The Role of Veterinary Medicine in Public Health; The Khwisero example

The role of VPH within the global health agenda is to promote activities that contribute to the achievement of health for all and help realize its objectives. Veterinarians assist in planning, policy-setting, allocating resources, and providing technical guidance, orientation, and support to the operational staff.

Public health is dependent on animal health in rural area because poor animal health directly affects the human food supply. New information and new approaches for the efficient and cost-effective delivery of reliable and accurate information to VPH users in these areas are required.


VETERINARY PUBLIC HEALTH IN KHWISERO, KENYA; SUCCESS,CHALLENGES AND OPPORTUNITIES.

Mark Nanyingi1§, Alfred Koballa 1, Humphrey Ongili1, Christopher Okello1, Tindi Bushuru 2, Kelly Nelima3

1Ministry of Livestock and Development, District Veterinary Office, PO BOX 60 -50135, Khwisero, Kenya
2Ministry of Livestock and Development, District Veterinary Office, PO BOX 1160, Butere, Kenya
3Ministry of Livestock and Development, Provincial Veterinary Office, PO BOX 871, Kakamega, Kenya

Abstract

Background
Public health is dependent on animal health in rural areas because poor animal health directly affects the human food supply. Veterinary public health entails the diagnosis, surveillance, epidemiology, control, prevention and elimination of Zoonoses. Unsatisfactory implementation of stringent disease control, meat inspectorate and drug dispensation legislations prevents the efficient production of food of animal origin; creating obstacles to international trade in animals and animal products and hence an impediment to overall socioeconomic development.

Methods

Data were extracted from the Khwisero veterinary relational database including clinical, meat inspectorate, disease surveillance, and extension from October 2009 to March 2010. Participatory approaches were used to collect data from private service providers and stakeholders concerning the status of veterinary service delivery. A qualitative and quantitative analysis was conducted to determine the challenges, incentives, cost-effectiveness and policies that would improve veterinary public health.

Results

An Epidemio-surveillance system (ESS) has been established enhancing detection and reporting of notifiable diseases in partnership with paraprofessionals. Meat inspectorate services improved consumption leading to a 75% revenue increment with a 27% decline in condemnation. Knowledge gap on legislation and regularization of private practitioners was combined with imprudent drug dispensation and home use had a significant negative impact on clinical services (67%). Workforce deprivation and Staff demotivation leads to suboptimal discharge of duties at 30% (p<0.001). Insufficient funding (-60%) was a contributor to poor service delivery.

Conclusions

New information and approaches for the efficient and cost-effective delivery of reliable and accurate information to VPH users in rural areas are required. Staff recruitment, training and motivation will foster service delivery. Establishment of regional laboratories to provide accurate diagnosis is essential for field research. A requisite combination of epidemiological, statistical and economic tools must be underpinned by detailed knowledge of livestock disease patterns for public-policy formulations in effective Veterinary Public health systems.

Key words: Veterinary Public Health, Khwisero, Zoonoses.

© 2010 Khwisero District Veterinary Office

Spatio-temporal epidemiology of dog bite injuries at Kakamega Provincial Hospital, Kenya

Spatial epidemiology is the study of spatial variation in disease risk or incidence. Several ecological processes can result in strong spatial patterns of such risk or incidence: for example, pathogen dispersal might be highly localized, vectors or reservoirs for pathogens might be spatially restricted, or susceptible hosts might be clumped.(Ostefield et al 2005).

In Kakamega District of Western Kenya We Assesed The Reporting patterns of Vertebrate bites in the Provinicial Referral General Hospital.

Spatio-temporal epidemiology of dog bite injuries at Kakamega Provincial Hospital, Kenya

Kelly A Nelima1, 6, Mark OO Nanyingi 2, 3§, Gideon M. Kikuvi4, Willis Akhwale5, Jared Omolo6
1Ministry of Livestock and Development, Provincial Veterinary Office, PO BOX 871, Kakamega, Kenya
2 Ministry of Livestock and Development, District Veterinary Office, PO BOX 60 -50135, Khwisero, Kenya,
3 Kenya Scientific Analysts, P.O. Box 531-00202, Kenyatta National Hospital, Nairobi, Kenya,
4Jomo Kenyatta University of Agriculture and Technology, Box 3249-00200, Nairobi, Kenya
5 Ministry of Public Health and Sanitation, PO Box 30016- 00100 Nairobi, Kenya
6 Field Epidemiology and Laboratory Training Program, US centers for Disease Control, PO Box Nairobi, Kenya

Abstract

Background
Endemic canine rabies is a reemerging neglected zoonosis often underestimated in Kenya but remains a public health and economic burden to the rural poor. Understanding the transmission dynamics and distribution of dog bites over specified time period can assist in assessment of risk factors, design of interventions to exposure and the estimation of rabies burden.

Methods
Retrospective and cross-sectional analysis of surveillance data of reported dog bite incidents from Kakamega Provincial General Hospital from 2006 to 2009 was performed to estimate the prevalence of dog bites. Univariate and Multivariate analysis were performed to assess the risk factors and prevalence of dog bites. The temporal distribution and spatial patterns of bites was mapped and analysed to estimate population at risk to rabies.

Results
There were 148 dog bite incidents with children below 10years being more involved (33.8%).Most bites occurred on the lower extremities 124/148 (83.8. 1.0% of bites resulted in rabies and death after post exposure treatment and were located more than 45km away from the PGH. Spatial-temporal clustering of dog bites showed irregular pattern of spread with declining incidence rates from the periurban center. On visual inspection, the highest (30%, 95% CI 14-52% N = 45) densities of dog bites were in areas around the central place of the study area, bites clustered in not more than 15km radius from the hospital. The second cluster centered around Lubao dog market 7.4 %( 95% CI, 5-12%, N = 11). 12% of the bites were along roads and rivers while 5% occurred in and around forests. The retrospective analysis revealed a temporal increase in prevalence 114 % (P<0.05) with high peaks in March and August with a mean monthly bite incidence of 22.44%. 2008 had the highest mean monthly incidence of 30%.

Conclusions
Spatiotemporally dynamic approaches and epidemiological models may predict emergence or spread of diseases to new geographic regions and could be effective in spatially targeting interventions. Descriptive spatial epidemiology of bites can assist in accurate measure of rabies burden where underreporting, inequity in vaccine provision and improper policies of disease mitigation exist.

Key words: Spatial epidemiology; Dog bites, Rabies.

© 2010 Khwisero District Veterinary Office

§Corresponding author and presenter: mnanyingi@gmail.com, +254721117845.

Potential of African Medicinal Plants in Malaria Therapy

Nanyingi et al 2010. Aspects of African Biodiversity, ISBN:1847559484, 9781847559487

ABSTRACT

Malaria is one of the most prevalent diseases in the world and a major public health problem, affecting 40% of the world population. It infects about half a billion people causing about 3 million deaths a year with 90 % of them being in sub-Saharan Africa.1,2 In Kenya, malaria is the leading cause of morbidity and mortality, accounting for 30-50% of all outpatient attendance and 20% of all admissions to health facilities.

Kenya has revised its treatment policy by adopting artemisinin combination therapy (ACT) as the first line drugs for treatment of uncomplicated malaria. Spread of multidrug-resistant (MDR) strains of Plasmodium and the adverse side effects of the existing antimalarial drugs have necessitated the search for novel, well tolerated and more efficient antimalarial drugs.3 Indigenous plants are important sources of biologically active compounds and have potential for the development of novel antimalarial drugs.

Drug-resistant strains of P. falciparum are endemic in many areas of the world and the majority of conventional antimalarial drugs have been associated with treatment failure. These developments and the difficulty of creating efficient vaccines, coupled with adverse reactions to chemotherapy, underline the urgent need for novel, cheap, safe and efficacious antimalarial drugs.8 It is estimated that 80% of people worldwide use herbal remedies, due to limited access to modern medicine because of low income and the shortage of efficient health care facilities.9 There is a dearth of evidence on the efficacy and safety of these remedies, despite the fact that validation of traditional practices could lead to innovative strategies in malaria control.

Read more http://www.rsc.org/shop/books/2009/9781847559487.asp

Screening of some kenyan medicinal plants for antibacterial activity

Phytother Res. 2009 Jun 22

Wagate CG, Mbaria JM, Gakuya DW, Nanyingi MO, Kareru PG, Njuguna A, Gitahi N, Macharia JK, Njonge FK.

Department of Public Health, Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Nairobi, P.O. Box 29053-00625, Nairobi, Kenya.

Eleven medicinal plants used by traditional healers in Machakos and Kitui District were screened, namely: Ajuga remota Benth, Aloe secundiflora Engl, Amaranthus hybridus L, Cassia didymobotrya Fes, Croton macrostachyus Del, Entada leptostachya Harms, Erythrina abyssinica DC, Harrisonia abyssinica Oliv, Schkuhria pinnata O. Ktze, Terminalia kilimandscharica Engl and Ziziphus abyssinica Hochst for potential antibacterial activity against four medically important bacterial strains, namely: Bacillus cereus ATCC 11778, Escherichia coli ATCC 25922, Micrococcus lutea ATCC 9341 and Pseudomonas aeruginosa ATCC 27853. The antibacterial activity of methanol extracts was determined as the minimum inhibitory concentration (MIC). The plant extracts were more active against Gram-positive (G+) than Gram-negative (G-) bacteria. The positive controls were streptomycin and benzylpenicillin for G- and G+ bacteria, respectively, both had a significant MIC at <1 mg/mL. The most susceptible bacteria were B. cereus, followed by M. lutea, while the most resistant bacteria were Ps. aeruginosa, followed by E. coli. The present study supports the use of these plants by the herbalists in the management of bacterial ailments. H. abyssinica and T. kilimandscharica showed the best antibacterial activity; hence these plants can be further subjected to phytochemical and pharmacological evaluation

Kenya Scientific Analysts

Background Information

Kenya Scientific Analysts (KSA) is a non-profit, organization committed to conducting high quality and policy-relevant scientific consultation.
KSA was established in 2006 with its headquarters in Nairobi, Kenya and satellite offices in Mombasa and Busia, Kenya.

Evolution
KSA was formerly known as Kenya Data Analysts (KDA) before expansion of its activities. KSA is registered with the Registrar of Companies in Kenya, giving it distinct legal status in the country.

Objectives
KSA has a wider aim to reach establish collaboration with reputable research institutes, individual researchers, doctoral students and other post graduates in undertaking relevant scientific research.
It has specific objectives:
 Contribute to Science through high impact research projects and publications.
 Provision of evidence based research finding to policy makers.

Research Focus
KSA research focuses on improving understanding of Epidemiology and Public Health of tropical and infectious diseases through development and implementation of innovative, policy-oriented research programs to address the health challenges. KSA particularly focuses on areas where there are considerable knowledge gaps.
Our methods include primary research projects where we collect new data; secondary analysis of existing data; synthesis of evidence; scenario building; and monitoring and evaluation of interventions. We also seek to develop and use new methodologies, partnering with other institutions as needed.

Collaborators

 Kenya Medical Research Institute, Nairobi
 International Livestock Research Institute
 University of Nairobi, Department of Public Health, Pharmacology and Toxicology
 University of Nairobi, Department of Chemistry
 Great Lakes University, Kisumu.
 African Medical Research Institute.
 Maseno University.
 Masinde Muliro University of Science and Technology
 Victoria Institute of Science and Technology

A Survey of Bovine Cysticercosis / Human Taeniosis in Northern Turkana District, Kenya

PREVENTIVE VETERINARY MEDICINE MARCH 2009
Lucas L Asaava, BVM; Philip M kitala, BVM., MSc., PhD; Peter B Gathura,
BVM.,MSc.,PhD; Mark O Nanyingi, BVM.,MSc; Gerald M Muchemi, BVM.,MSc.,PhD; Esther
Schelling , DVM, PhD

ABSTRACT
Bovine cysticercosis is a zoonosis that is mainly of socioeconomic and public health importance. A survey of this disease was carried out in northern Turkana District, Kenya to estimate the prevalence through both serology and meat inspection, to determine the prevalence of the adult tapeworm in the human definitive host, and to determine risk factors for cattle seropositivity. This information is of public health importance and will be of use in assessing economic losses due to down grading, refridgeration or condemnation of infested carcasses.The study area was stratified into the three livestock grazing regions of Oropoi to the south,
Lokichoggio-Mogilla centrally and Kibish in the north for the purposes of the serological and questionnaire (n=53 herd owners) data. Five adakaars (grazing units) were selected and 34, 63, 49, 75, and 571 cattle serum samples obtained from these. The slaughter slabs of Lokichoggio and Kakuma were visited and 188 serum samples were obtained from slaughter cattle and compared to results of meat inspection. Human stool samples were collected in each of the three grazing areas
and 66, 97,and 78 samples were obtained. The seroprevalence of cysticercosis in cattle was estimated at 16.7% (95%CI 13%-20.9%) using a secretory-excretory antigen detection ELISA. There was poor agreement between meat inspection and serology (k = 0.025; P=0.2797). The prevalence of taeniosis was estimated as 2.5% (95%CI
0.8%-5.6%) by microscopy. A backwards elimination logistic regression analysis indicated that the grazing unit (Adakaar), the deworming history of household members and the distance (>2km) of grazing fields from the homestead were significant explanatory variables for cattle being found to be positive on serology.
An intra-cluster correlation coefficient (ICC) of 0.07 (0.02 - 0.12); p<0.0001 was calculated for bovine cysticercosis in this area.

Keywords: Cattle-Cestoda; Taenia saginata; ELISA; Epidemiology-cestoda; Kenya-Turkana

Victoria institute of Science and Technology

Many antipoverty crusaders believe that closing the Digital Divide is not a top priority, arguing instead that the poor need clean water,good roads, electricity and jobs before they need computers. However, what they do not realize is that access to digital technology greatly enhances the effectiveness and affordability of efforts to improve the water supply, improve rural health and education, generate jobs and address any of the other interrelated problems of poverty. Closing the digital divide is not a silver bullet for reducing poverty. But there is a much lower likelihood of large scale and sustainable poverty reduction without doing so.
The emerging market countries of Asia are now major drivers of the digital economy and, in that vast region, the spread of wireless networks is stimulating all other dimensions of economic growth. In fact, the biggest technological growth is occurring outside big cities in these countries. As broadband networks spread into the countryside in Kenya, costs throughout the supply chain will drop. By adjusting their policies to close the digital divide, the major IT and telecom companies are achieving innovations that could spur growth in the advanced countries as well.
one prototype initiative is by a kenyan Harvard professor. Calestous Juma from the shores of Lake victoria in Budalangi. Calestous Juma is Professor of the Practice of International Development and the Director of the Science, Technology and Globalization Project at the Harvard Kennedy School He volunteers as a member of the International Advisory Council of World Computer Exchange (WCE).Professor Juma is now contacting his friends and colleagues to explore if they might be willing to join him in financially Sponsoring part of the $30,000 for content materials, sourcing the computers and other items as well as the logistical and shipping costs.
Victoria Institute of Science and Technology (VIST)will be key in bridging the digital divide and improve livelihoods of the rural communities of Bunyala Distirct in Kenya.