Trend of <i>Cryptosporidium</i>Infection among Children below 24 Months in an Informal Urban Settlement, Kenya

Cryptosporidium infection is estimated to cause 2.9 million diarrheal cases yearly among children aged under 24 months in sub-Saharan Africa. Studies have shown long-term climatic variations can affect infectious diseases. The burden of cryptosporidiosis in rural areas of sub-Saharan Africa is well characterized. However, the trend of Cryptosporidium infection is not known, especially in informal urban settings. This study therefore sought to determine cryptosporidiosis trends, and further explore the association between year and Cryptosporidium infection among children below 24 months in Kibera urban informal settlement in Kenya. Data collected by the Kenya Medical Research Institute longitudinal study in Tabitha clinic in Kibera from 2009 to 2015 were used. At least 3000 children aged < 24 months receive free health care at the clinic. In the longitudinal study, children presenting with diarrhea were eligible for stool sample collection (n = 477), out of which 421 stool samples were tested using TaqMan™ Array Card (TAC) polymerase chain reaction panel that included a target for Cryptosporidium genus. Data for the 421 children were included in the analysis. Logistic regression was used to explore the difference between the seven years and cryptosporidiosis. Overall, the pooled data indicated that 23.5% of the children who were tested had Cryptosporidium infection, with the highest proportions of Cryptosporidium-positive cases observed in 2015 (45.2%). The logistic regression results also indicated that children who were tested in the year 2015 were more likely to have Cryptosporidium infection (OR = 3.39;95% CI: 1.44 - 7.96;p = 0.005) than those in 2009. Watery stool was also found to be an important symptom of cryptosporidiosis. There was a high prevalence of Cryptosporidium infection among young children, especially in the most recent year. Routine testing of Cryptosporidium infection using molecular methods, constant monitoring and identification of the infection sources is therefore necessary towards reducing the disease burden in the low resource settings.

Does Tenure Security Reduce Disaster Risk? A Comparative Study of the Nairobi Settlements of Kibera and Kawangware

While scholarship suggests that improving tenure security and housing significantly reduces disaster risk at the household level within urban settings,this assertion has not been adequately tested.Tenure security can be conceived as being composed of three interrelated and overlapping forms:tenure security as determined by legal systems;de facto tenure security;and tenure security as perceived by residents.This article traces the relationship between tenure security,the quality of housing,and disaster risk on the basis of a mixed methods comparative case study of the settlements of Kawangware and Kibera in Nairobi.Although the findings suggest that owner-occupancy is associated with the structural integrity of dwellings to a greater extent than tenantship,no association was found between the length of occupancy by households and the structural integrity of the dwelling.Moreover,tenantship is not found to be closely associated with fires and flooding affecting the dwelling as extant scholarship would suggest.Formal ownership is linked with greater investment and upgrading of property with significant implications for disaster risk.Our findings highlight the complex relationship between tenure security and disaster risk in urban informal settlements and provide impetus for further investigation.