed responses by the number of eligible variables. We arbitrarily multiplied these scores by 8 to generate endpoint scores ranging from one to eight for each participant to help create a dichotomized outcome variable for utilization levels: limited utilization (1 to 4) and good utilization (5 to 8). Association between certain independent variables and the outcome variable (level of utilization of H.I.V./STIs preventive services) was analyzed using binomial logistic regression analysis in R statistical software. Results: The mean age of the LDTDs was 38.4 years, ranging from 24 -57 years. The majority (n = 287, 97%) of the LDTDs had been tested on HIV at least once since the beginning of their career. Only 4.9% of the LDTDs had been tested on HIV within the previous three months. Of the 175 LDTDs who reported a history of STI, most (n = 173, 98.9%