GHENT UNIVERSITY Karoline FONCK - International Centre for ...

In the 1980s Kenya had the fastest population growth rate in the world and increased by a
third in a decade to 1999 to reach over 30 million (FAO/World Bank, 1999) (Figure 3). Data
indicate that the birth rate has plummeted from 8.1 live births per woman in 1978, to 4.6 in
1998 and to 3.7 in 2000 (US census bureau). These declines can partially be attributed to
increased use of contraceptives, but the HIV/AIDS epidemic may also play a role. Overall life
expectancy was 59 years (1989-94). The crude birth rate is 29 per 1000 population, the
crude death rate 14 per 1000 population and the infant mortality rate 69 per 1000 live births.
Mortality rates are increasing due to aids-related deaths. The capital Nairobi, with over 2
million inhabitants, is expanding rapidly due to internal migration from rural areas. A large,
but uncounted, proportion of the urban population lives in shantytowns.
Figure 3: Population pyramid, Kenya 1998
Sexually Transmitted Infections (STI) have been recognized as a major public health
problem in Kenya. STI are among the most common complaints of adults at outpatient
clinics, representing up to 10% of the caseload at many health facilities. The overall
prevalence of these infections in the general population in Nairobi is unknown, but among
pregnant women the seroprevalence rate of syphilis is about 3 to 5%, and the prevalence of
gonorrhea is about 2 to 8%, chlamydia 8.8%, trichomonas 19.9% (Laga 1986, Temmerman
1992, Thomas 1996, Gichangi 1997). In a group of family planning attendees in Nairobi,
prevalence for gonorrhoea was 3.2%, syphilis serology 1.9% and trichomonas 5.2% (Daly
1994). In a study among male transport workers in Mombasa, eastern Kenya, the prevalence
of gonorrhoea was 3.4%, chlamydia 3.6% and trichomonas 6% (Jackson 1997). A recent
population based multi-center study revealed that in Kisumu, western Kenya, prevalence
rates for men were 0% for gonorrhoea, 2.6% for chlamydia, 3.4% for syphilis, 34.6% for
HSV-2 and 19.8% for HIV. For women, those prevalence rates were respectively 0.9%,
INTRODUCTION 11