scholarly journals Knowledge, attitudes and practices towards spotted fever group rickettsioses and Q fever in Laikipia and Maasai Mara, Kenya

Author(s):  
David Ndeereh ◽  
Gerald Muchemi ◽  
Andrew Thaiyah

Many factors contribute to misdiagnosis and underreporting of infectious zoonotic diseases in most sub-Saharan Africa including limited diagnostic capacity and poor knowledge. We assessed the knowledge, practices and attitudes towards spotted fever group rickettsioses (SFGR) and Q fever amongst local residents in Laikipia and Maasai Mara in Kenya. A semistructured questionnaire was administered to a total of 101 respondents including 51 pastoralists, 17 human health providers, 28 wildlife sector personnel and 5 veterinarians. The pastoralists expressed no knowledge about SFGR and Q fever. About 26.7% of the wildlife sector personnel in Laikipia expressed some knowledge about SFGR and none in Maasai Mara. None of these respondents had knowledge about Q fever. About 45.5 and 33.3% of the health providers in Laikipia and Maasai Mara respectively expressed knowledge about SFGR and 9.1% in Laikipia expressed good knowledge on Q fever and none in Maasai Mara. The diseases are not considered amongst potential causes of febrile illnesses in most medical facilities except in one facility in Laikipia. Majority of pastoralists practiced at least one predisposing activity for transmission of the diseases including consumption of raw milk, attending to parturition and sharing living accommodations with livestock. Education efforts to update knowledge on medical personnel and One-Health collaborations should be undertaken for more effective mitigation of zoonotic disease threats. The local communities should be sensitized through a multidisciplinary approach to avoid practices that can predispose them to the diseases.

Author(s):  
Sruti Pisharody ◽  
Matthew P. Rubach ◽  
Manuela Carugati ◽  
William L. Nicholson ◽  
Jamie L. Perniciaro ◽  
...  

Q fever and spotted fever group rickettsioses (SFGR) are common causes of severe febrile illness in northern Tanzania. Incidence estimates are needed to characterize the disease burden. Using hybrid surveillance—coupling case-finding at two referral hospitals and healthcare utilization data—we estimated the incidences of acute Q fever and SFGR in Moshi, Kilimanjaro, Tanzania, from 2007 to 2008 and from 2012 to 2014. Cases were defined as fever and a four-fold or greater increase in antibody titers of acute and convalescent paired sera according to the indirect immunofluorescence assay of Coxiella burnetii phase II antigen for acute Q fever and Rickettsia conorii (2007–2008) or Rickettsia africae (2012–2014) antigens for SFGR. Healthcare utilization data were used to adjust for underascertainment of cases by sentinel surveillance. For 2007 to 2008, among 589 febrile participants, 16 (4.7%) of 344 and 27 (8.8%) of 307 participants with paired serology had Q fever and SFGR, respectively. Adjusted annual incidence estimates of Q fever and SFGR were 80 (uncertainty range, 20–454) and 147 (uncertainty range, 52–645) per 100,000 persons, respectively. For 2012 to 2014, among 1,114 febrile participants, 52 (8.1%) and 57 (8.9%) of 641 participants with paired serology had Q fever and SFGR, respectively. Adjusted annual incidence estimates of Q fever and SFGR were 56 (uncertainty range, 24–163) and 75 (uncertainty range, 34–176) per 100,000 persons, respectively. We found substantial incidences of acute Q fever and SFGR in northern Tanzania during both study periods. To our knowledge, these are the first incidence estimates of either disease in sub-Saharan Africa. Our findings suggest that control measures for these infections warrant consideration.


2017 ◽  
Vol 84 (1) ◽  
Author(s):  
David Ndeereh ◽  
Andrew Thaiyah ◽  
Gerald Muchemi ◽  
Antoinette A. Miyunga

Spotted fever group rickettsioses are a group of tick-borne zoonotic diseases caused by intracellular bacteria of the genus Rickettsia. The diseases are widely reported amongst international travellers returning from most sub-Saharan Africa with fever, yet their importance in local populations largely remains unknown. Although this has started to change and recently there have been increasing reports of the diseases in livestock, ticks and humans in Kenya, they have not been investigated in wildlife. We examined the presence, prevalence and species of Rickettsia present in wildlife in two regions of Kenya with a unique human–wildlife–livestock interface. For this purpose, 79 wild animals in Laikipia County and 73 in Maasai Mara National Reserve were sampled. DNA extracted from blood was tested using the polymerase chain reaction (PCR) to amplify the intergenic spacer rpmE-tRNAfMet and the citrate synthase-encoding gene gltA. Rickettsial DNA was detected in 2 of the 79 (2.5%) animals in Laikipia and 4 of the 73 (5.5%) in Maasai Mara. The PCR-positive amplicons of the gltA gene were sequenced to determine the detected Rickettsia species. This revealed Rickettsia sibirica in a Topi (Damaliscus lunatus ssp. jimela). This is the first report of spotted fever group rickettsioses in wildlife and the first to report R. sibirica in Kenya. The finding demonstrates the potential role of wild animals in the circulation of the diseases.


Author(s):  
Patience B. Tetteh-Quarcoo ◽  
Nicholas T. K. D. Dayie ◽  
Kevin Kofi Adutwum-Ofosu ◽  
John Ahenkorah ◽  
Emmanuel Afutu ◽  
...  

Background: Malaria is still endemic in sub-Saharan Africa, with a high disease burden. Misconceptions about malaria contribute to poor attitudes and practices, further increasing the burden in endemic countries. Studies have examined the knowledge, attitudes, and practices (KAP) of malaria among different populations. However, there seems to be no available literature reporting on the perspectives of day and night market traders. To the best of our knowledge, this is the first report on malaria KAP with a focus on day and night market traders. Methods: A descriptive cross-sectional study involving day and night market traders in 10 selected markets within the Greater Accra Region of Ghana was carried out. Data were collected from consenting respondents using a structured questionnaire. Results: Of the 760 respondents (33.3% (n = 253) night and 66.7% (n = 507) day traders) interviewed, there was no significant difference between the day and night market traders in terms of malaria KAP. Although the market traders had an overall moderate knowledge (54.0% of the day traders and 56.5% of the night traders), misconceptions about malaria (especially that it could be caused by exposure to the sun) still existed among the traders. Moreover, the majority of the traders who demonstrated high knowledge (43.98%, n = 250) did not always take laboratory tests to confirm their suspicion, indicating poor attitude. Furthermore, the market traders’ choice of drug for malaria treatment (p = 0.001) and preferred malaria treatment type (orthodox or herbal) (p = 0.005) were significantly associated with their knowledge level. Conclusions: Despite the observation that no significant difference in KAP exists between day and night market traders, appropriate health education programs and interventions still need to be directed at misconceptions, poor attitudes, and poor practices revealed by this study. This will ultimately help in the prevention and control of malaria in Ghana, and globally.


Author(s):  
Lisa Sun ◽  
Michael V. Johnston

Tick-borne rickettsioses are emerging as more important health problems throughout the world. The spotted fever group including Rickettsia rickettsia can cause encephalopathy, meningitis and brain damage by selectively targeting capillary endothelial cells in the brain, and stimulating inflammation, capillary leakage, hemorrhage, and intravascular coagulation. Rickettsia are are arthropod-borne gram-negative coccobacilli bacteria and are obligate intracellular organisms that do not survive in artificial medium. In North and South America, the most common rickettsial disorder is rocky mountain spotted fever (RMSF) transmitted by the dog tick Dermacentor variabilis or the wood tick Dermacentor andersoni. A characteristic “starry sky” pattern can be seen on MRI imaging of the brain in some patients with RMSF encephalopathy and is thought to reflect the organisms targeting of brain endothelial cells in capillaries the white matter. Early treatment with doxycycline is curative and reverses signs of encephalopathy if given within a few day of onset, but delayed treatment can be associated with permanent neurological disability. The typhus group of rickettsia bacteria include R. prowazekii, which causes epidemic typhus and R. typhi, which causes murine typhus (endemic) typhus in tropical and subtropical parts of the world. Flying squirrels and humans carry R prowazekii and rats are carry R. typhi. Q fever caused by the rickettsia organism Coxiella burnetti is transmitted from farm animals including sheep and is seen throughout the world including the United States.


2021 ◽  
Author(s):  
Adamu Muhammad Hamid ◽  
Godwin Matthew Sule

The interest of health communication scholars hover on relationships between HIV/AIDS message exposure and HIV knowledge, attitude and practice as the epidemic is no longer seen as only a health issue; its ramifications cover all aspects of society from economic, social structures to psychological makeup of communities. The media, under normal condition are expected to complement governments’ efforts in achieving set objectives on such important issues as combating HIV/AIDS through the creation of awareness, mobilization and advocacy among other things, such as contained in the cardinal tenets of Development Media Theory. This is more so given that the only remedy to the epidemic is prevention through advocacy on the promotion of safe practices. Mass media play a central role in this direction. Exposure to HIV/AIDS messages especially on the mass media among adolescents in sub Saharan Africa has been reported as abysmal in the early 2000s, but now given growth in infrastructure and development in technology and program appeal, there emerges a need for reassessment. Given that communication particularly through the media is considered a major preventive strategy, this chapter set out to highlight a compressive review of scholarly works on HIV/AIDS media exposure, knowledge, attitudes and practices (KAP) across regions of the world, since the 80s. It is however concluded that the study of media use and HIV/AIDS KAP leaves much to be explored conceptually, methodologically and empirically.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Petmore Zibako ◽  
Mbuzeleni Hlongwa ◽  
Nomsa Tsikai ◽  
Sarah Manyame ◽  
Themba G. Ginindza

Abstract Background Cancer is a non-communicable disease and is the number 2 leading cause of death globally. Among all cancers, cervical cancer is the number 1 killer of women in low-income countries (LICs). Cervical cancer is a well understood preventable cancer. The rates of cervical cancer are very varied and inversely proportional to the effectiveness of disease management policies. Management of cervical cancer includes prevention, screening, diagnosis and treatment. The main objective of this scoping review is to map the evidence on cervical cancer management in sub-Saharan Africa (SSA) to understand the coverage of cervical cancer prevention and treatment services and provide an opportunity to generate knowledge on the risk factors, attitudes and practices extendable globally. Methods and analysis This review will be guided by Arksey and O’Malley’s framework recommended for conducting scoping review studies. The Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews (PRISMA-Scr) checklist will also be completed to ensure that the review adheres to the sound methodological rigour acceptable for scoping review studies. The following electronic databases will be searched for potentially eligible articles: PubMed, Ebsco Host, Scopus and Cochrane Database of Systematic Reviews. Study screening procedures recommended by Higgins and Deeks will be followed. A narrative synthesis will be used, with data synthesised and interpreted using sifting, charting and sorting based on themes and key issues. Discussion Cervical cancer can become a disease of the past with a proper control strategy in place. It is therefore imperative to map available evidence on the management of cervical cancer to inform policy and advocacy action. More knowledge on the status quo will guide policymakers in ensuring cancer management guiding policies are formulated/updated/revised accordingly. Systematic review registration Not registered with PROSPERO (not needed). Protocol and registration This scoping review was not registered.


2020 ◽  
Vol 117 (12) ◽  
pp. 6300-6307 ◽  
Author(s):  
Scott Barrett ◽  
Aisha Dasgupta ◽  
Partha Dasgupta ◽  
W. Neil Adger ◽  
John Anderies ◽  
...  

We consider two aspects of the human enterprise that profoundly affect the global environment: population and consumption. We show that fertility and consumption behavior harbor a class of externalities that have not been much noted in the literature. Both are driven in part by attitudes and preferences that are not egoistic but socially embedded; that is, each household’s decisions are influenced by the decisions made by others. In a famous paper, Garrett Hardin [G. Hardin,Science162, 1243–1248 (1968)] drew attention to overpopulation and concluded that the solution lay in people “abandoning the freedom to breed.” That human attitudes and practices are socially embedded suggests that it is possible for people to reduce their fertility rates and consumption demands without experiencing a loss in wellbeing. We focus on fertility in sub-Saharan Africa and consumption in the rich world and argue that bottom-up social mechanisms rather than top-down government interventions are better placed to bring about those ecologically desirable changes.


2020 ◽  
Vol 6 (Supplement_1) ◽  
pp. 42-42
Author(s):  
Anna Gillespie ◽  
Yadurshini Raveendran ◽  
Dafrosa Monko ◽  
Robert Gisiri ◽  
Kristin Schroeder

PURPOSE More than 30% of children in sub-Saharan Africa are malnourished at baseline. Patients with cancer become further malnourished by metabolically active tumors and starvation during extended hospital stays when parents cannot afford food. If cancer outcomes could be improved by optimizing nutrition, then this would provide a cost-effective intervention for future implementation and research. The current study targeted caregiver nutrition knowledge, attitudes, and practices to develop educational materials for children who are diagnosed with cancer at Bugando Medical Centre in Mwanza, Tanzania. METHODS A quantitative survey developed using UN Food and Agriculture guidelines was used to assess the knowledge, attitudes, and practices of nutrition among caregivers of children with cancer presenting from June to August 2019. On the basis of responses, targeted education materials—A2 posters, A4 posters, and 50 pamphlets—were developed in collaboration with a local nutritionist to address gaps in caregiver nutrition knowledge. RESULTS A total of 36 caregivers and 21 stakeholders completed surveys. The majority of caregivers reported food insecurity (94%) and limited knowledge on nutrition (92%). Identified key knowledge gaps included appropriate food selection, understanding of macronutrients, and food safety. Specific media—posters and pamphlets—were designed to be simple and targeted for specific symptoms, as well as to encourage positive eating habits among patients and families. CONCLUSION This study developed a targeted intervention to improve nutrition knowledge for caregivers of children with cancer. The multiple media sources created can be used alongside verbal education sessions by nutritionists to increase exposure and the likelihood of retention and application. Although this was developed at a single institution, the media created targeted consensus nutrition information for children with cancer and is mostly pictorial, so it can be used regardless of literacy or language. Implementation evaluation is ongoing, with plans to share these materials with pediatric cancer centers throughout Tanzania and sub-Saharan Africa.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Joseph O. Yaria ◽  
Adesola Ogunniyi

Background. Burden of epilepsy in sub-Saharan Africa is huge in the midst of shortage of human resource in its health sector. Using skilled staff to supervise and support lower level healthcare workers providing frontline primary healthcare is a pragmatic coping solution. But, lower level health providers face enormous challenges due to absent clinical algorithms or pragmatic rapid diagnostic tests. Objective. This study aimed to determine if the use of an epilepsy questionnaire in a traditional clinical setting would improve semiological details obtained and diagnostic accuracy. Methods. A prospective study was conducted involving patients diagnosed with epilepsy each with an eye witness who had regularly witnessed the seizures. Routine seizure history from clinical documentation and an interviewer-based questionnaire were compared. The data obtained were assessed for content, accuracy, intermethod and test-retest reliability. Results. Sixty-seven patients with a median age of 24 years were recruited. Routine seizure history had obtained less semiological details with inadequate description of nonmotor manifestations and lateralizing motor details. The questionnaire-obtained history showed higher accuracy for generalized onset seizure (0.83 vs. 0.56) and focal onset seizures (0.79 vs. 0.59). The questionnaire-obtained history also had good test-retest reliability for various semiological domains except automatisms. Conclusions. Routine seizure histories are not standardized. The use of a questionnaire goes a long way in improving semiology description in a low-resource setting and guides the health provider on what details to focus on. The use of epilepsy questionnaires should, therefore, be considered to improve semiology, especially in nonspecialist settings.


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