Poster Presenters

Introduction: By April 2025, Uganda had reported over 5,000 confirmed Mpox cases and 40 deaths across more than half of the country’s districts placing substantial strain on the healthcare system. However, data on recovery time and factors associated with delayed recovery were limited, constraining isolation capacity planning during the outbreak.

Aim: We estimated the median time to recovery and identified its predictors among hospitalised patients with Mpox in southwestern Uganda.

 Methods: We conducted a retrospective cohort study of laboratory-confirmed patients with Mpox admitted in Mbarara Regional Referral Hospital (MRRH) between October 2024 and April 2025. Time to recovery was defined as days from self-reported symptom onset to discharge following documented lesion resolution. Disease severity was clinician-classified as mild, moderate, or severe. Care seeking was categorized as early (≤3 days) or delayed (>3 days). Kaplan–Meier methods were used to estimate median recovery time, with log-rank tests for subgroup comparisons. Cox proportional hazards regression identified predictors of time to recovery.

 Results: Among 278 hospitalized patients, the mean age was 30 years (SD 8.8); 150 (54%) were male and 218 (78%) resided in urban areas. Median recovery time was 16 days (IQR 12–22). Sexual contact was reported as the likely exposure by 170 (61%) patients, and 241 (87%) presented late for care. Delayed presentation was associated with slower recovery (adjusted hazard ratio [aHR]=0.12, 95% CI 0.05–0.28), as was severe disease (aHR=0.63, 95% CI 0.47–0.84). Urban residence was independently associated with faster recovery (aHR=1.53, 95% CI 1.10–2.13).

 Conclusion: Recovery among hospitalized patients with Mpox was slower among those presenting late and those with severe disease. Interventions that promote early care seeking and timely clinical management could reduce hospital burden during Mpox outbreaks in similar resource-limited settings.

Background: Marburg Viral Disease (MVD) is a severe viral hemorrhagic fever with a case fatality rate of 24-88%. Kenya faced an elevated risk of MVD importation following the detection of cases in Jinka, Ethiopia, approximately 70km from the Kenyan border. We conducted a rapid risk assessment in North Horr Sub-county, Marsabit County, to assess the risk of MVD along the Kenya-Ethiopia border, preparedness of the county to respond to a potential MVD outbreak, conduct risk communication and community engagement (RCCE), and conduct targeted on-site capacity building for frontline healthcare workers and community-level actors.

Methods: A multidisciplinary team from the Kenya National Public Health Institute and Kenya Red Cross Society assessed MVD preparedness using the World Health Organization preparedness checklist tool. The team evaluated six core pillars: Infection prevention and control (IPC), laboratory capacity, surveillance, Points of entry, contact tracing, case management, logistics, RCCE, and continuity of essential health services. The team conducted capacity-building interventions, including sensitization sessions for healthcare workers and community members. Data was analyzed and presented in frequencies and proportions.

Results: Three major border crossing points: Selicho, Dukana, and Forale were mapped. Overall, MVD preparedness in North Horr sub-county was 37%. Pillar-specific scores were: Surveillance (33%), laboratory capacity (50%), contact tracing (43%), case management (44%), and RCCE (12%), IPC and safe dignified burials scored (25%), logistics scored (21%), and continuity of essential health services scored (0) %. As part of capacity-building efforts, the team sensitized 453 community members, 32 healthcare workers across seven facilities, and 81 community health promoters.

Conclusion: Preparedness for MVD in North Horr sub-county (37%) remains below the recommended (80) % threshold. Cross-border readiness should be strengthened through community-based active surveillance, screening at informal crossings, prepositioning of supplies, locally adapted risk messaging, and health systems strategies that account for population mobility patterns.

Background

Mpox is an emerging zoonotic disease with potential for person-to-person transmission and cross-border spread through travel. Early detection and coordinated response are critical in preventing community transmission. In October 2024, the first confirmed mpox case in Trans Nzoia County was identified at Maili Saba Dispensary in a patient with a recent travel history, raising concern about possible community spread.

Objective

To describe the surveillance, response, and facility preparedness observed during detection and containment of the first confirmed mpox case in Trans Nzoia County.

Methods

A suspected case presenting with compatible symptoms was identified at the OPD , mailisaba Dispensary. Case was reported through  routine surveillance system. The county team initiated an investigation per national guidelines, encompassing patient isolation, contact identification, and 21-day follow-up monitoring. Facility preparedness was documented through observation during the response. Risk communication was conducted via chief barazas and three consecutive days of local radio broadcasts covering prevention and transmission.

Results

Four close contacts were identified and monitored for 21 days with no secondary cases detected. Facility preparedness was limited; no dedicated isolation room existed, PPE was inadequate and required emergency sourcing from Moi Teaching and Referral Hospital Eldoret and partner organisations, and only 3 of 15 staff had received relevant training. Community awareness was raised through chief barazas and local radio, though total reach was not quantified.

Conclusion

Containment was achieved with no secondary transmission among four monitored contacts over 21 days, demonstrating the value of functional surveillance and multi-level coordination. However, critical gaps were exposed — no isolation room, inadequate PPE, and only 3 of 15 staff trained — which could have seriously compromised the outcome under greater transmission pressure. Addressing these gaps through staff training, PPE stockpiling, and designation of isolation spaces remains essential for future response readiness.

Background: Diarrhea, defined as the passage of three or more loose stools within 24 hours, remains a leading cause of morbidity and mortality among children under five globally, causing an estimated 1.7 billion cases and 525,000 deaths annually. In Kenya, approximately 19,500 deaths occur each year, largely linked to inadequate water, sanitation, and hygiene (WASH). In Rangwe Sub-County, Homa Bay County, diarrhea is the fourth leading cause of morbidity and mortality.

Aim: To determine the prevalence and modifiable WASH-related factors associated with diarrhea among children under five years in Rangwe Sub-County to inform targeted public health interventions.

Methods: A community-based cross-sectional mixed-methods study was conducted in June 2023 among 580 children selected through multistage sampling across four wards, 11 locations, and 29 community units. Quantitative data were collected using structured caregiver questionnaires and household observational checklists assessing WASH conditions, alongside laboratory analysis of household drinking water for fecal contamination. Diarrhea prevalence was assessed using a two-week recall period. Data were analyzed in STATA using descriptive statistics and multivariable logistic regression.

Results: The mean age was 24.0 months (SD ±13.1), with females comprising 73.9% (n=429). The two-week diarrhea prevalence was 22.8% (n=132), highest among children aged 7–12 months (33.7%). Independent modifiable predictors included lack of household water treatment (aOR 5.19; 95% CI: 2.22–11.95), presence of flies in latrines (aOR 19.82; 95% CI: 2.33–168.62), consumption of E. coli-contaminated water (aOR 1.56; 95% CI: 1.16–2.11), and uncovered water storage (aOR 5.44; 95% CI: 2.21–13.41). These findings identify actionable household and environmental intervention points.

Conclusion: Diarrhea prevalence remains high in Rangwe Sub-County, driven by preventable WASH-related exposures. Targeted interventions like household water treatment, safe water storage, improved sanitation with vector control, and community-based hygiene behavior change should be prioritized within local public health programs to reduce disease burden.

Background: Rabies is a fatal viral zoonosis caused by Lyssaviruses and is transmissible to all mammals. Globally, rabies causes 60,000 human fatalities annually, approximately 1 death every 10 minutes. In Africa, approximately 21,500 deaths occur each year due dog-mediated rabies, largely because of inadequate dog vaccination coverage, weak surveillance, and limited access to PEP. In East Africa, including Kenya, Uganda and Tanzania, rabies persists as a significant zoonotic threat linked to high free-roaming dog populations and insufficient coordinated control efforts. In Kenya, human deaths estimate 1,000-2000 annually. Coastal region of Kenya

Objectives: To determine prevalence of rabies in coastal region. counties and sub-counties most affected and describe the most affected species and months with highest cases of rabies cases

Methods: Decapitated animal heads suspected of rabies infection were submitted from various counties within the Coastal region of Kenya to the pathology laboratory in Mariakani. Brain tissue samples were obtained from the medulla oblongata through the occipital foramen using standard necropsy procedures. Rabies virus antigen detection was performed using the Direct Fluorescent Antibody Test (DFAT), following standard protocols recommended by the World Health Organization and the World Organisation for Animal Health.

Results: Approximately 35 brain screened for rabies, 75% (25/35) were positive for rabies. Kilifi and Mombasa county had positivity rate of 40% (10/25) and 36% (9/25), Taita Taveta 4%. Malindi Sub-county in Kilifi and Nyali sub-county each had 7 positive cases. Canines had the highest positivity of 80% (20/25), Zebra 8%, whereas Caprine, Feline and Equine each had positivity rate of 4%. Prevalence was high in months of July 32%( 8/25) and August 20% (5/25) and lower February and March each with 4% (1/25)

Conclusion: Rabies prevalence still high in coastal region with canines being the most affected.

Recommendation: Need for strengthened surveillance so that more suspected cases are detected and treated.  Mass dog vaccination to support national rabies elimination efforts. Enhanced awareness of Rabies disease

Background: Rapid growth in disposable diaper use in Kenya’s urban and peri-urban areas has outpaced waste management capacity. Improper disposal in open spaces, drainage channels, and pit latrines creates escalating environmental and public health risks. Kilifi County experiences a high burden of waterborne diseases, making faecal contamination from diaper waste a critical One Health concern.

Objective: To quantify improperly disposed disposable diapers and assess environmental, economic, and public health implications using a One Health approach.

Methods: A community-led 72-hour diaper collection campaign was conducted from 21–23 January 2026 across eleven purposively selected sites in two wards of Kilifi County. Sites represented common disposal pathways: municipal points, open dumps, drainage channels, roadside verges, and areas near pit latrines. The exercise covered 3,714 households within these catchments. Only visibly discarded used diapers were selectively collected; other waste streams were excluded. All visible diaper waste present during the period was gathered to approximate site load. Collected diapers were weighed. Counts were derived using an average post-use weight of 0.167 kg. Faecal load assumed 0.072 kg per diaper based on pediatric stool output averages. Economic loss used a mean retail price of KES 30 per diaper.

Results: A total of 2,318.45 kg of used diapers (approximately 13,880 diapers) were collected, mainly from undesignated dumping areas. These contained an estimated 1,000 kg of human faecal matter exposed to the environment, creating pathways for faecal–oral transmission including diarrhoeal, cholera diseases. Additional impacts included faster pit latrine filling, non-biodegradable land pollution, and an estimated retail value loss of KES 416,400 within 72 hours.

Conclusion: Disposable diaper waste is a significant yet overlooked One Health and climate-sensitive public health challenge requiring strengthened waste governance, public education, and enforcement of Extended Producer Responsibility to support progress toward SDGs 3, 6,11, & 12 locally driven multisectoral action urgently.

Introduction: Rabies continues to claim lives despite being preventable. In Kenya, over 600,000 dog bites and nearly 600 human rabies deaths were reported between (KHIS2017–2025). In February 2026, the death of a 9‑year‑old boy in Kiganjo, Thika subcounty, Kiambu County triggered a rapid, multisectoral investigation to understand the magnitude of the outbreak and strengthen community protection.

Methods: A mixed‑methods approach— retrospective review of human (Oct 2025–Mar 2026) and animal (Jan 2021–Mar 2026) records, active case search, data audits, KAP surveys, key informant interviews, and field observations. Human and animal rabies cases were classified per IDSR (2022) and CDC (2025). Target populations were bite victims, suspected rabies deaths, domestic animals, health workers, community health promoters, and veterinary officers. Data were collected using standardized tools, analyzed descriptively, and KAP scores categorized to compare knowledge and practices across cadres.

Results: From October 2025 to March 2026, 46 bite incidents were documented—most from dogs 38(82.6%), with boys aged 5-14 years disproportionately affected. Post‑exposure prophylaxis (PEP) was administered in only 27(58.7%) of cases. One rabies death was confirmed clinically. Animal surveillance showed 23/35(65.7%) positivity among submitted samples, mainly canine. A vaccination campaign reached 1,401 animals, though coverage varied by ward. Transect walks revealed environmental and behavioral drivers of transmission, including free‑roaming dogs, poor waste disposal, weak dog confinement practices, and frequent human–dog interactions.  Strikingly, only 1/56(1.7%) of healthcare workers had received rabies-related training in the past two years.

Conclusion: The findings highlight persistent transmission risks, gaps in PEP access, and limited health worker preparedness. Expanding vaccination, strengthening surveillance, and empowering communities through sensitization are urgent steps toward Kenya’s 2030 rabies elimination goal.

Introduction
Sustaining the elimination of onchocerciasis in formerly endemic areas requires continuous monitoring of both epidemiological and entomological indicators. This study presents a rapid assessment conducted in Western Kenya to evaluate residual community knowledge of onchocerciasis, document blackfly vector presence and biting patterns and assess the risk of transmission re-establishment. The assessment also aimed to identify geographic variations in knowledge retention and vector persistence following successful elimination efforts.

Methodology
A cross-sectional study design was applied across eight counties, covering 87 villages and 60 rivers. Data were collected through 156 structured community interviews and 267 geo-referenced mapping points. The assessment examined knowledge of river blindness, vector presence, biting behavior, and intermediate host (crab) distribution. Seasonal patterns and exposure characteristics were also analyzed to validate transmission dynamics and inform surveillance strategies.

Results
Overall awareness of onchocerciasis was 46.8%, with significant variation across counties, ranging from 5.3% in Vihiga to 100% in Homa Bay and Kisii. Blackfly presence was observed in 34.0% of areas, with the highest exposure in Kakamega (76.7%). Bite rates were high (79.2%), with peak activity reported in the evening (54.8%) and morning (47.6%). Exposure was predominantly on lower limbs (66.7%), consistent with known transmission patterns. Intermediate host presence was high (89.7%), indicating sustained ecological suitability for transmission. Seasonal peaks in April and August suggest a bimodal breeding pattern. Risk stratification identified Kakamega and Bungoma as high-priority areas for intervention.

Conclusion
The findings highlight high intermediate host density and declining community awareness. Sustained elimination will require strengthened surveillance, targeted health education and evidence based protocos for post elimination  monitoring to prevent disease recrudescence.

Background: Public Health Emergency Operations centres (PHEOC) are central pilllar of Kenya's security architecture, providing a structured platform for coordinating preparedness and response to  health emergencies. At national and county levels, PHEOCs play an important role in managing outbreaks and other public health threats. However, systematic evidence on their operational readiness, functionality and integration within existing health systems remains limited. This assessement aimed to evaluate the operational status of PHEOCs and identify gaps reqiuring improvement to strengthen preparedness and response capacity.

Methods: Across-sectional rapid assessment was conducted in December 2025 across all 26  operational PHEOCs in Kenya, including the national PHEOC and selected county EOCs representing diverse geographic and epidemiologic contexts. A mixed-methods tool adapted from WHO's joint External evaluation (JEE) and PHEOC framework and Standards was used. Communication and entry protocols involved official notification, scheduling and introductory briefings with county leadership. Data collection included structured questionnares, informant interviews with PHEOC leadership and staff, direct observation and document review. Key domains assessed included physical infrastructure, human resources and training needs, information flow, ICT capacity and coordination mechanism.

Results: The assessement revealed moderate operational capacity at the National Level PHEOC (76%) and county PHEOCs (71%). However, several operational gaps were identified across county-level PHEOCs. These include inadequate physical space to support surge staffing (67%) and prolonged emergency coordination, uneven communication systems, low staffing levels, limited access to real-time data and analytics platforms, inconsistent use of emergency communication tools and irregular  implementation of routine training and simulation exercise (4%)

Conclusion: The assesement demontrated progress in strengthening emergency coordination, particularly at national level while highlighting critical gaps at county-level PHEOCs. Targeted  investments in workforce development, infrastructure, ICT systems and routine simulation exercises are required to enhance PHEOC functionality and strengthen emergency preparedness and response systems across Kenya.

Background:
Anthrax is a priority zoonotic disease in Kenya, with outbreaks linked to handling infected carcasses. Environmental factors perpetuate Bacillus anthracis spores in soil, sustaining livestock exposure. In February 2026, a suspected cutaneous anthrax case in a meat trader at Shauri Moyo market (Burma) raised concern following a confirmed human case at the same market in November 2025. A One Health investigation was conducted to confirm the outbreak, identify additional cases, assess response timeliness, and evaluate implementation of prior recommendations.

Methods:
A descriptive outbreak investigation was conducted in Kamukunji Subcounty, Nairobi (February 16-26, 2026). A confirmed case was defined as a compatible clinical illness with laboratory confirmation of Bacillus anthracis. Active case finding involved review of outpatient records at two facilities, and clinician interviews. Veterinary surveillance data from Kenya Animal Health Biosurveillance System (KABS) (November 2025-January 2026) were reviewed to identify animal cases in source counties. Meat supply chain analysis traced carcass origins. Implementation of prior recommendations was assessed through key informant interviews response timeliness evaluated using the 7-1-7 framework.

Results:
Two laboratory-confirmed cutaneous anthrax cases were identified among male meat handlers aged 22 and 42. Detection, notification, and response targets (2-3, 1 and 2 days respectively) were met. Narok County supplied 25% (6,658/26,622) of carcasses to the market during the review period. Animal anthrax cases were reported in Tharaka Nithi, Kisumu and Kakamega counties, none major suppliers. Key gaps included lack of meat traceability, weak movement permit enforcement, suboptimal event‑based surveillance, limited risk communication, and an inactive County One Health Unit
Conclusion:
Despite timely human surveillance and response, persistent gaps in meat traceability, animal surveillance, and multisectoral coordination continue to enable zoonotic spillover. Strengthening enforcement of meat trade regulations, operationalizing County One Health Units, and implementing risk‑based livestock vaccination are critical to preventing recurrent anthrax outbreaks.

Introduction: On May 27, a measles outbreak was confirmed in Kabulasoke Subcounty, Gomba District, Uganda, following a suspected measles-related death, and laboratory confirmation of five IgM-positive cases.

Aim: Determine the magnitude of the outbreak, identify associated risk factors, estimate measles-rubella vaccination coverage (VC) and vaccine effectiveness (VE), and recommend control measures.

Methods: A suspected case was defined as fever and maculopapular rash with ≥1 of cough, coryza, or conjunctivitis in a Kabulasoke resident during March 1–August 31, 2025; confirmed cases were IgM-positive. We conducted a matched case-control study comparing 80 case-patients with 160 age- and sex-matched controls using structured caregiver questionnaires. VC was estimated as the proportion of vaccinated controls, and VE as (1–adjusted odds ratio)×100 using conditional logistic regression. Qualitative data from in-depth interviews were analysed using inductive thematic analysis.

Results: We identified 106 cases (5 confirmed, 101 suspected, 1 death). Median age was 24 months (IQR: 8–60), and the overall attack rate (AR) was 2.4/1,000 population. Children aged 9–17 months were most affected (AR: 13/1,000). Lugaaga Parish had the highest burden (AR: 120/10,000). Among 58 school-going cases, 52% were clustered in one school. Only 35% of case-patients had received ≥1 MR dose. The outbreak evolved over 12 weeks, peaking in May, with a 33-day delay before response initiation. School attendance (aOR=1.67; 95% CI: 1.05–2.71) and contact with symptomatic peers (aOR=2.12; 95% CI: 1.21–3.70) increased risk, while vaccination was protective (aOR=0.39; 95% CI: 0.27–0.55). VC was 72% and VE 60%. Qualitative findings highlighted male-dominated decision-making, vaccine mistrust, and reliance on traditional remedies.

 Conclusion: The outbreak was driven by suboptimal vaccination coverage, school-based transmission, and delayed detection. Strengthening routine immunization, school-based prevention, and promoting culturally sensitive community engagement are critical to preventing future outbreaks and advancing measles elimination.

Background: Rift Valley Fever Virus (RVFV) is a zoonotic arbovirus of major public health significance. The impact is significant, especially in pastoral communities with intense human-animal-environmental interactions. This study investigated the seroprevalence and risk factors of Rift Valley Fever (RVF) in healthy, unvaccinated human and livestock populations in Samburu County, Kenya.

Methods: A cross-sectional design was used to sample humans and livestock. A questionnaire was administered to the identified household heads and individuals to collect epidemiological data on risk factors for RVFV exposure. Descriptive and Bayesian statistical analyses were conducted to estimate prevalence and identify risk factors.

Results: Testing of 613 human and 795 livestock samples was done for anti–Rift Valley fever virus Immunoglobulin G (anti-RVFV IgG). Human anti-RVFV IgG was detected in 86 individuals (14.0%), males and females had 14.8% (45/304) and 13.3% (41/309), respectively. Only age >60 years (mean, 0.86; 95% CrI: 0.51–1.23) and contact with stagnant water (mean, 1.94; 95% CrI: 0.31–3.93) were credibly associated with RVF positivity. Livestock anti-RVFV IgG was found in 310 animals (39.5%), with rates of 39.6% (females: 212/536) and 37.8% (males: 98/259). Prevalence rates were: Sheep 49.3% (107/217), Goats 43.3% (123/284), Donkeys 38.9% (14/36), Cattle 29.9% (43/144), Camels 22.1% (23/104). After adjustment, species and age were independently associated with RVF seropositivity. Sheep (mean, 0.87; 95% CrI: 0.34–1.41) and goats (mean, 0.73; 95% CrI: 0.22–1.25) had higher seropositivity compared to camels. Younger animals had lower odds of RVF positivity than adults (mean, -0.76; 95% CrI: -1.21 to -0.31).

Conclusion: RVFV is actively circulating in both humans and livestock, with exposures increasing with age in Samburu County. Human exposure to stagnant water was a risk factor, while Sheep and goats were more exposed than other species. The results highlight importance of one-health approach to RVF surveillance, prevention, and control.