Home gardening is promoted as an adaptation strategy to ameliorate the increasing food insecurity from climate change impacts among subsistence farming families in rural sub-Saharan Africa. Yet, the geographic distribution of home gardens, their setup, management, and the effects on nutrition outcomes have not been fully described. This scoping review aimed to map and synthesize recent evidence on home gardening for two exemplar countries: Burkina Faso and Kenya. Between June and August 2020, we searched, screened, and extracted evidence about home garden projects in both countries, following the PRISMA guidelines for scoping reviews. Peer-reviewed scientific publications, and gray literature in English and French that reported about subsistence horticulture in rural settings of Burkina Faso or Kenya were included. The characteristics of the documents and the data pertaining to our research objectives were extracted into predefined spreadsheets. The data were synthesized in the form of a narrative review. Our search yielded 949 documents, of which 20 documents were included in the synthesis (Burkina Faso: 8, Kenya: 12). While the gardens varied in composition and size, the majority provided green leafy vegetables and indigenous horticultural crops. The challenges for successful home garden implementation comprised unfavorable climatic conditions, access to and affordability of inputs, water and land, and lack of know-how. We identified trends for improved food security, diet quality, and nutritional status among the target populations. This scoping review found that there is limited evidence on home garden practices in rural Burkina Faso and Kenya. To enhance the sustainability of home gardens, research and resources should he invested in codesigning context-specific home gardening projects. Pending rigorous impact evaluation, home gardens appear to be a promising tool for climate change adaptation while simultaneously improving food security and the nutritional situation among women and young children in these two exemplar countries of sub-Saharan Africa.
As the epidemiological transition progresses throughout sub-Saharan Africa, life lived with diseases is an increasingly important part of a population’s burden of disease. The burden of disease of climate-sensitive health outcomes is projected to increase considerably within the next decades. Objectively measured, reliable population health data is still limited and is primarily based on perceived illness from recall. Technological advances like non-invasive, consumer-grade wearable devices may play a vital role in alleviating this data gap and in obtaining insights on the disease burden in vulnerable populations, such as heat stress on human cardiovascular response. The overall goal of this study is to investigate whether consumer-grade wearable devices are an acceptable, feasible and valid means to generate data on the individual level in low-resource contexts. Three hundred individuals are recruited from the two study locations in the Nouna health and demographic surveillance system (HDSS), Burkina Faso, and the Siaya HDSS, Kenya. Participants complete a structured questionnaire that comprises question items on acceptability and feasibility under the supervision of trained data collectors. Validity will be evaluated by comparing consumer-grade wearable devices to research-grade devices. Furthermore, we will collect demographic data as well as the data generated by wearable devices. This study will provide insights into the usage of consumer-grade wearable devices to measure individual vital signs in low-resource contexts, such as Burkina Faso and Kenya. Vital signs comprising activity (steps), sleep (duration, quality) and heart rate (hr) are important measures to gain insights on individual behavior and activity patterns in low-resource contexts. These vital signs may be associated with weather variables-as we gather them from weather stations that we have setup as part of this study to cover the whole Nouna and Siaya HDSSs-in order to explore changes in behavior and other variables, such as activity, sleep, hr, during extreme weather events like heat stress exposure. Furthermore, wearable data could be linked to health outcomes and weather events. As a result, consumer-grade wearables may serve as a supporting technology for generating reliable measurements in low-resource contexts and investigating key links between weather occurrences and health outcomes. Thus, wearable devices may provide insights to better inform mitigation and adaptation interventions in these low-resource settings that are direly faced by climate change-induced changes, such as extreme weather events.
Climate change is a global threat, affecting the food security and food sovereignty of many depending on agriculture for their livelihoods. This is even more pronounced in Kenya, given their over-reliance on rain-fed crops and the frequency of floods and droughts in the country. Through qualitative interviews, this study set out to establish how climate change not only affects the food security, production and consumption of rural women farmers in Kakamega County, Kenya, but their response to climate shocks. Using resilience theory as a lens, we established that women use different pathways to mitigate the effects of climate change on their livelihoods. The study found that initially women adopt coping strategies that are reactive and not sustainable, but soon adapted their farming strategies, using their indigenous knowledge to exercise some control over both their food security and food sovereignty. Besides this, they use their human and social capital to expand their networks of support. By linking up to other organizations and gaining access to government support, they are able to challenge patriarchal relations that perpetuate poverty and inequality and bring about more transformative and sustainable responses to climate change.
The climate is changing, and such changes are projected to cause global increase in the prevalence and geographic ranges of infectious diseases such as anthrax. There is limited knowledge in the tropics with regards to expected impacts of climate change on anthrax outbreaks. We determined the future distribution of anthrax in Kenya with representative concentration pathways (RCP) 4.5 and 8.5 for year 2055. Ecological niche modelling (ENM) of boosted regression trees (BRT) was applied in predicting the potential geographic distribution of anthrax for current and future climatic conditions. The models were fitted with presence-only anthrax occurrences (n = 178) from historical archives (2011-2017), sporadic outbreak surveys (2017-2018), and active surveillance (2019-2020). The selected environmental variables in order of importance included rainfall of wettest month, mean precipitation (February, October, December, July), annual temperature range, temperature seasonality, length of longest dry season, potential evapotranspiration and slope. We found a general anthrax risk areal expansion i.e., current, 36,131 km(2), RCP 4.5, 40,012 km(2), and RCP 8.5, 39,835 km(2). The distribution exhibited a northward shift from current to future. This prediction of the potential anthrax distribution under changing climates can inform anticipatory measures to mitigate future anthrax risk.
Climate change-induced crises can aggravate intimate partner violence (IPV); the loss of income when weather affects the agricultural industry can exacerbate violence at home. In Kenya, climate change has increased precipitation during the rainy season and raised temperatures during the dry season, resulting in floods and droughts. For 75% of Kenyans, agricultural activities are their primary source of income. This research aims to assess patterns in IPV and severe weather events (SWE). We examined Integrated Public Use Microdata Series-Demographic Health Survey (IPUMS-DHS) data from 2008 and 2014 for IPV severity and frequency. We used Emergency Events Database (EM-DAT) data along with GPS coordinates to identify SWEs (defined as any flood >10 days) by county in Kenya. Overall, women were more likely to experience IPV if their spouse worked in agriculture (Odds Ratio (OR) = 1.22, 95% Confidence Interval (CI): 1.10-1.36). There was a 60% increase in the odds of reporting IPV in counties that experienced an SWE as compared to counties that did not experience an SWE (OR = 1.60, 95% CI: 1.35-1.89). This analysis further supports the growing body of research that suggests a relationship between climate change-related weather events and violence against women.
Studies have looked into how environmental and climate covariates affect under-and over-nutrition, but little is known about the spatial distribution of different forms of malnutrition in Kenya and whether there are locations that suffer from double-burden of malnutrition. This research quantifies spatial variations and estimates how climatic and environmental factors affect under-and over-nutrition among women in Kenya. This enables us to determine if the patterns in which these factors affect the malnutrition indicators are similar and whether there are overlaps in the spatial distributions. The study used data from the Demographic and Health Survey, which included cross-sectional data on malnutrition indicators as well as some climate and environmental variables. A multicategorical response variable that classified the women into one of four nutritional classes was generated from the body mass index (BMI) of the women, and a Bayesian geoadditive regression model with an estimate based on the Markov chain Monte Carlo simulation technique was adopted. Findings show that women in Turkana, Samburu, Isiolo, Baringo, Garissa, and West Pokot counties are more likely to be underweight than women in other counties while being overweight is prevalent in Kirinyag’a and Kitui counties. Obesity is prevalent in Kirinyag’a, Lamu, Kiambu, Murang’a, and Taita Taveta counties. The study further shows that as mean temperature and precipitation increase, the likelihood of being underweight reduces. The chances of being underweight are lower among literate women [OR: 0.614; 95% CrI: 0.513,0.739], married women [OR: 0.702; 95% CrI: 0.608,0.819] and those from rich households [OR: 0.617; 95% CrI: 0.489,0.772], which is not the case for overweight and obesity. The generated spatial maps identify hot spots of the double burden of malnutrition that can assist the government and donor agencies in channeling resources efficiently.
Acute malnutrition affects a sizeable number of young children around the world, with serious repercussions for mortality and morbidity. Among the top priorities in addressing this problem are to anticipate which children tend to be susceptible and where and when crises of high prevalence rates would be likely to arise. In this article, we highlight the potential role of conflict and climate conditions as risk factors for acute malnutrition, while also assessing other vulnerabilities at the individual- and household-levels. Existing research reflects these features selectively, whereas we incorporate all the features into the same study. The empirical analysis relies on integration of health, conflict, and environmental data at multiple scales of observation to focuses on how local conflict and climate factors relate to an individual child’s health. The centerpiece of the analysis is data from the Demographic and Health Surveys conducted in several different cross-sectional waves covering 2003-2016 in Kenya, Nigeria, and Uganda. The results obtained from multi-level statistical models indicate that in Kenya and Nigeria, conflict is associated with lower weight-for-height scores among children, even after accounting for individual-level and climate factors. In Nigeria and Kenya, conflict lagged 1-3 months and occurring within the growing season tends to reduce WHZ scores. In Uganda, however, weight-for-height scores are primarily associated with individual-level and household-level conditions and demonstrate little association with conflict or climate factors. The findings are valuable to guide humanitarian policymakers and practitioners in effective and efficient targeting of attention, interventions, and resources that lessen burdens of acute malnutrition in countries prone to conflict and climate shocks.
As global temperatures continue to rise unabated, episodes of heat-related catastrophes across the world have intensified. In Kenya, heatwave phenomena and their associated impacts are ignored and neglected due to several reasons, including unreliable and inconsistent weather datasets and heatwave detection metrics. Based on CHIRTS satellite infrared estimates and station blended temperature, this study investigated the spatiotemporal distribution of the heatwave events over Kenya during 1987-2016 using the Heatwave Magnitude Index daily (HWMId). The results showed that contrary to the absence of heatwave records in official national and international disaster database about Kenya, the country experienced heatwaves ranging from less severe (normal) to deadly (super-extreme) between 1987 and 2016. The most affected areas were located in the eastern parts of the country, especially in Garissa and Tana River, and in the west-northern side around the upper side of Turkana county. It was also found that the recent years’ heatwaves were more severe in magnitude, duration, and spatial extent. The highest magnitude of the heatwaves was recorded in 2015 (HWMId = 22.64) while the average over the reference period is around 6. CHIRTS and HWMId were able to reveal and capture most critical heatwave events over the study period. Therefore, they could be used respectively as data source and detection metrics, for heatwaves disaster emergency warning over short period as well as for long-term projection to provide insight for adaptation strategies.
Objectives Folate is an essential nutrient fundamental to human growth and development. Human milk maintains high folate content across the maternal folate status range, suggesting buffering of milk folate with prioritized delivery to milk at the expense of maternal depletion. We investigated whether and how the extent of this buffering may diminish under prolonged nutritional and/or disease stress, while taking into consideration infants’ varying vulnerability to malnutrition-related morbidity/mortality. Methods A cross-sectional study analyzed milk specimens from northern Kenyan mothers (n = 203), surveyed during a historic drought and ensuing food shortage. Multiple regression models for folate receptor-alpha (FOLR1) in milk were constructed. Predictors included maternal underweight (BMI < 18.5), iron-deficiency anemia (hemoglobin 5 mg/L), folate deficiency (hyperhomocysteinemia, homocysteine >12 or 14 mu mol/L), inflammation (serum C-reactive protein >5 mg/L), infant age and sex, and mother-infant interactions. Results In adjusted models, milk FOLR1 was unassociated with maternal underweight, iron-deficiency anemia and inflammation. FOLR1 was positively associated with maternal folate deficiency, and inversely associated with infant age. There was interaction between infant age and maternal underweight, and between infant sex and maternal folate deficiency, predicting complex changes in FOLR1. Conclusions Our results suggest that mothers buffer milk folate against their own nutritional stress even during a prolonged drought; however, the extent of this buffering may vary with infant age, and, among folate-deficient mothers, with infant sex. Future research is needed to better understand this variability in maternal buffering of milk folate and how it relates to folate status in nursing infants.
Pastoralists in East Africa are among the world’s most vulnerable communities to climate change, already living near their upper thermal limits and engaging in a climate-sensitive livelihood in a climate change global hot spot. Pregnant women and children are even more at risk. Here, we report the findings of a study characterizing Samburu pastoralist women’s experiences of severe drought and outcomes in their children (N = 213, 1.8-9.6 y). First, we examined potential DNA methylation (DNAm) differences between children exposed to severe drought in utero and same-sex unexposed siblings. Next, we performed a high-dimensional mediation analysis to test whether DNAm mediated associations of exposure to severe drought with body weight and adiposity. DNAm was measured using the Infinium MethylationEPIC BeadChip array. After quality control; batch, chip, and genomic inflation corrections; covariate adjustment; and multiple testing correction, 16 CpG sites were differentially methylated between exposed and unexposed children, predominantly in metabolism and immune function pathways. We found a significant indirect effect of drought exposure on child body weight through cg03771070. Our results are the first to identify biological mediators linking severe drought to child growth in a low-income global hot spot for climate change. A better understanding of the mechanisms underlying the association between drought exposure and child growth is important to increasing climate change resilience by identifying targets for intervention.
There is growing evidence that early life conditions are important for outcomes during adolescence, including cognitive development and education. Economic conditions at the time children enter school are also important. We examine these relationships for young adolescents living in a low-income drought-prone pastoral setting in Kenya using historical rainfall patterns captured by remote sensing as exogenous shocks. Past rainfall shocks measured as deviations from local long-term averages have substantial negative effects on the cognitive development and educational achievement of girls. Results for the effects of rainfall shocks on grades attained, available for both girls and boys, support that finding. Consideration of additional outcomes suggests the effects of rainfall shocks on education are due to multiple underlying mechanisms including persistent effects on the health of children and the wealth of their households, underscoring the potential value of contemporaneous program and policy responses to such shocks.
Objectives This study of Samburu pastoralists (Kenya) employs a same-sex sibling design to test the hypothesis that exposure in utero to severe drought and maternal psychosocial stress negatively influence children’s growth and adiposity. As a comparison, we also hypothesized that regional climate contrasts would influence children’s growth and adiposity based on ecogeographical patterning. Materials and Methods Anthropometric measurements were taken on Samburu children ages 1.8-9.6 years exposed to severe drought in utero and younger same-sex siblings (drought-exposed, n = 104; unexposed, n = 109) in two regions (highland, n = 128; lowland, n = 85). Mothers were interviewed to assess lifetime and pregnancy-timed stress. Results Drought exposure associated to lower weight-for-age and higher adiposity. Drought did not associate to tibial growth on its own but the interaction between drought and region negatively associated to tibial growth in girls. In addition, drought exposure and historically low rainfall associated to tibial growth in sensitivity models. A hotter climate positively associated to adiposity and tibial growth. Culturally specific stressors (being forced to work too hard, being denied food by male kin) associated to stature and tibial growth for age. Significant covariates for child outcomes included lifetime reported trauma, wife status, and livestock. Discussion Children exposed in utero to severe drought, a hotter climate, and psychosocial stress exhibited growth differences in our study. Our results demonstrate that climate change may deepen adverse health outcomes in populations already psychosocially and nutritionally stressed. Our results also highlight the value of ethnography to identifying meaningful stressors.
Floods affect the human security conditions of floodplain residents. The aim of this paper is to explore how residents of the Tana River Delta in Kenya become flood insecure. This paper utilises assemblage theory, particularly the principles of rhizomatic multiplicity to explain the concept of becoming flood insecure. It combines these rhizomatic multiplicity principles with disruptions to the pillars of human security which are becoming afraid, becoming wanting and becoming undignified and their composite conditions of human insecurity to create an analytical framework with which to understand becoming flood insecure. The study sources its data from Focus Group Discussions in 10 sampled villages in the Tana River Delta. The results reveal that becoming flood insecure is a rhizomatic multiplicity and that the pillars and conditions of human security that comprise it are heterogenous and interconnected. The results reveal the conditions of human insecurity in the Tana River Delta as personal, food, water, fuel, housing, health, environment, and political. They also reveal that while children become more flood insecure, they are also the most adaptive. Additionally, the results show that there are transitory conditions of human insecurity, food, housing health, to which people attempt to find local solutions and redundant conditions of human insecurity, political, health, water, personal and environment, to which people cannot find local solutions and public action is required.
Globally, drought impacts more people than any other natural hazard. However, drought is also the most complex natural hazard, and its impacts are not evenly distributed across the landscape or among human populations. Just as the impacts of drought vary, so do the coping strategies used by people during drought. The research to-date on drought coping strategies in Sub-Saharan Africa are highly quantitative, focused on top-down interventions, and do not emphasize individual perceptions, experience, and autonomous decision-making when coping with drought. This paper aims to fill these gaps by examining the human experience of coping with drought through narratives from farmers in Burat and Kinna, Isiolo County, Kenya. This paper highlights (1) their perceived impacts of drought, and (2) the various coping strategies used. A total of 83 interviews were conducted in 20 households. Results found that the perceived impacts of drought were decreased agricultural productivity, livestock hunger, death, and relocation, a lack of water in rivers, human hunger and disease, and violent conflict. The strategies for coping with drought included changing agricultural practices, adopting irrigation, relying on aid, charcoal burning, casual labor, livelihood diversification, and others. Importantly, these coping strategies can be classified into four categories: livelihood diversification, longer-term livelihood strategies, short-term coping activities, and erosive coping strategies. This research contributes to the effort to better document and understand farmers? perceptions and strategies to cope with drought through qualitative research methods and from the perspective of the individual smallholder farmer, which is important for making context-specific policy and project recommendations aimed at smallholder farmers.
Over the last decades, increased emission of greenhouse gases has led to hot weather extremes, heavy precipitation and worsening of agricultural and ecological droughts. Although Africa’s contribution to climate change is minimal, the continent is especially vulnerable to its effects. This report aims to describe the effect of climate change leading to drought in Kilifi County, Kenya, and the communities’ experiences of this effect on food availability. During their community rotation, residents from a university in Nairobi, Kenya, evaluated changes in weather patterns and nutrition indicators in Kilifi County and conducted focus group discussions (FGDs) with community members and health care stakeholders to explore challenges in access to adequate nutrition and possible local solutions. Kilifi County has one of the highest rates of undernutrition in Kenya, with one in five under-5 children being underweight. County data showed that rainfall in the last 4 years has become increasingly unpredictable, resulting in reduced household milk production, one of the indicators of nutrition security. Three major themes emerged from the FGDs: lack of food variety, collapse of drought mitigating projects and increasing poverty levels. Possible solutions to these problems include promoting alternatives to the current diet that are culturally sensitive and adaptable to recent climate changes, ensuring continuity of agricultural and financial support projects and improved local leadership and governance.
BACKGROUND: Environmental Enteric Dysfunction (EED) is a chronic intestinal inflammatory disorder of unclear aetiology prevalent amongst children in low-income settings and associated with stunting. We aimed to characterise development of EED and its putative risk factors amongst rural Kenyan infants. METHODS: In a birth cohort study in Junju, rural coastal Kenya, between August 2015 and January 2017, 100 infants were each followed for nine months. Breastfeeding status was recorded weekly and anthropometry monthly. Acute illnesses and antibiotics were captured by active and passive surveillance. Intestinal function and small intestinal bacterial overgrowth (SIBO) were assessed by monthly urinary lactulose mannitol (LM) and breath hydrogen tests. Faecal alpha-1-antitrypsin, myeloperoxidase and neopterin were measured as EED biomarkers, and microbiota composition assessed by 16S sequencing. FINDINGS: Twenty nine of the 88 participants (33%) that underwent length measurement at nine months of age were stunted (length-for-age Z score <-2). During the rainy season, linear growth was slower and LM ratio was higher. In multivariable models, LM ratio, myeloperoxidase and neopterin increased after cessation of continuous-since-birth exclusive breastfeeding. For LM ratio this only occurred during the rainy season. EED markers were not associated with antibiotics, acute illnesses, SIBO, or gut microbiota diversity. Microbiota diversified with age and was not strongly associated with complementary food introduction or linear growth impairment. INTERPRETATION: Our data suggest that intensified promotion of uninterrupted exclusive breastfeeding amongst infants under six months during the rainy season, where rainfall is seasonal, may help prevent EED. Our findings also suggest that therapeutic strategies directed towards SIBO are unlikely to impact on EED in this setting. However, further development of non-invasive diagnostic methods for SIBO is required. FUNDING: This research was funded in part by the Wellcome Trust (Research Training Fellowship to RJC (103376/Z/13/Z)). EPKP was supported by the MRC/DfID Newton Fund (MR/N006259/1). JAB was supported by the MRC/DFiD/Wellcome Trust Joint Global Health Trials scheme (MR/M007367/1) and the Bill & Melinda Gates Foundation (OPP1131320). HHU was supported by the NIHR Oxford Biomedical Research Centre (IS-BRC-1215-20008).
Rift Valley Fever (RVF) is a zoonotic disease whose outbreak results in heavy economic and public health burdens. In East Africa, RVF is mainly experienced in arid and semi-arid areas predominantly inhabited by the pastoralists. These areas experience sudden, dramatic epidemics of the disease at intervals of approximately 10 years, associated with widespread flooding and the resultant swarms of mosquitoes. Pastoralists’ indigenous knowledge and experience of RVF is critical for public health interventions targeting prevention and control of RVF. The study adopted a descriptive cross-sectional design combining both quantitative and qualitative methods of data collection. A total of 204 respondents participated in questionnaire survey and 15 key informants and 4 focus group discussions were interviewed and conducted respectively. In addition, secondary data mainly journal publications, books, policy documents and research reports from conferences and government departments were reviewed. Findings indicated that the Somali pastoralists possess immense knowledge of RVF including signs and symptoms, risk factors, and risk pathways associated with RVF. Ninety eight percent (98%) of respondents identified signs and symptoms such as bloody nose, diarrhea, foul smell and discharge of blood from the orifices which are consistent with RVF. Heavy rains and floods (85%) and sudden emergence of mosquito swarms (91%) were also cited as the major RVF risk factors while mosquito bites (85%), drinking raw milk and blood (78%) and contact with animal fluids during mobility, slaughter and obstetric procedures (77%) were mentioned as the RVF entry risk pathways. Despite this immense knowledge, the study found that the pastoralists did not translate the knowledge into safer health practices because of the deep-seated socio-cultural practices associated with pastoralist production system and religious beliefs. On top of these practices, food preparation and consumption practices such as drinking raw blood and milk and animal ritual sacrifices continue to account for most of the mortality and morbidity cases experienced in humans and animals during RVF outbreaks. This article concludes that pastoralists’ indigenous knowledge on RVF has implications on public health delivery approaches. Since the pastoralists’ knowledge on RVF was definitive, integrating the community into early warning systems through training on reporting mechanisms and empowering the nomads to use their mobile phone devices to report observable changes in their livestock and environment could prove very effective in providing information for timely mobilization of public health responses. Public health advocacy based on targeted and contextually appropriate health messaging and disseminated through popular communication channels in the community such as the religious leaders and local radio stations would also be needed to reverse the drivers of RVF occurrence in the study area.
Climate change and variability influence temperature and rainfall, which impact vector abundance and the dynamics of vector-borne disease transmission. Climate change is projected to increase the frequency and intensity of extreme climate events. Mosquito-borne diseases, such as dengue fever, are primarily transmitted by Aedes aegypti mosquitoes. Freshwater availability and temperature affect dengue vector populations via a variety of biological processes and thus influence the ability of mosquitoes to effectively transmit disease. However, the effect of droughts, floods, heat waves, and cold waves is not well understood. Using vector, climate, and dengue disease data collected between 2013 and 2019 in Kenya, this retrospective cohort study aims to elucidate the impact of extreme rainfall and temperature on mosquito abundance and the risk of arboviral infections. To define extreme periods of rainfall and land surface temperature (LST), we calculated monthly anomalies as deviations from long-term means (1983-2019 for rainfall, 2000-2019 for LST) across four study locations in Kenya. We classified extreme climate events as the upper and lower 10% of these calculated LST or rainfall deviations. Monthly Ae. aegypti abundance was recorded in Kenya using four trapping methods. Blood samples were also collected from children with febrile illness presenting to four field sites and tested for dengue virus using an IgG enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR). We found that mosquito eggs and adults were significantly more abundant one month following an abnormally wet month. The relationship between mosquito abundance and dengue risk follows a non-linear association. Our findings suggest that early warnings and targeted interventions during periods of abnormal rainfall and temperature, especially flooding, can potentially contribute to reductions in risk of viral transmission.
Available guidance to mitigate health risks from exposure to freshwater harmful algal blooms (HABs) is largely derived from temperate ecosystems. Yet in tropical ecosystems, HABs can occur year-round, and resource-dependent populations face multiple routes of exposure to toxic components. Along Winam Gulf, Lake Victoria, Kenya, fisher communities rely on lake water contaminated with microcystins (MCs) from HABs. In these peri-urban communities near Kisumu, we tested hypotheses that MCs exceed exposure guidelines across seasons, and persistent HABs present a chronic risk to fisher communities through ingestion with minimal water treatment and frequent, direct contact. We tested source waters at eleven communities across dry and rainy seasons from September 2015 through May 2016. We measured MCs, other metabolites, physicochemical parameters, chlorophyll a, phytoplankton abundance and diversity, and fecal indicators. We then selected four communities for interviews about water sources, usage, and treatment. Greater than 30% of source water samples exceeded WHO drinking water guidelines for MCs (1?g/L), and over 60% of source water samples exceeded USEPA guidelines for children and immunocompromised individuals. 50% of households reported sole use of raw lake water for drinking and household use, with alternate sources including rain and boreholes. Household chlorination was the most widespread treatment utilized. At this tropical, eutrophic lake, HABs pose a year-round health risk for fisher communities in resource -limited settings. Community-based solutions and site-specific guidance for Kisumu Bay and similarly impacted regions is needed to address a chronic health exposure likely to increase in severity and duration with global climate change.
