Center for Global Health

MSC10-5550
1 University of New Mexico
Albuquerque, NM 87131

Phone: (505) 272-8207
Fax: (505) 272-8441

Research and Clinical Facilities in Siaya, Kenya

Siaya District

House in the Siaya community

House in the Siaya community

Siaya district is located one hour from Lake Victoria and is one of 12 districts in the Nyanza Province of western Kenya. Siaya district is one of the poorest districts in Kenya, with the vast majority of households having incomes below the poverty line. According to the 1997 District Development Report, the population of the district was 919,832, with an average growth rate of 3.1% per annum. The district is primarily comprised of young individuals, with 58.3% of the population ranging between 0 to 9 years of age. Problems within the community include low farm productivity, high rates of unemployment, and most strikingly, resource-constrained health facilities due to poverty.

In addition to being one of the poorest districts in Kenya, Siaya district also has the highest rates of morbidity and mortality in the country due to infectious diseases. Infant mortality rates in Siaya are very high ranging from 80 to 200 per 1,000 births. The most common diseases in Siaya district are malaria, HIV/AIDS, respiratory infections, and skin diseases. Severe malnutrition is another major problem within the community, with rates estimated at 2.5 to 5% in children less than 36 months of age. This equatorial community of East Africa has one of the highest rates of malaria in the world, resulting in around a 20% mortality rate in children less than 48 months of age. At any point in time throughout the year, 83% of the children below 36 months of age are carrying malaria parasites in their system. Those children that survive frequent episodes of malaria during early life gradually gain immunity to the disease throughout late childhood and early adolescence. However, acquired immunity to malaria is lost when women become pregnant. The increased susceptibility to malaria and other infectious diseases during pregnancy translates into unacceptably high rates of morbidity and mortality for pregnant women and their unborn children. Recent statistics at Siaya District Hospital show that there are approximately 3 births per day. Further statistics illustrate that 11.2% of infants were born with low birth weight, and 4.9% were born pre-term. Since 17.4% of 1375 women (primarily primagravida) visiting the Siaya District Hospital Antenatal Clinic from August 2002 to August 2003 had a positive blood smear for malaria, these high rates of low birth weight and pre-term delivery are likely related to malarial infection during pregnancy.

Over the last decade, the health within the Siaya community has been dramatically affected by HIV/AIDS. Recent unpublished studies by an NGO working within the region show that as many as 33 to 41% of the women who attend antenatal clinic during pregnancy are HIV positive. This high rate of HIV in pregnant women has resulted in an alarmingly elevated rate of HIV in newborns and partners of these women. A recent confidential, volunteer HIV testing center found that 50.5% of individuals that were tested were positive for HIV during 2003. The exceedingly high rate of HIV creates additional problems such as the lack of a clean blood supply for treating the overwhelming burden of malarial anemia in the pediatric population.

Siaya District Hospital (SDH)

Siaya District Hospital Pediatric Ward

Siaya District Hospital Pediatric Ward

SDH is a 360 bed facility located in the heart of the Siaya district in western Kenya. Although the hospital was designed to accommodate 360 beds, it is frequently well beyond capacity since it is the only hospital serving the district of well over 1 million people. The pediatric ward is a 60 bed facility that admits as many as 30 children per day during peak malaria episodes following the rainy season. Since the average stay for each admission is approximately three days, the facility is overburdened throughout much of the year. Since the facilities are so overcrowded, patients and their families routinely sleep two children per bed. The addition of new beds, as part of our ongoing activities in the facility, has dramatically improved the ongoing crisis.

In addition, the project also performed renovations of the pediatric ward to improve the quality of health care in the impoverished rural setting. Improvements to the facility included, providing a clean source of water for drinking and bathing, implementing proper sanitation, and installation of an intact roof that no longer allows flooding during the tropical rains.

In addition to serving the pediatric population within the community, SDH is also the primary health facility for adult care as well. The maternity ward and other adult wards are faced with the challenging problem of taking care of the large population of adolescents and adults suffering from HIV/AIDS.

University of New Mexico/KEMRI Laboratories at SDH

UNM/KEMRI Laboratory in Siaya

UNM/KEMRI Laboratory in Siaya

As part of ongoing activities in Kenya, the project established state-of-the-art research facilities adjacent to the pediatric ward at the Siaya District Hospital (SDH). The University of New Mexico research laboratories at SDH are in collaboration with the Kenya Medical Research Institute (KEMRI) and Ministry of Health, Kenya. The various investigations being conducted on pediatric clinical specimens include: extensive hematological analyses, microscopic and molecular-based parasite determination, bacterial and virological investigations, molecular immunological experiments, genetic studies, and evaluation of the role of co-infections in promoting malarial anemia. These activities afford an opportunity for training and capacity building of the local populace to enable them to respond to the growing challenge imposed by infectious agents in western Kenya.