Category Archives: Health

Why viral diseases remain a big threat


KAKAMEGA

Aug 16th 2012

By Chris Mahandara.

Zoonotic illnesses, also known as zoonoses, are sicknesses caused by
germs, that are passed between or shared by animals and humans.

Some examples of these diseases are avian influenza, West Nile virus,
Lyme disease, rabies, cryptosporidiosis, plague and Rocky Mountain
spotted fever.

Caused by bacteria, viruses, protozoa, fungi, worms, or insects, most
of these diseases are very common and some are a serious problem all
over the world.

Overpopulation, moving from place to place, people traveling around
the world, continued expansion of people into places where nobody
lives, natural disasters like hurricanes, earthquakes, and other
factors all play a role in how different zoonotic diseases affect
human beings, animals and the ecosystem.

Apart from killing human beings, these diseases are now a threat to
the multibillion livestock industry.

In Kenya for example, the poultry industry was dealt a major blow
following a fear of the outbreak of avian influenza which was reported
in Juba, South Sudan.

Even though no case was reported in the country, the reality that
Avian Flu had reached Africa and a neighbouring country so many
Kenyans stopped eating chicken. As a result, the industry lost in
excess of Sh. 3 billion between 2005 and 2006.
Since then no bird flu has been detected in wild birds or domestic
poultry in Kenya but according to experts the country is still at
risk.
Avian influenza is an infection caused by avian (bird) influenza (flu)
A viruses. These influenza A viruses occur naturally among birds.
However, avian influenza is very contagious among birds and some of
these viruses can make certain domesticated bird species, including
chickens, ducks, and turkeys, very sick and kill them.
Infected birds can shed influenza virus in their saliva, nasal
secretions and feaces. Susceptible birds become infected when they
have contact with contaminated secretions or excretions or with
surfaces that are contaminated with secretions or excretions from
infected birds.
Domesticated birds may become infected with avian influenza virus
through direct contact with infected waterfowl or other infected
poultry, or through contact with surfaces (such as dirt or cages) or
materials (such as water or feed) that have been contaminated with the
virus.
Infection with avian influenza viruses in domestic poultry causes two
main forms of disease that are distinguished by low and high extremes
of virulence.
The “low pathogenic” form may go undetected and usually causes only
mild symptoms (such as ruffled feathers and a drop in egg production).
However, the highly pathogenic form spreads more rapidly through
flocks of poultry. This form may cause disease that affects multiple
internal organs and has a mortality rate that can reach 90-100% often
within 48 hours.
Most cases of avian influenza infection in humans have resulted from
contact with infected poultry (e.g., domesticated chicken, ducks, and
turkeys) or surfaces contaminated with secretion/excretions from
infected birds.
During an outbreak of avian influenza among poultry, there is a
possible risk of infection for people who have contact with infected
birds or surfaces that have been contaminated with secretions or
excretions from infected birds.
Symptoms of avian influenza in humans have ranged from typical human
influenza-like symptoms like fever, cough, sore throat, muscle aches
to eye infections to pneumonia, severe respiratory diseases such as
acute respiratory distress and other severe and life-threatening
complications. The symptoms may depend on which virus caused the
infection.
Highly pathogenic Influenza A (H5N1) virus is an influenza A virus
that occurs mainly in birds, is highly contagious among birds, and can
be deadly to them, especially domestic poultry.
H5N1 virus does not usually infect people, but infections with these
viruses have occurred in humans. Most of these cases have resulted
from people having direct or close contact with H5N1-infected poultry
or H5N1-contaminated surfaces.
Of the few avian influenza viruses that have crossed the species
barrier to infect humans, H5N1 has caused the largest number of
detected cases of severe disease and death in humans.
However, it is possible that those cases in the most severely ill
people are more likely to be diagnosed and reported, while milder
cases are less likely to be detected and reported.
Of the human cases associated with the ongoing H5N1 outbreaks in
poultry and wild birds in Asia and parts of Europe, the Near East and
Africa, about 60% of those people reported infected with the virus
have died.
Most cases have occurred in previously healthy children and young
adults and have resulted from direct or close contact with
H5N1-infected poultry or H5N1-contaminated surfaces.

In general, H5N1 virus does not infect humans easily, and if a person
is infected, it is very difficult for the virus to spread to another
person.

So far in Africa the avian flu has been reported in 12 countries among
them Egypt, Nigeria, Ivory Coast and South Sudan.

The most recent case in Africa was in Egypt where one person died on
June 22, 2011. Of the 150 cases confirmed to date in Egypt, 52 have
been fatal.

Attention to Kenya has therefore come because of its position on major
migratory paths. Migratory birds fly from Europe through Kenya to
South Africa meaning the disease might be introduced by the birds
coming from areas where bird flu outbreaks have been confirmed.

Senior Assistant Director of Veterinary Services in the Ministry of
Livestock Dr. Michael Cheruyiot says avian flu is transmitted mainly
by water birds and since Kenya is endowed with water bodies and river
Nile which flows from Lake Victoria to Egypt where the disease is
endemic, the country is at risk.

Dr. Michael Cheruyiot, who is the National Avian Influenza coordinator
adds that the fact that Kenya is a business hub for East and Central
Africa, a lot of people and poultry products are likely to come in and
out exposing the country to risk.

Another risk factor according to Dr. Cheruyiot is our poultry
production system. Out of the 31.5 million poultry in the country, 70%
of them are indigenous. These birds are left to scavenge for food and
sleep in the same houses with human beings or houses that are not
hygienic thus predisposing them to the flu.

“Our cultural practices where chicken is a delicacy, we give it out as
a gifts, use it to perform rites and also travel with the birds in our
vehicles is also a predisposing factor,” says Dr. Cheruyiot.

As a result, he says the government has set up an extensive disease
surveillance system to detect any disease outbreak early if it is
introduced and has measures in place to contain the disease if it
comes in.

The government has established a national multi-sectoral task force on
avian influenza co-chaired by three directors, the Director of Public
health and Sanitation, the Director of Veterinary Services and the
Director of the National Disaster Operations Center.

It comprises of members from across the board among them research
institutions, universities, Non Governmental Organizations, religious
organizations, the disciplined forces and other stakeholders.

The task force has six sub committees, coordination and resource
mobilization, laboratory and disease diagnosis, information and
education, disease control, surveillance and case management each
given key responsibilities in prevention and the fight against the
pandemic.

Since the establishment of the task force, the government has banned
the importation of poultry and poultry products at the same time
increased surveillance of both domestic and wild birds so that any
diseased birds can be tested.

In addition, farmers have been educated on safe ways of transporting
poultry, maintaining high standards of hygiene and cooking well
inspected poultry meat.

Dr. Cheruyiot adds that Poultry slaughter houses have been constructed
across the country, where veterinary officers inspect the meat before
it is sold to the public.

Surveillance at border entry points of Moyale, Busia, Malaba, Namanga,
Lunga Lunga and Lokichogio and also all international airports and the
port of Mombasa has been enhance to enforce the ban on importation of
poultry products in the country.

In an exclusive interview with Kakamegatimes, Dr. Cheruyiot said such meetings were necessary to enhance
the capacity of stakeholders to handle the pandemic whenever it
occurs.

The government, he said has strengthened the laboratory diagnostic
capacity at Kabete and the Kenya Medical Research Institute for quick
diagnosis.

Furthermore, medicine has been procured and medical personnel have
been trained to prepare them to detect, contain and manage an outbreak
of the disease.

Dr. Cheruyiot confirmed that influenza surveillance in humans is
ongoing and that plans for isolation of patients, treatment and
referral guidelines have been finalized.

He says that the government has made the disease notifiable, adding
that the media has also been trained to report objectively on the
issue.

Dr. Cheruyiot asked Kenyans not to panic. He assured the public that
the disease has not been reported in the country adding that stringent
measures have been put in place to deal with the disease if it occurs.

Government urged to equip Kakamega Provincial General Hospital


KAKAMEGA      Thursday, Feb 22nd , 2012

By Chris Mahandara.

Kakamega Provincial General Hospital, the only referral facility in Western Province is ill equipped to handle sophisticated medical conditions.

Dr. Jacob Maleche of Kakamega Highway Hospital said patients referred to the hospital are forced to be transferred to Eldoret and Kisumu.

As a result, majority of them die on the way while others are forced to wait for days before they are attended to.

Speaking to Kakamegatimes today, Dr. Maleche urged the government to purchase a CT scan machine and construct a High Dependency Unit (HDU) and an Intensive Care Unit (ICU) at the provincial hospital.

The facilities, he said were necessary to enhance access to quality medical care to the over five million people in the region.

Dr. Maleche said it was unfortunate for a hospital that is near the busy Kisumu Kakamega highway which is prone to road accidents to lack such basic facilities.

“A CT scan machine costs Sh. 83 million making us wonder why it has taken long for the government to purchase one for the hospital,” he said.

In an interview with Kakamegatimes, Shinyalu Member of Parliament (MP) Mr. Kizito Mugali said poor leadership in the area was to blame.

The MP said instead of leaders from the region sitting together and mapping out development initiatives, they were busy fighting each other pushing development to the periphery.

He pledged to set aside Sh. 10 million from Shinyalu Constituency CDF kitty to go towards the purchase of the CT scan machine for the hospital.

The legislator urged other MPs from the region to chip in at the same time work as a team to push the government to equip the hospital with state of the art equipment.

Housing Minister Soita Shitanda said he will schedule a meeting with President Mwai Kibaki soon to discuss the issue.

The only hospitals with the facilities near the region are Kisumu Provincial General Hospital, Eldoret General Hospital, Moi Teaching and Referral Hospital Eldoret and Nakuru Provincial General Hospital which is 250 km away.

Water Service Resumes


 

Lugari

November 29,2011              By Kakamegatimes

 

After going for two weeks without piped water, residents of Lumakanda trading centre can now enjoy this vital commodity again.

This was after the Water Resource Management Authority (WRMA) reconnected the centre’s main water supply pump last Friday, which it had disconnected two weeks ago over unpaid water bills.

Speaking to the media today, Lugari District Water Officer, Mr. Ernest Odwori, has confirmed that WRMA restored water distribution services within Lumakanda centre (the headquarters for Lugari district) and its neighbourhood following an agreement between the organization and Engineer David Stower, Permanent Secretary, Ministry of Water.

Mr. Odwori disclosed that Stower had written to WRMA officials asking them to reconnect all water schemes that had been disconnected countrywide, while his office worked on logistics for eventual settlement of the bills.

Accompanied by their chairperson, Mr. Francis Nyenye, WRMA officials from Nairobi led by their Chief Executive Office, Engineer Philip Olum, disconnected water services at Lugari district headquarter a fortnight ago due to Sh 700,000 water bills in arrears owed to it by the district’s water department.

The move adversely disrupted water services in the area, with Lumakanda district hospital being the worst hit.

Reacting on the two weeks of water shortage, Lugari District Public Health Officer, Mr. Festus Anaya, appealed to WRMA officers asking them to always serve relevant authorities with a two week notice when they have intentions of closing taps in order to enable key institutions like hospitals prepare themselves adequately in advance.

Respiratory infections increase


KAKAMEGA

Sunday,Sep 11, 2011

By Kakamegatimes correspondent

The number of outpatients treated for respiratory infections this cold season has sharply risen at Kakamega Provincial Hospital.
Statistics show that 1,882 more patients received treatment at the facility that admitted only 3,399 patients last season, causing a great concern among health practitioners.
Dr. Mike Ruto, speaking to Kakamegatimes on behalf of the medical superintendent, termed the phenomenon a threat to the public as the infections may easily lead to viral or bacterial infections.
Among the most common respiratory infections, according to Ruto, are Asthma, Pneumonia and Common cold that he said infected infants below the age of five whose immunity was still not developed. Others are tuberculosis and pharyngitis.
Among adults, Dr Ruto said exposure to diseases over time weakened their immune systems and thus predisposed them to respiratory infections. Adults aged 55 and over were most affected.
Ignorance equally contributed to the upsurge as it emerged that overcrowding in less ventilated places led to the rise. Patients also admitted they did not keep themselves warm most of the time.
The cold season begun in July and has remained unchanged to date with irregular pattern of showers characterizing the weather.
Asthma is an allergic condition that is characterized by wheezing and difficulty in breathing. It frequently attacks minors than adults and affects men more than women. It may be precipitated by respiratory infections, psychological factors such as anxiety and depression and allergy.
Pharyngitis and Pneumonia inflame both the pharynx and lungs respectively with the later affecting children more than adults. The symptoms of pneumonia include fever, coughing and chest pains.
Ruto advised the public to keep warm during the season and ensure that they stay in well ventilated places, even while traveling in public transport vehicles.

World Blood Donor Day marked as countries struggle to meet the demand for blood


KAKAMEGA    Saturday August 20, 2011

By Chris Mahandara.

On 14 June 2011, countries worldwide celebrated World Blood Donor Day with events to raise awareness on the need for safe blood and blood products and to thank voluntary unpaid blood donors for their life-saving gifts of blood.

The theme for this year’s World Blood Donor Day 2011 “More blood. More life.” reinforced the urgent need for more people all over the world to become life-savers by volunteering to donate blood regularly.

Every year, countries throughout the world organize a huge variety of events and activities to celebrate the day, from football matches to free concerts, and from mobile blood donation clinics to monumental decorations.

However despite, massive awareness campaigns and build up activities before the celebration of the day, countries worldwide are still struggling to meet the annual requirements of blood.

According to the World Health Organisation (WHO) Blood Transfusion Safety department of Essential Health Technologies (HSS/EHT/BTS) around 92 million blood donations are collected annually from all types of blood donors (voluntary unpaid, family/replacement and paid).

Approximately half of these blood donations are collected in high-income countries, home to 15% of the world’s population.

In 62 countries, national blood supplies are based on 100% or almost 100% (more than 99.9%) voluntary unpaid blood donations.

Forty countries in the world collect less than 25% of their blood supplies from voluntary unpaid blood donors.

The World Health Organization’s (WHO) goal is for all countries to obtain all blood supplies from voluntary unpaid donors by 2020.

The provision of safe and adequate blood is a government responsibility and should be an integral part of each country’s national health care policy and health care infrastructure.

WHO recommends that every country should put in place policies, systems and structures to ensure the safety, quality, accessibility and timely availability of blood and blood products to meet the needs of all patients who require transfusion.

There are three types of blood donors: voluntary unpaid; family/replacement and paid. Voluntary unpaid blood donors are vital for ensuring a sufficient, stable blood supply.

A well-established voluntary unpaid blood donor programme can contribute to a significant reduction in the risk for infections such as HIV, hepatitis B, hepatitis C and syphilis.

Kenya like other countries has a national blood safety policy to oversee donation and transfusion of safe blood.

However like other developing countries Kenya is currently facing a serious shortfall in the availability of safe blood to meet transfusion needs.

Women and children in Kenya like other developing countries are the most in need of blood in particular for complications during childbirth and anemia caused by malaria respectively. More than half a million women die each year from complications during pregnancy and childbirth “with hemorrhaging accounting for 25% of deaths worldwide.

Seventy percent of all blood transfusions are given to children suffering from severe anaemia due to Malaria which is responsible for about one in five of all childhood deaths in the country.

A blood donor recruiter at the Regional Blood Transfusion Center (RBTC) Kisumu Mr. Albert Onyango says the biggest barrier to people donating blood in Kenya is lack of awareness.

“Majority of Kenyans are not aware of the urgent need for blood and also of the process of donation which is actually very safe and easy,” he says.

According to Onyango, anyone aged between 16 and 65 years and is in good health can donate blood.

A man can donate 4 times a year while women can donate 3 times a year without any adverse effect on their health. Each pint donated is actually 450ml & it takes 15 minutes to donate. He adds that blood expires after 35 days thus the need to continue donating.

Mr. Onyango says last year Kenya managed to collect approximately 130,000 pints while the need is 386,000 pints per year as recommended by the World Health Organisation.

The demand for blood in Kenya has increased tremendously, he says. Every ten minutes three people in the country need blood transfusion.

Mr. Onyango adds that Blood Transfusion Centers across the country heavily rely on school children which explains lowest collections in April, August and December when the schools are closed.

Unfortunately it is during these months that the demand for blood is too high given that most people travel during the holidays and many accidents are reported.

In the West region (Western province, Nyanza province and parts of Rift Valley), only 25, 150 pints of blood were collected in the year 2010 against the regional demand of 82, 575 units.

The need for blood in the region, he says is worsened by the H.I.V pandemic and poor health indicators.

HIV prevalence in Nyanza Province is 13.9% while in Western Province it is 6.6%. Of the infected population (15-64 years of the HIV positive persons) are in Nyanza and 83% of all infected adults are unaware of their status according to a 2010 National Aids Control report.

West Kenya Region is one of the constituent six Kenya National Blood Transfusion Services operations mandated to ensure adequate supply of safe blood in the region.

It is supposed to collect process and distribute blood and blood products to hospitals in the region at no cost.

It is against this backdrop that the center has teamed up with Red Cross and an administration police officer to inculcate the culture of voluntary donation of blood.

Mr. Onyango says that plans are underway to establish what he calls Clubs 25 where donors would be encouraged to donate at least 25 times in their lifetime.

“This would assist them to live a healthy life because they will avoid anything that is likely to tamper with their blood and make it unfit for transfusion,” he said.

The center, he adds will soon start separating blood separating blood into its different components: Platelets, Red Blood Cells (RBCs) and Plasma.

Once the service is started, donors will only make a special kind of donation to give select components – platelets, red blood cells, plasma.

As part of enhancing awareness, Francis Kooli the Administration Police commandant for Kakamega central district embarked on a 250 kilometers walk from Kakamega to Nakuru to create awareness on the need to donate blood and also help raise 2, 500 pints of blood.

From Kakamega town, the AP made stop overs at Mbale, Kisumu, Nyando, Kericho, Molo, Elburgon, Njoro and Nakuru where administration police officers came in their numbers to donate blood to replenish blood banks in the region.

Kooli says apart from sensitizing the community on the need to donate blood regularly, the law enforcement officers demonstrated to the public that there was need for all Kenyans regardless of their background to participate in the exercise.

The walk, he says managed to bring on board 500 voluntary repeat donors. The donors, he adds would enhance availability of safe blood for transfusion in Western, Nyanza and Rift Valley Provinces.

Kooli now plans to extend the walk to the remaining five provinces to bring on board more voluntary blood donors to enhance access to safe blood for transfusion.

He calls upon Kenyans to team up with him and donate regularly to replenish blood banks across the country.

How malaria became the leading killer of children


KAKAMEGA  Thursday, August 18, 2011    By Chris Mahandara.

Malaria has been singled out as the leading cause of child mortality in Western province.

Out of every 1,000 live birth in the province, 121 children die with malaria contributing to 30% of the deaths.

Western Provincial Director of Public Health Dr. Quido Ahindukha said 90% of the province is prone to malaria with Lugari and Mount Elgon districts being the epidemic zones.

Dr. Ahindukha said the government has initiated high impact intervention measures among them free distribution of treated nets, vector control through spraying, free malaria treatment and intermittent preventive treatment where expectant mothers are given medicine to prevent them from infection.

This, he said has reduced the number of outpatients seeking malaria treatment in hospitals from 50% -30%.

He said the government has scaled up the distribution of nets in the province to curb the spread of malaria and enhance child survival. At least two members per household have received treated mosquito nets.

The programme, he said has been hampered by some members of the community in lower and upper parts of the province who use the nets to establish kitchen gardens and for fishing in parts of Busia.

“Using the nets for the intended purpose remains a challenge in these areas dealing a major blow to the war against malaria,” he said.

He further said that traditional beliefs, sects and some church organizations in the province that stop patients from seeking medical treatment were also derailing the fight against malaria.

“By the time they are coming for treatment, the condition is unmanageable resulting to death,” he said.

The ministry of public health and sanitation, he said was working hand in hand with the provincial administration to enhance proper use of nets and sensitize the communities on the need to seek early malaria treatment which is offered free.

This, he said is expected to further reduce the number of outpatients seeking malaria treatment to 25%.

In an interview with Kakamega Times in his office today, Dr. Ahindukha disclosed that the department of public health and sanitation in collaboration with APHIA Plus and UNICEF has established 160 community strategy (CSUs) units to scale up the fight against the disease.

The (CSUs) located in all sub locations in the province have been trained and are expected to sensitize the communities on proper use of mosquito nets and the need to seek early treatment.

Two thirds of child mortality rates in Kenya are reported in Western, Nyanza and Rift valley provinces.

Nyanza province leads by 29%, followed by Western at 18% and Rift valley at 17.2%.

Even though malaria is the leading cause of the deaths for children under five years, diarrhea, malnutrition and poor breastfeeding are also key contributors.

Dr. Ahindukha said proper personal hygiene can reduce the deaths by 20% while proper breastfeeding can reduce the deaths by 25%.