Browsing by Author "Mwanzo, Isaac"

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    Acceptability of Positive Deviance Mentorship for Diabetes Management among HIV Clients Living with Diabetes in Eastern Uganda a Cross-Sectional Study
    (asiapacificpublishers, 2025-01) Okia, David; Kimiywe, Judith; Olupot- Olupot, Peter; Mwanzo, Isaac
    Introduction: The high risk of PLHIV on ART to become diabetes clients and to develop metabolic disorders is well investigated. Regular monitoring and health care is an essential requirement. A majority of HIV clients living with diabetes have poor diabetes knowledge and poor treatment outcomes. Positive deviance mentorship may be a better option for improving diabetes knowledge and treatment outcomes among registered HIV clients living with diabetes. Assessing the acceptability of public health interventions is key to understanding their potential for long-term success and feasibility. Limited literature exists about the acceptability of positive deviant mentorship (PDM) for improving knowledge and treatment outcomes among HIV clients living with diabetes.The findings of this study provide additional important insights for improving future positive deviance HIV and diabetes interventions and enhancing health programs and sustainability.Aim: This study, conducted in October 2024, quantitatively evaluated the acceptability of the positive deviant mentorship for improving knowledge and treatment outcomes among diabetes clients living with HIV (mentees) exposed to PDM for three months (July to September) in Eastern Uganda. Study Design: In October 2024, a cross-sectional survey was conducted in Mbale and Soroti Regional Referral Hospitals in Eastern Uganda.Materials and Methods: The sample size was twenty-two registered participants exposed to PDM for three months. Purposive sampling was done to select eligible registered exposed participants. Electronic data collection was done using a structured questionnaire by trained research assistants. The twenty-two participants were asked to rate their agreement with various statements regarding the PDM's perceived satisfaction, effectiveness, and cultural suitability. All the research assistants were trained in data quality management. Ethical approval was obtained from Busitema University REC. Stata version 15 was used for analysis. Descriptive statistics (frequencies and percentages) were employed, to summarise the acceptability scores. Results:All the 22(100%) participants participated in the study. The majority (77.3%) were above the age of 50 years, 54.6% were married, and only 13.6% had tertiary education. More than half of the participants, 54.5%, were employed, and a relatively large proportion, 59.1%, lived within a radius of 5 km from the nearest Health facility. The Muslims were only 31.8% and 45.4% of the participants' source of funds when sick was salary or business. A majority of the participants 95.5% were satisfied (very satisfied/satisfied) with positive deviant mentorship(intervention) and 95.4% would recommend the interventions to other HIV clients with low diabetes knowledge and poor glycemic control. A large proportion of the participants 91% perceived the intervention as feasible and effective in achieving its goals. Almost all the participants 95.5% felt the intervention was culturally appropriate for them.Conclusions:The study revealed that Positive deviant mentorship is highly acceptable among the research participants in Soroti and Mbale Hospitals Eastern Uganda. The positive deviant mentorship-prescribed activities were easy to do and were culturally appropriate. This intervention is recommended for HIV clients living with diabetes who have low diabetes knowledge and poor glycemic control in similar contexts.This study's limitations include selection bias, recall bias, a cross-sectional design, and a small sample size. These were mitigated during the data collection, mentorship and analysis process.
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    HIV & AIDS Baseline Sero-Behavioural Study in Six Universities in Kenya
    (2014-11-25) Kimiywe, Judith; Callistus, K.P.O; Waudo, Judith N.; Mwanzo, Isaac; Orinda, George
    Universities and institutions of higher learning in general consist mainly of young people in the 17-24 year old category, most of whom are sexually active, and therefore most vulnerable to HIV infection. And though studies such as KAIS (2007) and KDHS (2003, 2008) have been conducted on the general Kenyan population, studies specific to institutions of higher learning are scanty, in particular, sero-prevalence data on this target group is lacking. This prompted the EALP/IUCEA to commission a study to understand the extent, nature and impact as well as response to HIV and AIDS within universities. The purpose of this assignment therefore was to generate an understanding of the way that HIV/AIDS is affecting universities and host communities and to identity responses and gaps in the management of the pandemic that could be used to strengthen and expand interventions at national and regional levels. The study had a total representative sample of 3942 students drawn from six universities in Kenya, four of which were from the Lake Victoria Basin region. Thus, this study is aimed at providing evidence to guide the responses and policy formulation to the challenge of HIV in institutions of higher learning. Findings of the EALP/IUCEA HIV and AIDS baseline study in institutions of higher learning carried from 1st March to 12th March and from 25th May to 5th June 2009, revealed that 20 (0.51%) of the 3942 respondents were diagnosed as infected with HIV at the time of the survey. Significantly greater prevalence was recorded among men (0.58%) than women (0.40%) Thus, HIV prevalence among students at Kenyan universities is way below the national average of 3.8% for the age group of 15-24 years (KAIS, 2007) where most belong. HIV prevalence among male students was within the national range of 0.4% to 2.6% for that age group. However, HIV prevalence among female students was well below the national range of 3% to 12% for the age group. HIV prevalence among total orphans was higher than other parenthood groups Sexual debut was at 18 years and was earlier in males than females. For those testing HIV positive, sexual debut was one year earlier at 17 years. Primary abstinence was reported in a quarter of the respondents, was higher in females, and decreased with increase in year of study. The main reasons given for abstinence were religion (70%), followed by waiting for marriage (66.5%) and fear of contracting HIV (62.3%). The prevalence of the high risk anal sex was generally low at 2.5%. However, anal sex for HIV positives respondents was four times higher than the overall prevalence rate in the study.
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    Knowledge about Physical Hazards and Use of Personal Protective Equipment Based on Demographic Characteristics and among Small Scale Welders in Nairobi City, Kenya
    (Journal of Scientific Research & Reports, 2020) Onguto, Nicholas Odhiambo; Warutere, Peterson; Mwanzo, Isaac
    Introduction: The sprawling of small and medium-sized enterprises (SMEs) in the developing world provides several challenges to ensuring health and safety practices among workers in the urban poor. Purpose: The main objective of the study will be to determine the knowledge of physical hazards and the use of PPEs based demographic characteristics among welders in Embakasi constituency, Nairobi County. Methods: This was a cross-sectional descriptive study conducted among 214 welders from 72 workshops in the Embakasi region, namely in Kariobangi South Light Industries, Kayole, and Umoja. Data collection procedure entailed observation, focus group discussions, and interviews with welders in Embakasi, Nairobi. Data were analysed using SPSS version 22 and both descriptive statistics and inferential statistics were conducted to explain the association between the study variables. Results: The study indicated that 90.2% of welders knew the activities at the workplace that pose health hazards. Welders’ knowledge of physical hazards at their workplace was significantly associated with experience (Fishers Exact Test =45.025, p = .05), number of hours worked per day (Fishers Exact Test = 9.322, p = .05), and PPE use (2 = 3.884, df = 1, p = .05). Conclusion: Factors such as age, earning a level, hours per day worked, level of education, type of training, and knowledge of physical hazards or PPE use are significantly associated with selfreported injuries among welders.
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    Knowledge and Associated Factors of Diabetes Mellitus among HIV Clients Living with Diabetes in Eastern Uganda: A Cross-sectional Study
    (International Journal of Tropical Disease & Health, 2024-11-19) Okia, David; Mwanzo, Isaac; Olupot- Olupot, Peter; Kimiywe , Judith
    Introduction: Poor diabetes knowledge among diabetes clients living with HIV remains a big public health challenge in Africa. Effective self-management of diabetes requires clients to be knowledgeable about the recommended diets, exercises, drugs, lifestyle modifications, and possible diabetes complications. The proportion of diabetes clients living with HIV with poor diabetes knowledge is on the rise in Eastern Uganda. Poor level of diabetes knowledge among clients is a serious threat to individual health, and Knowledge is essential for effective control of diabetes, as it allows the patient to play an active and cooperative role in planning and monitoring the therapeutic, which promotes informed decisions Aim: This study, conducted from May to June 2024, assessed the level of diabetes knowledge and its associated factors among diabetes clients living with HIV in Eastern Uganda. Study Design: A cross-sectional study was conducted in Mbale and Soroti Regional Referral Hospitals in Eastern Uganda from May to June 2024. Materials and Methods: The sample size was 267 registered participants though ten didn’t participate. Random sampling was done to select eligible registered participants. Electronic data collection was done by trained research assistants under the supervision of the principal investigator. All the research assistants were trained in data quality management. Ethical approval was obtained from Busitema University REC. The diabetes knowledge questionnaire was used to gather the data, and Stata version 14 was used for analysis. Univariate analysis and Binary logistic regression were used to identify associated factors. P <0.05 was considered statistically significant at a 95% confidence interval. Results: A total of 257 participants in Mbale and Soroti Hospitals participated in this study. The majority 152(59.1%) were females and 156(60.7%) of these participants were above the age of 50 years. The married were 59.1%. Only 20.2% had tertiary education. More than half (58.4%) had a below-average level of knowledge regarding diabetes, 78.2% did not know how diabetes is managed and 58.4% were not aware of the common diabetes complications. In addition, 49.80% were not knowledgeable about the recommended diabetes tests, and 46.30% were not knowledgeable about the diets. Conclusions: The level of knowledge about diabetes is low among diabetes people living with HIV at Mbale and Soroti Hospitals in Eastern Uganda. No factor was found to be significantly associated with low diabetes knowledge. Routine diabetes education by the facility's health workers is encouraged and the focus should be on recommended diabetes tests, diets, drugs and possible complications. Contribution: Identifies specific areas to be strengthened in diabetes education.
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    Missed treatment opportunities and barriers to comprehensive treatment for sexual violence survivors in Kenya: a mixed methods study
    (BioMed Central, 2018) Gatuguta, Anne; Merrill, Katherine G.; Colombini, Manuela; Soremekun, Seyi; Seeley, Janet; Mwanzo, Isaac; Devries, Karen
    Background: In Kenya, most sexual violence survivors either do not access healthcare, access healthcare late or do not complete treatment. To design interventions that ensure optimal healthcare for survivors, it is important to understand the characteristics of those who do and do not access healthcare. In this paper, we aim to: compare the characteristics of survivors who present for healthcare to those of survivors reporting violence on national surveys; understand the healthcare services provided to survivors; and, identify barriers to treatment. Methods: A mixed methods approach was used. Hospital records for survivors from two referral hospitals were compared with national-level data from the Kenya Demographic and Health Survey 2014, and the Violence Against Children Survey 2010. Descriptive summaries were calculated and differences in characteristics of the survivors assessed using chi-square tests. Qualitative data from six in-depth interviews with healthcare providers were analysed thematically. Results: Among the 543 hospital respondents, 93.2% were female; 69.5% single; 71.9% knew the perpetrator; and 69.2% were children below 18 years. Compared to respondents disclosing sexual violence in nationally representative datasets, those who presented at hospital were less likely to be partnered, male, or assaulted by an intimate partner. Data suggest missed opportunities for treatment among those who did present to hospital: HIV PEP and other STI prophylaxis was not given to 30 and 16% of survivors respectively; 43% of eligible women did not receive emergency contraceptive; and, laboratory results were missing in more than 40% of the records. Those aged 18 years or below and those assaulted by known perpetrators were more likely to miss being put on HIV PEP. Qualitative data highlighted challenges in accessing and providing healthcare that included stigma, lack of staff training, missing equipment and poor coordination of services. Conclusions: Nationally, survivors at higher risk of not accessing healthcare include older survivors; partnered or ever partnered survivors; survivors experiencing sexual violence from intimate partners; children experiencing violence in schools; and men. Interventions at the community level should target survivors who are unlikely to access healthcare and address barriers to early access to care. Staff training and specific clinical guidelines/protocols for treating children are urgently needed.
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    Utilization of antenatal care services among mothers in Central Divison, Kitui District, Kenya.
    (2011-08-04) Muinde, N. Fridah; Okelo, Agina; Mwanzo, Isaac
    To promote the health and survival of mothers and babies, Kenya has adapted the W1-10 goaloriented Antenatal Care (ANC) package, popularly known as Focused ANC (FANC).The Ministry of Health (MOH) has designed new guidelines for FANC services, placing emphasis on refocusing antenatal care, birth planning and emergency preparedness. ANC visits are now used as an entry point for a range of other reproductive health services, thus promoting comprehensive integrated service delivery. The objectives of this study were; to establish whether antenatal mothers in Central Division of Kitui District were aware of the antenatal cure services available in the health care facilities and their health benefits, assess the levels of utilization of these services and establish the social- cultural and economic lectors that influence the utilization of these services. This was a cross-sectional descriptive study. Convenient sampling was employed to identify the study area and simple random sampling to select the research participants. A total number of 254 antenatal mothers were sampled. Data collection tools included structured questionnaires, key informant interview guide and focus group discussion guide. Quantitative data analysis was done using SPSS version 11.5. Descriptive and inferential statistics were used. 76.4% of the mothers fully utilized antenatal care services while 23.6% did not. The utilization of ANC services increased with the number of previous deliveries (X2=22.891, df=4, p=0.0001). It was also observed that the level of knowledge for antenatal care services being offered was higher with an increase in the number of deliveries (X2=83.973, df=12, p=0.0001). This was an indication that those women with prior deliveries were more likely to report for antenatal care services at an earlier gestation age. Age was also observed to affect utilization of antenatal care services, whereby the younger respondents had little knowledge about the antenatal care services. From the study findings, awareness of the benefits of antenatal care services influenced the utilization of ANC services. It was observed that the respondents who thought that it was important for pregnant mothers to receive intermittent presumptive treatment of malaria were more likely to utilize antenatal care services (X2=6.833, df=l, p=0.009). Negative attitude towards health providers was also found to hinder utilization of antenatal care services (X2=8.019, df=l, p=0.005). It was further noted that respondents who were aware of the dangers of anaemia in pregnancy were more likely to utilize antenatal care services (X2=12.966, df=3, p=0.005). Consequently, women who had support from the spouse were also more likely to utilize antenatal care services (X2=4.1 12, df=1, p=0.043). Other factors like the distance to the health facility, availability of the antenatal care services and time taken to reach the health facility were also found to influence ANC services utilization. Tile study concludes that the level of utilization of ANC services was relatively high and that socio-cultural and economic factors hindered utilization of antenatal care services. It is recommended that the Ministry of health and hospitals should improve training sessions for ANC staff regarding client handling in order to make the services more acceptable. Hospitals should utilize CBOs to sensitize tile community about ANC services in order to encourage early visits among women in their first pregnancy as well as spouse support. The government through the ministry of health should provide health facilities within the reach of the people to optimize their utilization. This will assist in improving utilization of antenatal care services and also reduce the utilization of traditional birth attendants.
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    Voluntary Medical Male Circumcision Services and Related Psychosocial Factors among Men in Kenya
    (IJTMRPH, 2024-08) Lokorio, Ekidor Ateyo; Mwanzo, Isaac; Ogweno, Gordon
    Background and Objective: Voluntary medical male circumcision (VMMC) has been popularized over the years as a public health intervention geared toward reducing HIV infection. Turkana County, inhabited mainly by traditionally uncircumcised communities with a high prevalence of HIV at 4%, has however only achieved between 5% and 10%, which is below the national average of VMMC strategic target. This study, therefore, sought to determine the association between the uptake of VMMC and associated factors amongst adult men. Methods: This cross-sectional study was carried out in Loima, Turkana Central and Turkana North sub-counties, with a sample size of 434 adult men. Data was collected using both quantitative and qualitative tools. Statistical package for the Social Science version 22 was used to analyze quantitative data, whereas qualitative data was analyzed thematically. Results: Of the 374 male participants in the study, 79.9% had undergone circumcision, 77.0% were aged 18– 35 years, 94.1% were Christians, 44.7% were unemployed and 54.8% were married. The overall mean scores of responses for psychosocial and socioeconomic factors were 3.602 (positive) and 2.894 (negative), respectively. The study found that only psychological factors were significant predictors of embracing VMMC. Conclusion and Implications for Translation: Psychosocial and socioeconomic factors have a significant influence on the uptake of VMMC among male participants in Turkana County. Therefore, there is a need to address these factors when designing interventions to improve VMMC uptake in the county