Poster Presenters

Background: Translating vaccination willingness into actual uptake remains a persistent implementation challenge. In the context of Kenya's healthcare worker (HCW) influenza vaccination demonstration project, discordance between stated intentions and vaccination behaviour was observed in both directions, among willing and unwilling HCWs alike. Understanding these bidirectional gaps is essential for designing effective, sustained vaccination programmes.

Methods: A mixed-methods evaluation was nested within the HCW influenza vaccination project across four counties including Kakamega, Nakuru, Mombasa and Siaya. A structured survey was administered to 1614 HCWs at a pre-vaccination timepoint to assess willingness and repeated at post-vaccination to assess actual uptake. Sub-counties were randomly selected within each county. A qualitative component comprising nine focus group discussions and 63 in-depth interviews, stratified by vaccination status and willingness, was conducted between July 2024 and January 2025 to explore drivers of this discordance.

Results: Among HCWs who pre-vaccination reported willingness to receive the influenza vaccine, 74% were subsequently vaccinated while 26% were not – indicating that even strong prior intention does not guarantee uptake. Conversely, among those initially unwilling, 57% were nonetheless vaccinated, demonstrating that on-site delivery and peer influence successfully converted a majority of hesitant HCWs. Qualitative findings identified four primary motivators: workplace-based vaccine access, zero vaccination cost, peer social proof from vaccinated colleagues and structured health education. Key barriers among the non-vaccinated included low perceived personal risk, reluctance toward annual dosing, safety concerns among pregnant women and those with comorbidities, inadequate pre-campaign sensitization, and residual COVID-19 vaccine mistrust.

Conclusion: Discordance between vaccination intention and behaviour runs in both directions, pointing to distinct intervention targets. Logistical and access barriers prevent uptake even among willing HCWs, while on-site peer delivery effectively overcomes initial hesitancy. Targeted pre-campaign sensitization, digital reminder systems, and vaccination certification are needed alongside sustained convenient access to strengthen HCW vaccination programs.

Background: Malaria in pregnancy remains a major public health concern in sub-Saharan Africa. The prevalence in Western Kenya exceeds 20%. While the association between malaria in pregnancy and low-birth weight (LBW) is well-established, critical gaps persist in understanding how the timing and frequency of infection modify this risk. This study aimed to assess the burden, timing, and frequency of malaria infection in pregnancy and their association with LBW in Western Kenya.

Methods: We conducted a Kenya-specific sub-analysis from Pregnancy Risk, Infant Surveillance, and Measurement Alliance (PRISMA) Maternal and Newborn Health, a multi-country, prospective, open-cohort study that enrolled pregnant participants

Sickle cell disease (SCD) affects approximately 305,800 newborns annually worldwide, with nearly 75% of these births occurring in Sub-Saharan Africa. In Kenya, SCD remains a significant cause of childhood morbidity, yet structured outpatient support between clinic visits is largely absent. Key challenges include inconsistent medication adherence, poor continuity of care and limited caregiver engagement, particularly during acute pain episodes and in the intervals between clinical encounters.

CELLA is a mobile health application designed to address these gaps in SCD self-management. Developed for patients and their caregivers, the application provides scheduled medication reminders, symptom and hydration logging, caregiver-linked monitoring dashboards, and peer-support forums.

Usability and feasibility were assessed through a pilot study involving 15 patients and caregivers, with data collected using structured questionnaires administered via Google Forms. Usability was measured using the System Usability Scale (SUS). Preliminary findings demonstrated above-average usability, with a mean SUS score of 76.3. Self-reported medication adherence improved from 60.4% before app use to 84.6% after use, and participants used the application for an average of 11.5 of 14 days. Formal evaluation of medication adherence rates and clinical outcomes is, however, ongoing.

CELLA demonstrates the potential of mobile health tools to extend SCD care beyond the clinic, supporting both patient self-management and caregiver involvement. These findings warrant further evaluation through larger, controlled studies in resource-limited settings.

Background
Early in 2025, increased chikungunya activity was reported in Indian Ocean territories, signalling regional risk before the outbreak was suspected along the Kenyan coast. In June 2025, Mombasa County reported an unusual increase in acute febrile illnesses with severe arthralgia following heavy rainfall. We investigated to determine the magnitude of the outbreak and describe its distribution by time, place, and person.

Methods
We conducted a descriptive outbreak investigation in Mombasa County from March to June 2025. We reviewed health facility records, conducted active case finding, and  laboratory testing. A suspected case was defined as acute fever (>38.5°C) or reported fever with severe arthralgia, negative malaria and dengue tests. A confirmed case was a suspected case with chikungunya virus detected by reverse transcription polymerase chain reaction (RT-PCR) or IgM rapid diagnostic test (RDT). Demographic and clinical data and blood samples were collected for RT-PCR testing for chikungunya, dengue, and Zika viruses. Descriptive analysis was conducted.

Results
Between March and June 2025, 569 suspected cases were identified; 207 were tested and 107 (51.7%) were confirmed, including 83 (77.6%) by RT-PCR and 24 (22.4%) by IgM RDT. The median age was 27 years and 51% were female; no deaths occurred. Among 48 acute-phase blood samples, 23 (51.1%) were RT-PCR-positive for chikungunya and 2 (4.2%) for dengue virus; no co-infections with malaria, dengue, or Zika were detected. Cases increased from April, peaked in May, and declined by mid-June. Likoni 69/107 (64.5%) and Jomvu 24/107 (22.4%) sub-counties reported the highest burden.

Conclusions
The investigation confirmed widespread community transmission of chikungunya in Mombasa County, limited RT-PCR capacity, and poor performance of IgM RDTs. Strengthening RT-PCR access, surveillance, early outbreak recognition, and vector-control preparedness is recommended to mitigate future transmission.

Key Words: Chikungunya, Reverse transcription polymerase chain reaction, Mombasa

Background: H.C.W contains harmful microorganisms, posing risks to patients, health workers, and communities. In Kenya, HCW management remains a systemic challenge—most facilities lack segregation protocols, and hazardous waste is often mixed with general waste and disposed of unsafely. This contributes to environmental degradation, disease transmission, and vulnerability to climate-sensitive health threats such as flooding and waterborne outbreaks.

Problem Statement: Migori County generates approximately 0.2 kg of HCW per patient per day acrossservice delivery units. Historically, waste was not separated or treated, reflecting national gaps. The county sought a climate resilient, sustainable solution that would reduce contamination, enhance public health, and support infrastructure for vulnerable populations.

Aim: To develop and implement a health care waste management system that safely treats hazardous waste and repurposes it into durable sanitation materials, contributing to climate resilience and circular economy goals.

Methods: With support from UNDP and the Ministry of Health, Migori County installed the SterileWave250 microwave HCW treatment facility, licensed by NEMA. The machine sterilizes and shreds waste at 40 kg per cycle and producing over 3 tons of sterile byproduct. Treated waste was sieved, dried, and mixed with murram and cement using a Makiga block moulding machine. Various ratios were tested to produce bricks for sanitation infrastructure.

Results: The most stable mixture—3 parts HCW: 2 parts murram: 1 part cement—yielded durable paving blocks. These bricks were used to construct latrines, walkways, and drainage systems, enhancing climate resilience by reducing reliance on virgin materials, lowering greenhouse gas emissions, and improving sanitation in flood prone areas.

Conclusion: This study demonstrates that circular economy approaches to healthcare waste can simultaneously reduce environmental hazards and strengthen public health resilience. These findings support integration of circular economy principles into Kenya’s healthcare waste management policy and national health security frameworks.

Introduction: Antimicrobial Resistance (AMR) is a primary threat to Kenya’s fiscal stability, with drug-resistant infections projected to drain up to 5% of national GDP by 2030 through productivity loss and escalating treatment costs. A critical economic gap exists in the "prescription-dispensing loop," where irrational prescribing and informal over-the-counter access bypass national stewardship protocols. Manual systems allow for massive "leakage" of restricted antimicrobials, forcing the state to spend significantly more on expensive, second-line "Reserve" drugs that currently cost up to 10 times more than standard treatments.

Aim: This study proposes a closed-loop, standards-based digital e-prescription framework designed to structurally enforce antimicrobial stewardship as a mechanism for national cost-containment and health security.

Methods: The proposed framework utilizes machine-readable clinical logic to translate the Kenya Essential Medicines List into mandatory digital guardrails. The system is designed to require dual-token verification, a validated digital clinician signature, and a matching diagnostic code before any antimicrobial dispensing can occur at the pharmacy level. The research will simulate the transition from manual to digital workflows to measure potential reductions in fiscal "waste" caused by unauthorized dispensing and treatment failures.

Anticipated Results: The implementation of these digital guardrails is projected to reduce irrational antibiotic use by 65%, potentially saving the Kenyan healthcare sector over Ksh 1.2 Billion annually in avoided secondary treatment costs. Furthermore, by ensuring patients receive the correct first-line therapy, the system is expected to reduce hospital stay durations by an average of 3.5 days, directly boosting labor productivity and protecting the national "Human Capital" index.

Conclusion: Strengthening public health for economic growth requires moving beyond passive guidelines toward digital fiscal enforcement. This proposed e-prescription framework offers a scalable solution for health sovereignty, ensuring that limited public resources are preserved to safeguard both the lives and the economy of the nation.

Background
Undetected tuberculosis (TB) in children ≤5 years can rapidly progress to active disease, including drug-resistant forms, posing a threat to child health and public health. Children living in households with bacteriologically confirmed TB patients are at high risk, yet barriers such as long distances to health facilities and transport costs delay timely screening and preventive care.

Aim
To evaluate the effectiveness of transport-supported contact invitation in improving TB detection and TPT initiation among household contacts, particularly children ≤5 years.

Methods
Household and social contacts of 111 bacteriologically confirmed TB index patients were systematically identified and invited for facility-based screening. Contacts were reimbursed KSh 300 (USD 2.30) for transport costs. Screening followed the national TB diagnostic cascade, including symptom screening, clinical evaluation, Xpert MTB/RIF and smear microscopy, chest radiography, treatment initiation, and TB preventive therapy (TPT) for eligible contacts. Descriptive analyses summarized outcomes, comparing children ≤5 years and >5 years. Programmatic outcomes during implementation (Jan–Dec 2025) were compared with a pre-implementation baseline (Jul–Dec 2024) using monthly rates.

Results
Of 349 contacts invited, 57 were children ≤5 years (16%) and 292 were >5 years (84%). 71 contacts (20%) were presumptive TB, 53 (75%) were evaluated, yielding 11 TB cases (21%), including 7 children ≤5 years (64%) and 4 individuals >5 years (36%). Of 338 (97%) TPT eligible contacts, 232 (69%) were initiated. Programmatically, monthly contact screening increased from 232 to 823, paediatric TB detection from 2.5 to 5.4 cases, and TPT initiation among children ≤5 years from 14 to 53 per month following implementation.

Conclusion
Transport-supported contact invitation is associated with improved paediatric TB detection and TPT uptake, particularly in children ≤5 years, by enhancing access to screening, early detection, and prevention. Integrating contact invitation into routine Maternal and Child Health services can strengthen equitable TB detection systems.

Background: Kenya reports an average of 10 outbreaks per year. Murang’a County has had a recurrence of anthrax, including in February 2024, when 18 suspected human cases were linked to a dead cow. The magnitude of the outbreak and the drivers of recurrence were unknown. Investigation sought to characterize anthrax cases and identify the possible drivers of recurrence in Murang’a.

Methods: An active case search was conducted in health facilities and the community. Suspected animal case was a sudden death with non-clotting bleeding from body orifices and confirmed case was Bacillus anthracis gram stain positive. Suspect human case was a case with painless skin lesion (eschar) or abdominal pain and diarrhoea after exposure to a suspected animal case. Cases were interviewed and data collected subjected to descriptive analysis.

Results: Investigation identified 14 animals (13 suspected and 1 confirmed) with a county attack rate of 8.8/100,000 population, and Kigumo being most affected at 18.9/100,000. In humans, 71 cases (22 from health records and 49 in the community) were identified. There was one community death hence a case fatality rate of 1.4% (1/71). Attack rate among humans was 14.3/100,000 population in three sub-counties, with Kigumo sub-county recording 31.4/100,000 population. The 10–19-year age group accounted for the majority at 23.9% (17/71). Based on 59 interviewed cases, abdominal form was 62.7% (37/59) and cutaneous form was 52.5% (31/59). Of animal cases, 85.7% (12/14) were buried unprofessionally, 7.1% (1/14) were fed to dogs, and 7.1% (1/14) were consumed by humans. Livestock owners respondents, 82.4% (14/17), would neither disinfect slaughter sites nor vaccinate livestock.

Conclusion: Human outbreak was linked to poor handling and consumption of livestock carcasses. Improper carcass disposal and poor livestock vaccination could be contributing to anthrax outbreaks  recurrence. Enhanced community engagement on handling of anthrax cases and livestock vaccination was recommended.

Introduction

Tungiasis is a neglected tropical disease mostly attributed to poor living conditions. Social behavior change is key in achieving proper hygiene as a preventive measure. Regular smearing of houses is a doable practice that promotes an environment free from fleas. If carried out communally, the goal is efficiently achieved. 

Objective:

To evaluate the impact of collective community smearing towards control of Tungiasis.

Methodology:

In February 2024, 156 jigger cases were treated in 84 households in Emanyinya CU and 141 cases in 72 households in Emmukunzi CU (the neighboring CU). Dusting was done in all households.  

Additionally, community members in Emanyinya CU were engaged in a discussion on doable practices of jiggers’ prevention with a focus on smearing of households. 

The community members agreed to be carrying out smearing of households on Wednesday of every month. Towards the day, the community were being mobilized to gather the required resources which included dung and water.

On the material day, smearing was done by the household members across the community unit.

Findings:

Evaluation was carried out in April 2024 to assess the impact of the practice. It was noted that prevalence of Jiggers infestation in Emanyinya CU had dropped significantly from 156 cases to 18 (88%) cases in 6 households (91%) due to reduced household re-infection compared to Emmukunzi CU whose prevalence had reduced from 141 cases to 115 (18%) in 58 households (19%), where the community smearing day was not being implemented.

Conclusion:

Community smearing day doesn’t overrule but supplements the routine household smearing. This strategy is cost effective as it is self-driven by the community using local resources.

Leveraging on existing community structures like local administration boosts advocacy and social mobilization since the community have already-builty trust in their local leadership.

Title: Comorbidities and Hospital Stay Among Mpox Patients in Utange Field Isolation Centre.

Authors: Dr. Nihal Nabhani1, Anthony Makenga Boniface1, Nassoro Mwanyalu2, Mwanasiti Abdalla2, Dr. Khadija sood2

Affiliations: 1Utange Field Hospital, Department of Health Services, Mombasa County2, EOC, Department of Health Services, Mombasa County2.

Corresponding author email: nihalnabhani@gmail.com 

Mob no: 0112307390

Background:

Mpox is a re-emerging public health threat that particularly impacts vulnerable groups with existing health conditions. Comorbidities like Human Immunodeficiency Virus, substance use, Tuberculosis and type 2 diabetes can extend illness and recovery times, affecting hospital capacity and care results. Identifying these trends can help with readiness and medical responses.

Objective:

To identify the presence of comorbidities among confirmed Mpox cases and evaluate their connection to the length of hospital stay at Utange Field Hospital.  

Methods:  

A retrospective descriptive analysis was performed using a Mpox line list of 264 patients admitted between August 2024 and September 2025. Key variables included comorbidity status, date of admission and discharge dates. Descriptive statistics such as frequencies and proportions summarized the findings.

Results:  

Among the 303 (56.4%) admitted positive Mpox patients, the case fatality rate was at 2.3%. Patients with comorbidities were 63 (20.8%) and HIV was the predominant disease at 52/63 (82.5%), substance use were at 4/63 (6.3%), while 11/63 (17.5%) were co-infected with HIV, Type 2 diabetes, Tuberculosis, Hypertension and substance use. The longest stay, at 144 days, occurred in a patient co-infected with HIV. All patients with comorbidities needed extended inpatient care, likely due to complications and slower recovery.

Conclusions:  

The presence of comorbidities among Mpox patients was linked to longer hospital stays. These findings highlight the importance of early identification of chronic illnesses during outbreak responses and tailored clinical monitoring for vulnerable groups.

Mycobacteriophage D29, a lytic phage against Mycobacterium tuberculosis, shows abortive infectivity toward Mycobacterium leprae. However, specific D29 encoded proteins may retain activity against M.leprae through conserved molecular interactions. This study employed computational modelling to investigate the structural stability and dynamic behaviour of three D29 lytic proteins; Holin, Endolysin A(LysA) and Endolysin B(LysB), when bound to M.leprae cell wall enzymes MurD and MurE, with the objective of identifying stable and functionally relevant protein-protein interactions for use as adjunct therapeutics.

Protein sequences were retrieved from UniProt and NCBI and modelled using Swiss-Model and Alphafold. Protein-protein docking was performed using HDOCK, followed by 100 nano-second molecular dynamics simulation using the Desmond package under NPT conditions. Conformational stability and flexibility were assessed through analyses of the Root Mean Deviation(RMSD), Root Mean Square Flactuation(RMSF), and Secondary Structure Element percentage(SSE%)

The results showed that most complexes equilibrated at an RMSD of within 1-3Å signifying stable conformational ensembles. RMSF results highlighted expected flexibility at terminal and loop regions while maintaining rigidity in core secondary structures. SSE% analysis revealed that LysB exhibited the highest stability across both MurD(48.26%) and MurE(44.54%) complexes, while LysA displayed variable stability- particularly low with MurD(22.59%)- suggesting conformation-dependent interactions. Holin complexes demonstrated overall moderate stability.

These findings indicate that D29 lytic proteins, particularly Endolysin B, can maintain stable interactions with M.leprae, warranting further experimental validation through extended simulations, in-vitro and in-vivo analyses.

Ultimately, this study bridges computational structural biology with targeted antimicrobial design, establishing a foundational framework for harnessing phage-derived lytic proteins as precision adjunct therapeutics and advancing innovative, non-traditional strategies in the global fight against antimicrobial and multidrug resistance.

Background:
Kenya faces recurrent public health threats that require sustained capacity to prevent, detect, and respond to health emergencies. The Joint External Evaluation (JEE) is a voluntary peer-to-peer mechanism for assessing implementation of the International Health Regulations (IHR 2005) core public health capacities. We evaluate Kenya's progress in developing these capacities and inform national health security strengthening priorities.

Methods:
We conducted a comprehensive qualitative assessment of Kenya’s IHR (2005) capacity using the World Health Organization (WHO) IHR JEE Tool, version 3.0. The evaluation covered 56 indicators across 19 technical areas organized under four domains: Prevent, Detect, Respond, and IHR-related hazards. Each indicator was assigned one score: 1 (no capacity), 2 (limited capacity), 3 (developed capacity), 4 (demonstrated capacity), and 5 (sustained capacity) based on capacity-specific attributes. To determine capacity scores, a consensus-based peer-to-peer method was employed, along with prior assessments and expert knowledge. An external team of experts subsequently reviewed the self-assessment results and conducted structured verification visits at national and subnational levels.

Results

Of 22 prevent indicators assessed, 14 (63.6%) had developed or demonstrated capacity, and 4 had limited or no capacity (18%). In the detect domain, 7/11 (63.6%) indicators had developed or demonstrated capacity, and 3 (27%) had no capacity. Of 16 indicators under response, 1 (6%) had sustainable capacity, 8 (50%) had developed or demonstrated capacity, and 6 (38%) had limited capacity. In the IHR-related hazard domain, only 1/7 (14%) indicators had developed capacity, with 6/7 (86%) having no or limited capacity. Overall, 31/56 (55%) indicators had developed, demonstrated, or sustainable capacity. 

 
Conclusion
These findings indicate that Kenya has developed capacity across many technical areas but still requires targeted improvements, particularly in areas with limited or no capacity. Strengthened advocacy, prioritization, and sustainable financing are essential to advance and maintain IHR (2005) capacities nationwide.