Poster Presenters

Introduction: Acute malnutrition remains a major public health concern in Mandera County, Kenya, where prevalence exceeds the emergency threshold (≥15%). Nutrition surveillance systems are essential for timely detection of vulnerable populations and for guiding evidence-based public health action. The Kenya Health Information System (KHIS) monitors acute malnutrition among children aged 6–59 months. This evaluation assessed the performance of the surveillance system using standard surveillance attributes.

Methods: A mixed-methods cross-sectional evaluation was conducted from December 2025 to January 2026 in 18 purposively selected health facilities across six sub-counties. Respondents, frontline healthcare workers and county and sub-county health managers involved in surveillance were purposively selected. Data were collected using structured questionnaires, key informant interviews, and retrospective review of KHIS data from 2023 to 2025. The evaluation was guided by the CDC surveillance evaluation framework and assessed usefulness, simplicity, acceptability, flexibility, representativeness, timeliness and stability. Quantitative data were analysed using Microsoft Excel, while qualitative data were analysed thematically.

Results: A total of 62 respondents participated. Perceived usefulness was high (98%), with surveillance data informing decision-making such as outreach planning, emergency response, and resource allocation. Simplicity and acceptability were also high. Reporting completeness remained above 93%, and representativeness was strong, with all six sub-counties consistently submitting monthly reports. However, timeliness declined from 86.6% in 2023 to 71.1% in 2025. System stability was limited, with only 25% of facilities reporting reliable internet connectivity. Declining trends in Severe and Moderate Acute Malnutrition cases were observed but may reflect reporting variations, service utilization, or case detection rather than true reductions in disease burden. Key challenges included commodity stockouts, climate-related shocks, and limited staff capacity.

Conclusion: The surveillance system is functional but constrained by weaknesses in timeliness and stability. Strengthening infrastructure, reporting systems, and workforce capacity is essential to improve performance and responsiveness.

Background: Participation in External Quality Assessments (EQA), a system for objectively checking laboratory performance using an external agency is key in ensuring laboratories are offering quality results.  Kenya has an individual-based HIV EQA scheme, where testers are provided with panels and assessed as individuals. This scheme was initiated in 2012 and is coordinated by Kenya External Quality Assessment Scheme (KNEQAS).  During the COVID-19 pandemic, service delivery interruptions were experienced. To monitor whether the quality of testing was compromised during this period, we reviewed performance of HIV EQA from 2018 to 2022.

Methods: From 2018 to 2022, KNEQAS produced five EQA cycles. Each EQA cycle was composed of six HIV EQA samples that were sent to HIV-testing service providers enrolled in the EQA scheme. Following testing, the service providers entered their results in the HIV PT web portal. Evaluation of performance from the HIVPT web portal was based on correct interpretation of all six samples, following testing procedures, testing as per the national algorithm and correct documentation. These aspects were used during root cause analysis for unsatisfactory results. A satisfactory performance was given when all these were correctly done.   Results were analyzed on the HIV PT portal and provided as percentage of service providers obtaining a satisfactory performance.   

Results: The total number of participants enrolled between 2018 and 2022 was 97838 with 21825, 20870, 21655, 11953 and 21535 in 2018, 2019, 2020, 2021 and 2022 respectively. The satisfactory performance was as follows:  91% (in 2018) 91% (in 2019), 89% (in 2020), 89% (in 2021) and 93% (in 2022). There was a decline in satisfactory results in 2020 and 2021 and upon conducting root cause analysis, it revealed failure to observe standard operating procedures and transcription errors.    

Conclusion:  Service delivery interruptions in rapid HIV testing were experienced during COVID-19 pandemic. 

Background

Tungiasis is a neglected tropical disease caused by the sand flea Tunga penetrans. It thrives in conditions of poverty, poor housing, and inadequate sanitation. The flea burrows into the skin, mainly affecting the feet, causing pain, itching, and secondary infections. In Kenya, over 1.4 million people are affected, with earlier estimates reaching 2.6 million, mostly in rural and marginalised communities.

Objectives

This study assessed the occurrence of tungiasis and the environmental and behavioural factors sustaining its transmission in Trans Nzoia County, to inform practical control interventions.

Methods

A descriptive cross-sectional study was conducted in rural and peri-urban areas of Trans Nzoia County. Data were collected from 50 households through surveys, environmental observations, and interviews with community health volunteers. Variables assessed included floor type, footwear habits, sanitation practices, domestic animal presence, and awareness of tungiasis prevention.

Results

Of 50 households surveyed, 8 (16%) had confirmed tungiasis cases. Six cases (12%) were from earthen-floor households and 2 (4%) from plastered-floor households. No cases were recorded in terrazzo or tiled-floor households, identifying floor type as a key environmental risk factor. Children aged 5–14 years and the elderly were most affected. Sandals and shoes were each used by 40% of residents, with 10% walking barefoot. Despite low barefoot rates, infestation persisted, suggesting open footwear provides insufficient protection. Across five quarterly periods from January 2025 to March 2026, 325 cases were recorded, peaking in April–June 2025 (79 cases) and lowest in October–December 2025 (53 cases).

Conclusion

Tungiasis in Trans Nzoia County is strongly associated with earthen floors and inadequate footwear. Floor improvement, promotion of closed footwear, and targeted community health education remain the most practical measures for reducing transmission in affected households.

Background: An outbreak of Mpox, a zoonosis caused by Monkeypox virus, was declared in Kenya in July 2024. National surveillance through Integrated Disease Surveillance and Response (IDSR) system is limited by delayed detection, diagnostics, under-reporting, and inadequate contact tracing impeding identification of transmission chains sustaining outbreaks. This study applied network-based analysis to characterize Mpox transmission dynamics and inform future surveillance.

Methods: Using National Mpox surveillance data, probable transmission links were inferred using spatio-temporal criteria: symptom onset within 3-21 days and ≤50 km. Transmission networks were constructed and aggregated at County and Sub-County levels. Centrality metrics including degree, betweenness, and eigenvector centrality classified individual cases (nodes) as dual-threat, pure bridge, or pure spreader to guide surveillance prioritization.

Results: Among 620 cases reported (mean age 28.7 years), males aged 30-44 were disproportionately affected. Transmission concentrated in Mombasa (Kisauni, Nyali, Likoni, Mvita), Nairobi–Kiambu and Western border areas (Teso, Matayos). Network reconstruction revealed clustered superspreader transmission dynamics with ~15% of cases generating nearly 50% of onward transmission. Missing data and delayed reporting led-to fragmented clusters indicating silent transmission chains beyond detection by current surveillance system. Dual-threat nodes (Machakos-Mavoko, Kikuyu, and Kilifi-Kaloleni) exhibited high local transmission and inter-regional connectivity; bridge nodes (Nakuru–Naivasha, Nakuru–Gilgil, and Kakamega-Lugari) served as critical nodes for geographic expansion. High-risk professions included transport workers, traders, port workers, healthcare workers, and commercial sex workers in hotspot areas. Peripheral areas experienced sporadic cases with limited onward transmission.

Conclusion: Kenya Mpox transmission is localized, hotspot-driven, and corridor-mediated. Network analysis reveals transmission dynamics, including superspreading events, bridge locations and inter-regional pathways, that routine case-based surveillance alone cannot resolve. Findings support integrating network-based approaches into Kenya’s IDSR frameworks to strengthen outbreak investigations. Future surveillance should prioritize hotspot Sub-Counties, transit corridors, and high-contact professions to prevent spread.

Background:
Trachoma remains the leading infectious cause of blindness globally. Although Kenya has made substantial progress toward elimination, recent surveys indicate persistent or recrudescent trachomatous inflammation–follicular (TF) in parts of Kajiado and Narok counties. This study aimed to identify the key drivers of ongoing trachoma transmission in these settings.

Methods:
A mixed-methods cross-sectional study was conducted in nine purposively selected villages (five in Kajiado County and four in Narok County) with TF prevalence >5%. Quantitative components included community censuses conducted in two rounds, coverage evaluation surveys, clinical grading for TF, testing for Chlamydia trachomatis (Ct) infection using nucleic acid amplification tests, serological assessment using anti-pgp3 antibodies, and an exploratory fly investigation involving fly counts and species identification. Qualitative data were collected through nine focus group discussions exploring socio-cultural, behavioural, and environmental factors related to trachoma transmission.

Results:
Ct infection prevalence was extremely low across all evaluation units in Kajiado County (

Background:Universal Health Coverage (UHC) and health security requires resilient primary healthcare (PHC) systems for early threat detection, integrated service delivery and equitable access. Kenya’s PHC implementation has been hindered by siloed vertical programs, workforce gaps, fragmented data systems, weak referral and poor community-facility coordination. The Kenya PHC Strategic Framework and 2023 Primary Care Network (PCN) Guidelines prioritized PCN‑led integration, digital intelligence and community accountability as pillars of people‑centred transformation. Nyeri and Nakuru Counties lacked functional PHC dashboards, standardized data structures and interoperable analytics, limiting effective planning and early warning. Between March 2024 – December 2025, Project THRIVE addressed these gaps, providing a scalable pathway to accelerate UHC and reinforce health security.

Methods:The Project employed an iterative, learning-by-doing approach to implement a comprehensive PCN model across 13 PCNs in Nyeri and Nakuru Counties, integrating Community Health Promoters (CHPs), facilities, multidisciplinary teams (MDTs) and county structures. Real-time PHC dashboards were deployed across 108 facilities and 398 community units, supported by 70 trained M&E teams. Service delivery was strengthened through integrated outreaches, MDT mentorship, joint CHP-facility supervision and improved referrals. Community engagement was enhanced via dialogues, scorecards and Work Improvement Teams (WITs), fostering social accountability and service uptake.

Results:The model improved integration, leadership and accountability across PCNs. Initial data reviews identified low male health-seeking behavior, prompting Male-only camps that yielded new diagnoses of 1076 hypertension, 864 diabetes and 47 elevated PSA cases. Dashboards enabled evidence-driven resource allocation for MDT outreaches and targeted service expansion leading to establishment of 18 mental health clinics, 66 NCD support groups and commodity budgeting. Scorecards and WITs strengthened trust, demand creation and responsiveness, reducing inequities and bolstering resilience.

Conclusion:A PCN‑led, data‑driven PHC model demonstrates how science, community power and innovation can accelerate UHC and strengthen health security for a resilient, people‑centred PHC.

Introduction: Measles and rubella remain major public health threats in low- and middle-income countries despite effective vaccines. Uganda introduced the second dose of measles–rubella vaccine (MR2) for children aged 18–23 months in 2022. Few studies have applied the Behavioral and Social Drivers (BeSD) model to assess MR2 uptake.

Aim: We estimated national and regional MR2 coverage and identified behavioral and social determinants among children aged 18–23 months in Uganda, August–September 2024.

Methods: We conducted a two-stage stratified cluster survey across four regions. In stage one, 165 of 44,013 enumeration areas were selected with probability proportional to size. In stage two, households were systematically sampled. Caregivers of children aged 18–23 months were interviewed using structured questionnaires informed by BeSD model. Sampling weights adjusted for population size and unequal selection. Weighted MR2 coverage was estimated, and determinants analysed using modified Poisson regression to obtain adjusted prevalence ratios (aPR) with 95% confidence intervals.

Results: Among 750 children (median age 20 months, IQR 19–22; 51% male), 70% were born in health facilities and 79% vaccinated at public facilities. National MR2 coverage was 32.0% (95% CI: 25.5–38.7%), varying by region: Northern 41.4%, Western 34.5%, Central 27.6%, Eastern 22.0%. First-born children had higher uptake than higher birth order (aPR=1.71; 95% CI: 1.10–2.61). Households with ≥2 eligible children had higher uptake (aPR=2.42; 95% CI: 1.41–4.10). Each additional month increased uptake by ~9% (aPR=1.09; 95% CI: 1.00–1.20). Adverse events (aPR=0.41; 95% CI: 0.23–0.73) and dissatisfaction with services (aPR=0.18; 95% CI: 0.06–0.51) reduced uptake.

Conclusions: MR2 uptake in Uganda remains well below the ≥95% threshold required for measles and rubella elimination. Addressing immunity gaps will require strengthened second-year-of-life vaccination strategies that prioritise improved caregiver experience, follow-up of eligible children, and targeted communication around vaccination services and safety.

Introduction

Kenya reported its first confirmed case in July 2024, with subsequent local transmission across multiple counties. Nakuru County, situated along Kenya’s Northern Transport Corridor and characterized by high population mobility, emerged as a hotspot for Mpox transmission. In response to evidence of sustained community spread, the MoH in collaboration with Nakuru County and with support from WHO & KRCS deployed National Rapid Response Teams to strengthen surveillance and interrupt transmission.

Objectives

To strengthen Mpox surveillance and implement early control measures in hotspot sub-counties of Nakuru County. Specific objectives included improving case detection through active case search, enhancing contact identification and follow-up, conducting detailed case investigations, and instituting timely public health interventions to halt further transmission.

Methods

A descriptive outbreak investigation and response was conducted from 15th to 28th December 2024. Multidisciplinary RRTs conducted active case search in public and private health facilities, chemists, communities, bars, lodges, and brothels within hotspot sub-counties. Suspected cases were identified using national Mpox case definitions, interviewed and sampled for laboratory confirmation at the National Public Health Laboratory. Contact tracing and 21-day follow-up were conducted using ADaM tools. Risk communication and community engagement (RCCE) activities targeted high-risk populations. 

Results

By the end of December 2024, Nakuru County had reported (10) confirmed Mpox cases. Females accounted for 80% of cases, with the most affected age group being 31–40 years (40%), followed by children aged 0–10 years (30%). Naivasha Sub-County contributed 60% of confirmed cases. Active case search covered 231 sites, including 99 health facilities and  community settings. A total of 56 contacts were identified, all of whom completed follow-up, with (5) testing positive. RCCE activities reached over 370 individuals.

Conclusion

Deployment of Rapid Response Teams played a critical role in strengthening Mpox surveillance, improving case detection, and interrupting community transmission in Nakuru County.

Background: Following a polio outbreak response campaign in Marsabit County, a verification and validation exercise was conducted in May 2025 in line with guidelines from the Global Polio Eradication Initiative. The exercise aimed to ensure accountability of all Potentially Infectious Materials (PIMs), particularly novel oral polio vaccine type 2 (nOPV2) vials, after the second round of Supplementary Immunization Activities (SIA).

Objectives: The primary objective was to verify that all nOPV2 vials used during SIA Round 2 were fully accounted for. Specific objectives included confirming vial reconciliation across the vaccine supply chain, inspecting vaccine storage conditions, assessing completeness of documentation, and verifying the return of all vials to the national vaccine store through reverse logistics.

Methods: An independent verification team conducted field validation across Marsabit County, operationally divided into seven sub-counties. Using random sampling for geographic representation and operational feasibility, two sub-counties Saku and Laisamis were selected. Within these, 16 of 43 health facilities (37.2%) that participated in SIA Round 2 were sampled. Data sources included Vaccine Accountability Monitoring (VAM) forms, vaccine stock ledgers, sub-county depot records, and physical inspection of vaccine storage equipment and returned vials. Descriptive analysis reconciled issued, returned, and physically verified vaccine vials.

Results: The campaign vaccinated 156,278 children under 11 years. Verification confirmed that all 5,200 nOPV2 vials distributed for SIA Round 2 were fully accounted for, with zero losses. All usable and unusable vials were retrieved and returned through the reverse logistics system. However, documentation gaps were noted at several health facilities, and the county lacked a dedicated vaccine depot.

Conclusion: The verification exercise demonstrated strong vaccine accountability during the outbreak response campaign. Strengthening documentation practices and establishing a county-level vaccine depot would further improve vaccine management and reduce operational risks in future immunization campaigns and outbreak responses.

Introduction

Visceral leishmaniasis (VL) is a life-threatening neglected tropical disease and a recurrent health security threat in Kenya’s arid and semi-arid regions. In Kenya, VL is endemic in 11 of 47 counties. Climate variability, poverty, population mobility, and weak access to diagnosis and care continue to sustain transmission and outbreaks. In recent trends, Kenya recorded 13,143 VL cases since 2005, with at least 1,000 cases reported annually since 2017 except in 2018, and nearly 6,000 cases reported between 2022 and 2025. In 2025 alone, Turkana reported over 2,043 cases, ahead of West Pokot and Wajir, highlighting the disease’s growing pressure on county health systems.

Aim

To synthesize evidence on the burden, distribution, case management, and health-system response to VL in Kenya, and to identify key gaps and priority opportunities for equitable control.

Methods

Conducted a narrative synthesis of peer-reviewed literature, national reports, surveillance trends, and policy/guideline documents published between 2010 and 2025, with complementary case trend data from 2005 onward. Reviewed domains included epidemiology, diagnostics, treatment, service availability, and barriers to access.

Results

VL remains concentrated in underserved counties, but geographic spread is increasing. Service access is limited, among 1,428 health facilities in endemic counties, 43 provide VL diagnosis and treatment and 84 offer testing. Progress includes adoption of the 17day sodium stibogluconate-paromomycin regimen and decentralization initiatives in some counties. However, delayed diagnosis, limited confirmatory testing, long travel distances, hidden patient costs, under-reporting, and weak surveillance persist. High-risk groups include children, malnourished individuals, nomadic populations, and households in poor housing conditions.

Conclusion

VL remains a significant health security challenge in Kenya despite progress in treatment policy and service delivery. Strengthening integrated surveillance, expanding diagnosis and treatment closer to affected communities, and investing in patient-centered, climate-responsive control strategies are essential for equitable VL reduction and stronger outbreak resilience.

Background:
Despite sustained efforts toward polio eradication, gaps in vaccination coverage persist in fragile and hard-to-reach settings. Understanding the reasons why children are not vaccinated during supplementary immunisation activities is essential for improving campaign effectiveness.

Methods:
This study presents a descriptive analysis of operational monitoring data from the November 2025 polio vaccination campaign in Maniema Province, Democratic Republic of Congo. Data from 99,018 children were analysed to examine reasons for non-vaccination, including absenteeism, refusal, and operational gaps, as well as reported communication channels.

Results:
Of the 99,018 children assessed, 2,281 (2.3%) were not vaccinated. Absenteeism was the leading contributor (54.8%, n=1,250), followed by refusals (17.2%, n=392) and operational gaps, including households not visited or not revisited (17.4%, n=397). Among absent children, the most reported locations were farms (36.8%), social events (27.1%), and playgrounds (19.2%), reflecting routine livelihood and community activities. Refusals were primarily associated with fear of adverse effects (26.2%) and perceptions that routine vaccination was sufficient (22.6%). Communication exposure was predominantly interpersonal, with volunteers (30.2%) and community-based channels playing a central role, while digital channels were minimal.

Conclusion:
Most children who were not vaccinated were not refusing immunisation but were absent at the time of campaign visits. These findings suggest that non-vaccination is shaped by the interaction of mobility patterns, communication contexts, and service delivery factors. Improving vaccination coverage in similar settings may require mobility-sensitive scheduling, strengthened microplanning, and locally adapted communication strategies.

INTRODUCTION:

Inadequate access to information and stigma towards HIV has hindered access to HIV care and services especially among the youths and adolescents thus increasing the spread of the disease.  Inadequate linkage to care and access to other commodities like condoms has immensely contributed to improper care.

OBJECTIVE:

The study aimed at increasing knowledge and access to HIV services amongest the youths.

METHODOLOGY:

In June 2025, Cohort and Snowball sampling methods were used to select 20 youths aged 18 - 28 across the 4 community health units attached to Luanda Town Health Centre. Composed of 10 males and 10 females, both living positively and those without HIV. They were then taken through the basic module on HIV /AIDS and graduated as Youth Champions. These champions were tasked with a responsibility of peer to peer advocacy on prevention of HIV/AIDS, linking youths to HIV testing services at Luanda Town H/Centre and help distribute condoms to the youths in need. In October 2025, cross-sectional sampling method was used to ascertain their impact in the four community health units. Data from 400 youths and comprehensive care centre at Luanda Town H/Centre was collected and analyzed. 

RESULTS:

Accessibility to condoms when in need: YES - 88% NO - 12%

Where do you get them: Youth champion - 70% CHPs – 13% H/facility – 17%

Correct usage of condoms: YES – 91% NO – 9%

Received information on other HIV prevention methods: YES – 90% NO -10 %

Linkage to accessibility HIV services: YES - 70% NO - 30%

Source of information on HIV services, care and management: Youth champion - 70% CHP - 10% Health worker at facility- 20%

CONCLUSION:

Youth and adolescents lack access to HIV services due to improper linkage. Peer to peer engagement and linkage increases accesibility to HIV services and commodities as well as reducing stigma.