Bio

Prof. Kogi-Makau Bio

Bio-data: Prof. Wambui Kogi-Makau, Associate Professor (Human Nutrition) at the Department of Food Science Nutrition and Technology (DFSNT). I hold PhD in Human Nutrition, London School of Hygiene and Tropical Medicine, University of London, United Kingdom; MSc, Community Health (Nutrition) and BEd. (Home Economics) University of Nairobi (UON).

Publications


2014

2013

2012

2011

Tasokwa, K;, Nyariki D;, Mkwambisi D;, Kogi-Makau W.  2011.  Gender vulnerability to climate variability and household food insecurity. Abstract

Climate variability presents different challenges for men and for women in their efforts to ensure household food security. However, despite their central role, gender issues have received only cursory attention in adaptation studies. This article looks at causes of gender vulnerability to climate variability and household food insecurity in one sub-Saharan African country: Malawi. Data were collected through a household questionnaire survey, focus group discussions and key informants' interviews in Chikhwawa and Ntcheu districts, located in the southern and central areas of Malawi. Results revealed that exposure and sensitivity to climate risks vary between men and women; therefore, each gender responds differently to climate risks, with men having more opportunities than women. The results highlight the need for policies and interventions to empower women in the access to resources that can strengthen households' resilience to climate variability.

2010

Shay, TZ;, Haidar J;, Kogi-Makau W.  2010.  Magnitude of and driving factors for female genital cutting in schoolgirls in Addis Ababa, Ethiopia: a crosssectional study. Abstract

Background. Female genital cutting (FGC) is practised throughout the world, and is common in many Asian and African countries. Although FGC in Ethiopia has decreased, the practice is still very widespread. Methods. A cross-sectional study design with an analytical component was used to study girls attending randomly sampled primary schools in Addis Ababa between August and June 2008. A total of 407 girls, selected from four primary schools, and their respective families were recruited. Data were collected through self-administered and open-ended questionnaires and analysed using bivariate and multivariate models. Results. In this group of schoolgirls, 26.0% had undergone FGC at a median age of 4 years. FGC had most commonly been performed at age 1 - 5 years, when 50.9% of the total group had been circumcised. Of the girls attending government schools, 36.6% had undergone FGC. The majority of the procedures had been performed by traditional circumcisers (62.3%), followed by health workers (22.6%). The decision to subject the girl to FGC was most frequently made by mothers (38.7% of the FGC group), the remainder of the decisions being made by fathers (24.5%), both parents (22.6%) and relatives (14.2%). There was a significantly higher prevalence of FGC among girls attending government schools, girls of Guraghe ethnicity, and girls whose mothers had no knowledge about the harm of FGC. A smaller proportion of girls living with both parents than of those living with relatives had undergone FGC. Conclusions. FGC is prevalent in primary schoolgirls in the capital city of Ethiopia, despite improved availability of health information. This situation underscores the need to reinforce the national law against FGC. Creation of awareness should be focused on parents of Guraghe ethnicity and on government schools. Parental education should be promoted, and empowerment of women is required to fight FGC.

2007

Kirogo, V;, Kogi-Makau W;, Muroki NM.  2007.  The role of irrigation on improvement of nutritionalstatus of young children in Central Kenya. Abstract

A comparative, retrospective cross-sectional study was conducted to investigate the role of irrigation on improvement of nutritional status of children aged 6 - 59 months in a semi-arid setting. Two equal samples of fifty-nine children (aged 6 - 59 months) hereafter, referred to as the Project and the Non-project groups, respectively were randomly selected from households with and without access to irrigation water in Kieni East Division of Nyeri District, Kenya. The study area is situated in the drier western leeward side of Mt. Kenya and is characteristic by unreliable rainfall of between 500 to 1200 mm per annum. Weight, height and age of index children were determined and the corresponding standard deviations of weight-for-age, weight-for-height and height-for-age calculated and compared to the reference standards developed by the US National Centre for Health Statistics. Energy and nutrient intake was determined using 24-hour dietary recall method. The findings on socio-demographic characteristics showed that the Project and Non-project households were similar in terms of household size, land size, marital status of the respondent, maternal and paternal education and occupation. The calorie intake of over two-fifth (42%) of the children from the Non-project households compared to 39% from the Project households was below the Recommended Daily Allowance. The children from commercial farming Project households had significantly higher weight-for-age Z-score than those from commercial farming Non-project households. Similarly, children from high-income Project households had significantly higher height-for-age Z-score than those from high-income Non-project households. The prevalence of stunting was also significantly lower in the high-income Project households compared to high-income Non-project households. Among the male children, the prevalence of underweight was significantly higher in Non-project households than in Project households. Overall, the prevalence of stunting and underweight which are indicators of long-term nutritional deprivation were higher in Non-project households than Project households. The findings of the study led to the conclusion that irrigation contributes to increased per capita food availability resulting in higher energy intakes and subsequently enables households to safeguard young children against chronic malnutrition. Also, poverty as characterised by low household income remains a main determinant of nutritional status.

2006

Haidar, J;, Abate G;, Kogi-Makau W;, Sorensen P.  2006.  Risk factors for child undernutrition with a human rights edge in rural villages of North Wollo, Ethiopia. Abstract

Objective: To identify the factors associated with childhood under-nutrition in North Wollo, Ethiopia. Design: A cross-sectional study. Setting: Four purposefully selected rural villages (kebeles) in North Wollo zone of the Amhara Region, Ethiopia. Subjects: One hundred-forty four sampled households with under five year old children (n=200) comprising of 96 male-headed, 24 female-headed and 24 landless with children aged between six and 59 months. Main outcome measures: Determinations of anthropometric measurements and various socio-economic factors. Results: The overall prevalence rate of under nutrition as determined by stunting, underweight and wasting was 44.5%, 25.0% and 9.0% respectively with more preponderance among the toddlers. The proportion of under nutrition was higher in female-headed households. Shortage of farmland, lack of irrigation, dispossession of livestock, shortage of non-farm employment options, parental illiteracy, high number of children, water inadequacy, food taboos and wrong eating habits of families, poor child feeding practices, deprivation of health nutrition education as well as maternal attributes such as young motherhood, low body mass index and short stature of mothers influenced the nutritional status of the children. The prominent risk factors for under-nutrition among children were dispossession of livestock, child food taboos and wrong eating habits of families, deprivation of health/nutrition education, short stature and early marriage of mothers. Conclusion: This study led to the conclusion that improvement of household resources through promotion of irrigation and initiation of income generating livelihood options can reverse the nutrition situation for better. Health and nutrition education focusing on appropriate child feeding, eradication of harmful traditional practices such as early marriage and inequitable intra-household food distribution, encouragement of family planning and nutrition interventions including food diversification is recommended

Kogi-Makau, W;, Mwangi AM;, Mwikya SM;, Ngala S;, Sehmi JK;, Obudho E;, Mugo J.  2006.  The Joy and Challenges of Capacity Building for Better Nutrition in Africa.. Abstract

partners to recognize the need for tangible support in capacity building at institutions of higher learning for better nutrition in Africa. Objective: To articulate the experience of capacity building in nutrition in Africa using the Applied Nutrition Programme of University of Nairobi as a case. Design: Case study. Setting: Applied Nutrition Programme, Department of Food Technology and Nutrition University of Nairobi, Kenya The Experiences: In response to lack of critical mass of qualified nutrition professionals for effective mainstreaming of nutrition at community and national levels in Africa, the Applied Nutrition Programme of the University of Nairobi, since 1985, has been providing sound nutrition training at postgraduate degree level, to international students; mainly from Africa and with some from New Zealand, Sweden and Brazil. The Programme also conducts capacity building in form of short courses for Government Ministries, development partners and communities and will be launching a BSc degree programme in nutrition and dietetics this year (2005). The capacity building venture has helped integrate regional indigenous nutrition knowledge and local technologies with mainstream nutrition training, producing graduates who know both their subject and field. The Programme has expanded into nutrition in emergencies, interventions, dietetics, food as a human rights and nutrition policy, inline with its goal of contributing to regional development. Lack of consistent long-term funding is a major challenge. Others include the rigid nature of donor funding, increasing competition for students and delay, though in the phase-out, in timely completion of the degree programme. Conclusion: There is adequate demand for training and the Programme has the potential to meet a substantial portion especially if provided with the necessary support. The Programme is flexible and vibrant in keeping with the dynamism that nutrition, health and development challenges require. There is a need to define and impart a critical portion of nutritional knowledge to all working in development in Africa. Recommendations: The nutrition fraternity must define a package of critical nutrition knowledge for developmental communication, increase opportunities for training and lobby for responsive policy and partnership environment that supports all aspects of capacity building including technical, infrastructure, information communication technology, equipment and scholarships either in form of direct funding or through commissioned assignments.

WAMBUI, PROFKOGIMAKAU-.  2006.  Kogi-Makau, W. Report on Review of Food and Nutrition Security Technical Papers. For Food and Agriculture Organization (FAO). East African Medical Journal 68(9): 714-9. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.
WAMBUI, PROFKOGIMAKAU-.  2006.  Bayeh, Y.M., Kogi-Makau, W. and Mwikya, S.M.(2006). Microenvironment resource capacities, understanding of the right to food and nutritional security of under-five years old children in urban Bahirdar, Ethiopia (an intra-spatial perspective).. A paper presented at the 2nd International Food and Nutrition Conference (IFNC), Tuskegee, Alabama, USA: 8-10th October 2006.. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.

2005

Haidar, J; Umeta, M;, Kogi-makau W.  2005.  Effect of iron supplementation on serum zinc status of lactating women in Addis Ababa, Ethiopia.. Abstract

OBJECTIVE: To evaluate the impact of daily and weekly iron supplementation on serum zinc status among anaemic lactating mothers. DESIGN: A randomised iron intervention controlled trial. SETTING: Seven urban slum communities of Addis Ababa. SUBJECTS: Phase one of the study involved 207 anaemic lactating women assigned into two intervention groups; the daily (N=71) and weekly (N=71) Iron supplemented and the control group (N=68). Supplementation with 60 mg tablet containing 300 microg ferrous sulphate and 400 microg folic acid was done for three months while the control group was n otsupplemented. Phase two involved 53 participants systematically drawn from phase one. Main outcome measures: Haemoglobin from all subjects and serum zinc and ferittin levels following three months supplementation. Zinc status based on serum zinc value of less than 10.7% micromole/L. RESULTS: The mean baseline characteristics and serum zinc of the women at baseline were similar, overall marginal zinc deficiency prevalence was 11.3% and no zinc deficiency was detected. Following supplementation, zinc deficiency was detected in the supplemented groups but not in the control group. The mean serum zinc significantly changed in both supplemented groups while no change was observed in the control group. The reduction in the mean serum zinc was significantly higher in the daily than in the weekly supplemented group. CONCLUSION: Iron supplementation impacts negatively on serum zinc status (exacerbates zinc deficiency) and hence, its contribution to zinc deficiency deserves further investigation especially in the context of the on-going promotion of double fortification strategies that involve iron.

WAMBUI, PROFKOGIMAKAU-.  2005.  Adere, J.W., Kogi-Makau, W and Karuri, E.G. The Right to Adequate Food and Nutrition as Actualized by Christian and Muslim Mothers in Kibera. A Case Study of Kibera Slums in Nairobi, Kenya.. Paper presented at the Inaugural National Nutrition Congress. 21st-23rd February 2005.. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.
WAMBUI, PROFKOGIMAKAU-.  2005.  Maseta, E.,Kogi-Makau, W. and Omwega, A.M. Childcare Practices and Nutritional Status of Children Aged 6-36 Months Among Short and Long Term Beneficiaries of the Child Survival Protection and Development Programmes (The Case of Morogoro, Tanzania). Paper presented at the Inaugural National Nutrition Congress. 21st-23rd February 2005.. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.
WAMBUI, PROFKOGIMAKAU-.  2005.  Kogi-Makau, W., Project Evaluation Report, Middle Juba PHC-Somalia. A paper presented at the 2nd International Food and Nutrition Conference (IFNC), Tuskegee, Alabama, USA: 8-10th October 2006.. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.
WAMBUI, PROFKOGIMAKAU-.  2005.  Haidar, J., Umeta, M. and Kogi-Makau, W (2005). Effect of iron supplementation on serum zinc status of lactating women in Addis Ababa, Ethiopia. The East African Medical Journal. Vol. 82 No.7:349-352.. A paper presented at the 2nd International Food and Nutrition Conference (IFNC), Tuskegee, Alabama, USA: 8-10th October 2006.. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.
WAMBUI, PROFKOGIMAKAU-.  2005.  Adolescent Health: Programmatic Evaluation of the AoW Child and Adolescent Health in Tanzania. World Health Organization, Geneva. A paper presented at the 2nd International Food and Nutrition Conference (IFNC), Tuskegee, Alabama, USA: 8-10th October 2006.. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.
WAMBUI, PROFKOGIMAKAU-.  2005.  Kogi-Makau, W. Adolescent Health in Programmatic Evaluation of the Area of Work- Child and Adolescent Health in Tanzania. World Health Organization, Geneva (WHO). A paper presented at the 2nd International Food and Nutrition Conference (IFNC), Tuskegee, Alabama, USA: 8-10th October 2006.. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.
WAMBUI, PROFKOGIMAKAU-.  2005.  Haidar, J., Abate, G., Kogi-Makau, W. and Sorensen, P. Risk factors for child undernutrition with a human rights edge in rural villages of North Wollo, Ethiopia. East African Medical Journal. Vol 82 No. 12:625.. A paper presented at the 2nd International Food and Nutrition Conference (IFNC), Tuskegee, Alabama, USA: 8-10th October 2006.. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.
WAMBUI, PROFKOGIMAKAU-.  2005.  Mwangi A.M., Kogi-Makau, W and Ngala S. Report of the world vision. A paper presented at the 2nd International Food and Nutrition Conference (IFNC), Tuskegee, Alabama, USA: 8-10th October 2006.. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.

2004

WAMBUI, PROFKOGIMAKAU-.  2004.  Macharia, C.W., Kogi-Makau, W. and Muroki, N.M. Dietary Intake and Care Practices of Children in Kathonzweni Division, Makueni District, Kenya. East African Medical Journal, Vol 81 No. 8: 402-407. (A comparison of beneficiaries of a World Vision Kenya Pro. Paper presented at the Inaugural National Nutrition Congress. 21st-23rd February 2005.. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.

2002

WAMBUI, PROFKOGIMAKAU-.  2002.  Kogi-Makau, W. Women, Nutrition and Community Development. In: WOMEN Basic Education, Community Health and Sustainable Development. Monograph of Papers Presented at a Strategic Planning Workshop, University of Nairobi/UNESCO: 57-60.. Paper presented at the Inaugural National Nutrition Congress. 21st-23rd February 2005.. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.

2001

Kogi-Makau, Wambui; Tibaijuka, MG; MRGM;.  2001.  The Tanzania Family Planning Training Program:The Impact of an Innovative Training Strategy on Reproductive and Child Health Service Performance of Health Attendants in Tanzania. Abstract

This report is based on a study, implemented in Kasulu and Kibondo districts in Kigoma Region, Tanzania, to assess the impact of a health attendants’ pilot training strategy on reproductive and child health (RCH) services. The strategy was developed and implemented by the RCH-Unit of Ministry of Health (MOH) with technical assistance from Intrah/PRIME and was implemented with financial support from USAID. The training strategy, covering a period of four months (July to October, 1998), used a combination of on-the-job-training (OJT) and traditional central and distance-based learning (DBL). The training was divided into four modules. Modules 1 and 3 were centrally based while Modules 2 and 4 used OJT and DBL in which the HAs remained at the facilities where they worked. The DBL was backed by supportive supervision from facility in-change staff as onsite supervisors, district-based supervisors and trainers and regional trainers. It also utilized two key leaning aids (developed as part of this strategy): a handbook and solar-powered cassette player with audiotapes. Each trainee was given a solar/battery-powered cassette player and six audiotapes containing course content. The study utilized three different intervention designs to assess three different levels of impact. The study used pre-and post-test assessments of knowledge and skills to determine whether learning occurred among trainees as a result of the training. A non-equivalent control group design was used to compare whether the training significantly influenced provision of reproductive and child health services in trainee facilities over facilities whether providers had not been trained. The study requested feedback from various players on the HA training strategy. This assessment addressed attributes such as appropriateness, acceptance, achievement of the project’s objectives, how the project was comprehended/perceived and the reliability of this training approach. The HA training led to acquisition of knowledge as indicated by a significant change in the mean score of Module 1 pre-test (32.8) compared to post-test mean score (71.4)(P<.05). A similar trend was found in module 3 in which the mean pre-test score (70.5) was significantly lower than the post-test mean score (87.1)(P<.05). The skills assessment demonstrated a substantial gain in two skills: antenatal clinic client assessment and conducting growth monitoring. However, counseling services, care for mothers and neonates during the postpartum period and care during and monitoring progress in labor did not improve. As a result, the investigators conducted that HAs gained adequate skills in some areas while continued learning is essential in others, possibly through further OJT by the RCH trained CO/ACO at the HA work site. Comparison sites are also in need of improved training to improve their RH/FP skills. The data collection period for the service statistics assessment was divided into three blocks: prior to training (March-June 1998), during training (July-October 1998). The intervention group comprised 29 health facilities while the comparison group contained 25 facilities. For the comparison group, data were collected only for the periods before and after training. Six study instruments (five questionnaire and one data collection sheet) were used as data collection tools. From the RCH-Unit through the regional, district and facility levels, the training approach was considered to be suitable, especially for the targeted (HA) cadre. It was agreed that this target group required a training approach that emphasized practice oriented learning methods instead of a traditional didactic approach. To meet these needs, the project provided two key learning aids: the handbook and cassette tapes. The handbook was considered to be appropriate for three reasons: the handbook satisfactorily covered the training content, it was well illustrated, and it utilized language appropriate to the target audience. The cassette tapes were considered to be suitable learning aids because they were audible and contained appropriate and adequate content. However, audibility reportedly decreased sharply as battery power diminished. Nevertheless, feedback also highlighted area for improvement. Respondents pointed out that the approach was expensive. District planning boards that are responsible for financing training in the post health sector reform (HSR) era may not be able to afford to replicate the training. As a result, they may revert to the traditional central training approach. Respondents also reported that the use of solar powered cassette players were found to be vulnerable to frequent breakdown and other minor mishaps, As a result of these failings, a recommendation was made that ordinary battery-powered cassette players be adopted for future training. A recommendation was also made to review and edit the handbook was easy to understand and the illustrations were clear, they reported that there was room for improvement in these areas as well. The sustainability of this training strategy depends on the availability of sufficient funding to carry out all of the project’s elements, especially learning at the work site. The feasibility of replicating this successful intervention remains to be demonstrated.The HA training strategy set out to achieve certain objectives: develop a curriculum and two complimentary learning aids; select and prepare trainers, and both on and offsite supervisors; update facility in charge staff on RCH; and train a selected number of HAs. It was also planned as a pilot study for testing all of the components and documenting the strengths and weaknesses of the approach. In addition, the training was geared at empowered both the DHMT members and staff at the intervention facilities. This evaluation conducted that the HA training strategy achieved these objective.

Abate, Gugsa; Kogi-Makau, W; MNM.  2001.  Hygiene and health-seeking behaviours of households as predictors of nutritional insecurity among preschool children in urban slums in Ethiopia: the case of Addis Ababa. Abstract

The objective of the study was to establish hygiene and health-seeking practices most likely to be predictors of nutritional insecurity among children living in slums. A cross-sectional study was conducted from March to May 1997 comparing 192 households with and 192 without malnourished children. All the households with children in the 3 - 36-month age group were identified. Using underweight (weight-for-age) as an indicator of nutritional insecurity, the households were classified into two groups, namely nutritionally secure and insecure households Subsequently, sampling frames for each set of households were established and used to select the study households randomly. Four slums in Addis Ababa, Ethiopia, constituted the study sites. The results indicated that there was not a significant difference between secure and insecure households with regard to prevalence of immunisation and dietary (food withholding) habits during episodes of diarrhoea. After adjusting (by means of logistical regression) for covariates, six household behaviours were established as having the power to predict exposure to childhood natritional insecurity in urban slums of Ethiopia. The presence of children's faeces inside the house, failure to have diarrhoea treated at a health facility, prolonged storage of cooked foods (beyond 24 hours), feeding children with unwashed hands, and poor handling of drinking water and foods are risk factors that can predict nutritional insecurity. Advice with a view to achieving sustainable behaviour change in households, namely good personal and household hygiene practices and increased utilisation of health facilities is recommended as being essential in addressing challenges to nutritional insecurity and in optimising the success of public health programmes.

2000

WAMBUI, PROFKOGIMAKAU-.  2000.  Kogi-Makau, W. and Muthoka, S. Food Security of a Population Living in a fragile environment. International Conference on Nutrition, Tuskegee, Alabama, USA.. Paper presented at the Inaugural National Nutrition Congress. 21st-23rd February 2005.. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.

1999

Abate, Gugsa; Kogi-Makau, Kogi-Makau, Wambui; Muroki NM, Muroki NM.  1999.  Child-feeding practices as predictors of nutritional status of children in a slum area in Addis Ababa, Ethiopia. Abstract

In a across-sectional study carried out in four purposefully selected slum kebeles of Addis Ababa, the nutritional status of 758 children aged 6 - 36 months was measured and subsequently classified into malnourished and well nourished groups. Child-feeding practices of randomly selected mothers of the two groups of children were compared with the view of identifying practices that contribute to child-nutrition insecurity in the study area. The result indicated that the majority of the mothers (i.e. 99.5% in the malnourished and 98.4% in well nourished groups) had initiated breast-feeding, and no significant difference was found either in the median or mean duration of breast-feeding between the two groups of mothers. After adjustment has been made (through logistic regression) for covariates, the study established that exclusive breast-feeding beyond four months, feeding low quality diet with a frequency of less than four times and giving porridge with feeding bottle as well as low household income are the risk factors contributing to young children’s nutrition-insecurity in the slum section of Addis Ababa. Hence, demonstrative and sustained education focusing on appropriate child-feeding is recommended together with initiation of income generating projects with a view of empowerment of those families whose monthly income is low. [Ethiop. J. Health Dev. 1999;13(3):229-2 Introduction About 79% of the population of Addis Ababa lives in low-grade, congested slum areas (1). Studies which address nutritional problems have found that malnutrition continues to be a serious health problem in the slums (2-5). One study in Nairobi slum (6), where 86.2% of the preschoolers were reported to have been stunted, provides a good basis for understanding that slum children are most vulnerable to malnutrition. Hofvander and Eksmyer (7), who found about 3% prevalence of severe PEM, reported that PEM is the main nutritional problem for young children in the slum of Addis Ababa. It is a well established fact that malnutrition manifests itself as a function of many and complex factors (8-10). It is directly linked to poor dietary intake and diseases, which in turn result from an interaction of various underlying factors which include crisis in household food security, inappropriate child care and feeding practices, unhealthy place of residence, and insufficient basic health services (8-11). An unfavourable health environment caused by inadequate water and sanitation can increase the probability of infectious diseases and indirectly form certain types of malnutrition (8-11). Further, poor socio-economic variables, cultural beliefs, and lack of parental education, especially that of mothers, are all cited to affect a person's nutritional status (8-13). Thus, nutrition planning and advice to a community needs to be grounded on good information and knowledge of which individual variables

WAMBUI, PROFKOGIMAKAU-.  1999.  Kogi-Makau, W., Tibaijuka, G. Mtawali, G. and Mapunda, R. Study on the impact of an innovative training strategy on reproductive and child health service performance of health attendants in Tanzania. For Program for International Training in Health (INTRA. Paper presented at the Inaugural National Nutrition Congress. 21st-23rd February 2005.. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.
WAMBUI, PROFKOGIMAKAU-.  1999.  Abate, A., Kogi-Makau, W. and Muroki, N.M. Hygiene and Health Seeking Behaviour of Households as Predictors of Nutritional Insecurity among Preschool Children in Urban Slums in Ethiopia- The Case of Addis-Ababa. South African Journal of Clinical Nutrition. Paper presented at the Inaugural National Nutrition Congress. 21st-23rd February 2005.. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.

1998

Demissie, T;, Muroki NM;, Kogi-Makau W.  1998.  Food aversions and cravings during pregnancy: Prevalence and significance for maternal nutrition in Ethiopia. Abstract

A cross-sectional study of the nutritional significance of food aversions and cravings during pregnancy was conducted on 295 women in southern Ethiopia between February and May 1995. A questionnaire was used to collect data on dietary practices. Mid-upper-arm circumference (MUAC), triceps skinfold thickness (TSFT), and weight measurements were used to assess nutritional status. Slightly fewer than three-quarters (71%) of the women craved one or more foods, whereas about two-thirds (65%) avoided at least one food. Cereal foods, despite being staple foods in the area, were avoided by more women (41%) than any other foods. Livestock products, which were scarce at the time of the study, were craved by more women (55%) than any other foods. Comparisons using various anthropometric indicators revealed that women who avoided foods had significantly higher MUAC and TSFT than those who did not (p < .05), whereas there was no difference in nutritional status between women who craved foods and those who did not. However, those craving women who managed to get the desired foods had significantly higher weight gain (p < .05), but not significantly higher MUAC or TSFT, than those who did not. Aversion and craving were positively associated (c2 = 10.66, p < .001; odds ratio, 2.36). Thus, women who avoided foods were 2.4 times more likely to crave foods than those who did not avoid foods. This implies that aversion and craving are complementary processes geared towards ensuring optimal nutrition during pregnancy. Aversion results in the avoidance of monotonous diets, whereas craving calls for varied and nutritious foods. More research, however, is needed before such a conclusion is warranted.

WAMBUI, PROFKOGIMAKAU-.  1998.  Tsegaye, D., Muroki, N.M. and Kogi-Makau, Wambui. Food taboos among pregnant women in Hadiya Zone, Ethiopia. Ethiop. J. Health Dev.: 12(1):45-49.. Paper presented at the Inaugural National Nutrition Congress. 21st-23rd February 2005.. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.
WAMBUI, PROFKOGIMAKAU-.  1998.  Tsegaye, D., Muroki, N.M. & Kogi-Makau, W. Food Aversions and Cravings During Pregnancy: Prevalence and Significance for Maternal Nutrition in Ethiopia. Food and Nutrition Bulletin, Vol 19 no 1 1998: 20-26.. Paper presented at the Inaugural National Nutrition Congress. 21st-23rd February 2005.. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.
WAMBUI, PROFKOGIMAKAU-.  1998.  Meme, M.M., Kogi-Makau, W. and Muroki, N.M. (1998). Energy and protein intake and nutritional status of primary schoolchildren 5 to 10 years of age in schools with and without feeding programmes in Nyambene District, Kenya. Food and Nutrition Bulletin, Vo. Paper presented at the Inaugural National Nutrition Congress. 21st-23rd February 2005.. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.

1996

WAMBUI, PROFKOGIMAKAU-.  1996.  Muroki, N.M, Maritim, G.K., Karuri, E.G. Tolong H.K, Imungi, J.K., Kogi-Makau, W., Mamman, S., Carter, and Maretzik A.N., "Involving Rural Kenya Women in the Development of Nutritionally Improved Weaning Foods: A Nutribusiness Strategy. J. Nutrition Educa. Paper presented at the Inaugural National Nutrition Congress. 21st-23rd February 2005.. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.
WAMBUI, PROFKOGIMAKAU-.  1996.  Waihenya E.W., Kogi-Makau, W. and Muita, J.W. "Maternal Nutritional Knowledge and the Nutritional Status of Preschool Children in a Nairobi Slum: The Case of Kibera" East African Medical Journal, Vol 73 No 7 July: 419-423. Paper presented at the Inaugural National Nutrition Congress. 21st-23rd February 2005.. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.

1994

WAMBUI, PROFKOGIMAKAU-.  1994.  Kogi-Makau, W. (1994). Diets and Lifestyles. A comparison of traditional diets with modern ones. Presented at a Seminar on diets and Lifestyles for Executives. Vee Nutrition and Health Associates, Nairobi.. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.

1993

WAMBUI, PROFKOGIMAKAU-.  1993.  Kogi-Makau, W. (1993). Nutritional and health status among the Samburu".. Presented at the Gessllschaft Fur Agrarprojekte (GFA) Planning Workshop for the Samburu District Development Project. Narumoro; 3-8th May. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.

1992

WAMBUI, PROFKOGIMAKAU-.  1992.  Kogi-Makau, W., "Risk Indicators of Nutritional Status of Households of a Kenyan Semi-arid Population", East African Medical Journal, Vol 69, No 10: 560-62.. Presented at the Gessllschaft Fur Agrarprojekte (GFA) Planning Workshop for the Samburu District Development Project. Narumoro; 3-8th May. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.
WAMBUI, PROFKOGIMAKAU-.  1992.  Kogi-Makau, W., Muita J.W and Mboganie, A.M. (1992). Knowledge, attitude and needs assessment study of traditional birth attendants in Kibera, Nairobi. Presented at the National Capacity Building for Child Survival and Development Project of University of Nairobi/UNICEF. Planning Workshop at Kabarnet, 23-27, November. : AIDS 24(6):891-7 Abstract
Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.

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