Health problems of street children in Eldoret, Kenya.
BACKGROUND: The street children phenomenon is an increasing problem in most cosmopolitan cities of the world including Eldoret, which is a fast growing town. With the growth of the town so is the increasing number of street children. It is therefore important to have baseline data on their health problems. OBJECTIVE: To determine the health problems of street children in Eldoret. DESIGN: A prospective and descriptive study. SETTING: Eldoret Town, Kenya. SUBJECTS: Eldoret street children aged 5-21 years. Type 1 street children were the "on" the street children who spent most of their time on the streets but went home in the evenings, type 2 were the "of" the street children who spent all their time in the streets and had severed their links with their families and did not have a home to go to, type 3 were abandoned children staying in a shelter and type 4 were normal primary school children. RESULTS: One hundred and ninety one children were studied. There were 38, 47, 56 and 50 types 1, 2, 3 and 4 children, respectively. The most common symptom was cough (28.9%) while frequent diagnosis was upper respiratory tract infection (URTI) (12.1%) followed by skin disease (50.9%) as the leading disease category. The common drug of addiction was cigarette (37.6%) and none of the school children was taking any drug of addiction. The prevalence of disease was 467 per 1000 children. Type 2 street children had the highest prevalence of disease (833 per 1000 children). Shelter children had the least disease prevalence (474 per 1000). Factors determining prevalence of disease were the same as in normal children. The malnutrition rate was high with 31.1% and 41.9% of the children being stunted and underweight, respectively. Type 3 children had the highest rate of malnutrition with 51.8% and 64.3% being stunted and underweight. CONCLUSION: Street children have a high incidence of childhood diseases. Factors determining occurrence of disease among street children are as in normal children. Respiratory and skin diseases were the leading causes of morbidity. Drug abuse was rampant among the street children but none of the school children abused any drug. Sexually transmitted infections were not prevalent. Most of the shelter children were malnourished. RECOMMENDATIONS: The government of Kenya should provide free health care for street children in public hospitals. Further studies should be carried out on the prevalence of sexually transmitted diseases based on laboratory testing and on the causes of the injuries suffered by the street children. The reasons for the poor nutritional status of the shelter children should be analysed and appropriate measures taken.