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    Mosquitoes around the home can be reduced significantly by minimizing the amount of standing water available for mosquito breeding. Residents are urged to reduce standing water around the home in a variety of ways.


    The best way is to avoid being bitten by mosquitoes.This can be accomplished using personal protecting  while outdoors when mosquitoes are present. Treated bed nets should be used sleeping. Mosquito repellent should be used when outdoor.


    Nearly half of the world’s population is at risk of getting malaria. Pregnant women are particularly at risk of malaria. Children under 5 years are at high risk of malaria.


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Deep in rural Western Kenya lies a clinical research center which has not only changed the face of the surroundings but has equally brought improvements in health research issues in the region and beyond.

This is the story of Kisumu West District based Kombewa Clinical  Researce Center of the Kenya Medical Research Institute (KEMRI) in a joint  project  with the  Walter  Reed  Project (WRP).

It  has  transformed the  region  through improved  health  services  and research activities through partners.

Propelled  by its vision of excellent  health research, the WRP/KEMRI Kombewa Center came  up with a  health and  demographic surveillance  system (HDSS),  within  its geographical area to improve general health services in the region.

The Kombewa HDSS which is a member of INDEPTH Network, is designed to track
on a regular basis the evolving demographics and health status  of the study populations over time.

The International Net work for the Demographic Evaluation of Populations and their  Health  (INDEPTH)  Network is an umbrella organization for a group of independent health research centres operating health and demographic surveillance system (HDSS) sites in low- and middle-income countries.

INDEPTH Network is a pioneer in health and population research, providing answers to the most important questions in development, a move  that  has  seen  the  Kombewa  center benefit from facilities through the Network.

Dr. Walter Otieno who is a Principal Investigator at the Kombewa Center acknowledges  the  support from  INDEPTH Network. “The center continues to strive for excellence in health  research  and  this  has been boosted by our HDSS.” said Dr. Otieno.

Apart from Health and Demographic dynamics monitoring, the HDSS site is also providing a  platform for the  USA Medical Research Unit in Kenya (USAMRU-K's) work in clinical trials, infectious disease research and a Platform to assist in community health care.

According to the Kombewa HDSS Chief Mr. Peter  Sifuna, the  site  provides a sampling frame for studies and collaborative research projects, as well as the provision of reliable denominators  to calculate rates of diseases  within the  geographic areas in Kisumu and Siaya counties in the Nyanza region.

“This program has GPS-located every home that  exists within the  catchment   area  and conducted  baseline population  and housing survey.

It has a population of 137,987 which is drawn from over 30,000  households residing in the geographic areas of interest mainly in Kisumu and Siaya counties,” says Sifuna.

Malaria  is  endemic  in  the areas  under surveillance. The HDSS which   involves an integrated  field and  computing  operations, designed to manage the longitudinal follow up of residential units, households, individuals,

and access to and utilization of health facilities, has greatly helped in easing the  work,  explains Dr. Otieno who has for several years worked in the area of malaria.

He explains that  the  computing operations involved the  management  of a  relational database  and the  production  of  household registers for monitoring the population. “In this system,  household  socioeconomic  and educational status surveys are also conducted annually  to  complement the morbidity and  demographic  data,” says Dr.Otieno, an authority in clinical trials.

The field operations involve periodic house-to-house interviews, surveillance of pediatric out-patient  visits  in  peripheral  health facilities,  and  monitoring  of  pediatric  in-patient visits to the hospitals.

The population  is monitored by field staff who  visit each  household  bi-annually  to capture health and demographic information which include pregnancies, birth rates, death rates, causes of death, immunization status,  in-and  out-migrations  rates  and  a range of other socio-economic information.

Various  studies conducted on  the  HDSS platform  take  advantage  of  the sampling frame  inherent  in the  HDSS, whether  at individual, house hold/compound or regional levels, explains Sifuna.

”INDEPTH Network remains the  only organization in  the world  capable  of  producing reliable longitudinal data on the lives of people in low- and middle-income countries.” he says.

This has been through its global network of health  and  demographic surveillance system (HDSS) field sites in Africa, Asia and Oceania.”

Among the key studies that  the Kombewa center prides  itself with  are  malaria  in pregnancy, including the interaction between malaria and HIV during pregnancy, interactions between vitamin supplementations and malaria treatments given during pregnancy, and the effectiveness antiretroviral drugs to reduce the risk of maternal to child transmission during breast feeding.

With  its HDSS, Kombewa  site  has  maintained  a sterling  performance  through  its engagement with INDEPTH.

The WRP/KEMRI Health &  Demographic Surveillance System (HDSS) is a population registration system designed to track on a regular  basis, the  evolving  demographics and health status of study populations over time

By Bernard Okebe, Kisumu,