Community Adaptation to Malaria and Rift Valley Fever in Baringo County, Kenya

Abstract

Community Adaptation to Malaria and Rift Valley Fever in Baringo County Malaria and Rift Valley Fever (RVF) are climate sensitive mosquito borne diseases of great public health concern. Baringo County experiences seasonal transmission of malaria during the rainy season while RVF was reported for the first and only time in 2006-2007 during the El-Nino rains. This study sought to establish the extent of community adaptation to malaria and RVF among community members in Baringo County. A mixed methods approach was adopted. Key informant interviews (KII) with veterinary officers, nurses and community members; focus group discussions (FGDs) with community members and observations generated qualitative data while surveys with household members (n=560), livestock traders (n=203) and slaughter facility workers (n=10) produced quantitative data. Analyses for FGDs and KIIs were conducted through content analysis. Quantitative data was analyzed using summary and inferential statistics. The results indicate that communities had bio-medical and local knowledge of malaria etiology and engaged in socio-cultural practices that influenced their vulnerability to the disease. Communities coped with malaria using both traditional and conventional methods of vector control. At the onset of suspected malaria, 28.9% of respondents sought care from a health facility, 37.2% used painkillers, 26.6% herbal remedies, 2.2% remnant malaria medicines, 2.2% over-the-counter anti-malaria drugs, 1% traditional healers and 1.8% other treatments. Subsequent treatment was sought in health facilities. Their ability to deal with malaria was compromised by lack of or limited bed nets, inconsistent use of bed nets and non-compliance to malaria medicine. In contrast to malaria, the communities had little knowledge of RVF etiology and seasonality but reported that the main avenues through which an individual could be infected with any zoonotic disease were consumption of meat (79.2%) and milk (73.7%) or contact with blood from sick animals (40%). Ownership of susceptible livestock species, risky consumption patterns of livestock products, and poor handling of sick and dead animals increased community vulnerability to RVF. There were neither community led initiatives towards prevention of human/animal RVF cases nor sensitization campaigns. In conclusion, communities in Baringo had a better adaptive capacity for malaria than RVF and more action is required to make them resilient to both diseases. The study therefore recommends that continuous health education regarding the importance of adopting prevention and management measures of malaria and RVF infections be provided to community members in appropriate formats. In addition, strengthening of veterinary services and inclusion of communities in participatory disease surveillance will enhance the County’s ability to detect livestock disease outbreaks.