Background: Accurate mapping of schistosomiasis (SCH) and soil transmitted helminths (STH) is a prerequisite for effective implementation of the control and elimination interventions. A precision mapping protocol was developed and implemented in the coastal region of Kenya by applying the current World Health Organization (WHO) mapping guide at a much lower administrative level (ward). Methods: A two-stage cluster survey design was undertaken, with 5 villages in each ward selected. From within each village 50 households were randomly selected, and a single child between the ages of 8 and 14 sampled following appropriate assent. The prevalence and intensity of infection of Schistosoma mansoni and STH were determined using the Kato-Katz method (single stool, duplicate slides) and urine filtration for S. haematobium. Results: Of the 27,850 school age children sampled, 6.9% were infected with at least one Schistosoma species, with S. haematobium being the most common 6.1% (95% CI: 3.1–11.9), and Tana River County having highest prevalence 19.6% (95% CI: 11.6–31.3). Prevalence of any STH infection was 5.8% (95% CI: 3.7–8.9), with Lamu County having the highest prevalence at 11.9% (95% CI: 10.0–14.1). The most prevalent STH species in the region was Trichuris trichiura at 3.1% (95% CI: 2.0–4.8). According to the WHO threshold for MDA implementation, 31 wards (in 15 sub-Counties) had a prevalence of ≥10% for SCH and thus qualify for annual MDA of all age groups from 2 years old. On the other hand, using the stricter Kenya BTS MDA threshold of ≥2%, 72 wards (in 17 sub-Counties) qualified for MDA and were targeted for treatment in 2021. Conclusions: The precision mapping at the ward level demonstrated the variations of schistosomiasis prevalence and endemicity by ward even within the same sub-counties. The data collected will be utilized by the Kenyan Ministry of Health to improve targeting.

Age-disparate transactional sex relationships are often coerced and exploitative. The gender and economic disparities between affluent men and economically disadvantaged girls often perpetuate these relationships, resulting in their exploitation. This qualitative study assessed men’s understanding of factors influencing schoolgirls’ engagement in age-disparate transactional sex relationships in two rural districts in Kenya. Four focus group sessions were conducted with men from two primary professions: motorcycle taxi operators (Boda Boda) and teachers from primary and secondary schools from two districts in Kitui South, Sub County, Kenya. Focus group data were analyzed using conventional content analysis. Several influential factors associated with schoolgirls’ engagement in these transactional relationships are discussed in three broad themes: access and coercion, parental influence, and peer-related factors. Study results indicate that schoolgirls in rural areas are more susceptible to predation by men willing to trade sexual favors with underage girls. These findings make it imperative to address the predation of adolescent girls by men involved in these transactional relationships by implementing comprehensive sex education programs that empower schoolgirls to recognize and resist coercion. Additionally, implementing measures involving community leaders, parents, and other stakeholders in a collective effort to combat the exploitation of underage girls is paramount. These measures should be accompanied by the stricter enforcement of laws and regulations to hold perpetrators accountable for their actions.

Background: The backbone of Kenya’s soil-transmitted helminthiasis control program is the periodic distribution of anti-helminthic preventive chemotherapy (PC). PC distribution has been conducted since 2012 through the National School-Based Deworming Programme, which deworms school-age children (SAC, 5–14 years) living in areas at high risk for soil-transmitted helminth (STH) infections. After nearly a decade of deworming, the Ministry of Health sought to generate evidence for program monitoring by estimating the prevalence and intensity of STH infection in Narok and Bomet counties among at-risk groups: preschool-aged children (PSAC, 2–4 years), SAC, and women of reproductive age (WRA, 15–49 years), of which only SAC are covered by the deworming program. Methods: During August and December of 2021, we conducted cross-sectional, population-based household surveys in Narok and Bomet counties, using multi-stage, cluster random sampling among resident PSAC, SAC, and WRA. Individual and household questionnaires were administered using an electronic mobile platform. Stool samples were collected and tested for roundworms ( Ascaris lumbricoides ), hookworms ( Necator americanus, Ancylostoma duodenale ), and whipworms ( Trichuris trichura ) using the Kato-Katz method. Results: Stool samples were provided by 1,062 PSAC, 1,922 SAC, and 364 WRA. Results indicated that the prevalence of any STH infection in Bomet county was similar among SAC (16.2% [upper 95% design-corrected confidence interval [U95% CI]: 23.1%]) and PSAC (15.8% [U95% CI: 21.7%]). In Narok county, STH prevalence was marginally higher among PSAC (12.8% [U95% CI: 18.2%]) compared to SAC (11.3% [U95% CI: 16.2%]). Moderate-to-high intensity infection prevalence among PSAC and SAC exceeded the morbidity elimination threshold of 2% in both counties. A. lumbricoides and T. trichura were most identified; few hookworm infections were detected. Conclusions: STH infections remain a public health problem in Narok and Bomet counties. There may be a need to expand PC distribution to include risk groups beyond SAC during deworming exercises, as envisioned in the Breaking Transmission Strategy, to hasten progress toward the achievement of STH as a public health problem.