MST-Department of Public Health

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    Knowledge of the Relationship between Sexually Transmitted Infections and HIV Transmission Among Secondary School Students in Kabartonjo Division, Baringo District
    (Kenyatta University, 2004-11) Amiami, A. P.
    A descriptive cross-sectional study was conducted among secondary schools in Kabartonjo Division of Baringo District, Kenya, between October 2002 and April 2003. The study aimed at establishing the students' knowledge of the relationship between Sexually Transmitted Infections and the transmission of IDV. A total of three hundred and sixty five sampled respondents were interviewed and four Focus Group Discussions (FGDs) held, in addition to interviews with key informants. Data was analyzed using the SPSS and figures done using MS-Excel before being transferred to MS-Word. The results show that more than half of the respondents (55.3%) were males with females constituting (44.7%). The knowledge of STI among the respondents was highest on gonorrhoea (99.6%), syphilis (97.1%) and IDV (84.7%) while poor on Herpes (35.4%), Chlamydia (19.4%), genital warts (14.5%), trichomoniasis (10.2%), Candidiasis (7.8%) and Hepatitis B were (6.5%). About 50% of the respondents were aware of clinical symptoms of STI in both males and females. Only few respondents (14.8%) reported noticing symptoms of STI in the last 12 months. The results further show that (86.0%) considered STI to be a serious problem, (39.7%) perceived themselves as being at risk of contracting STI and (39.7%) reported being at risk of contracting IDV. The respondents who had suffered from STI had poor health seeking behaviour as only (8.2%) sought professional help from health workers in clinics or health centre, while (4.7%) visited traditional healers, (5.8%) bought medicines from shops or pharmacies and (7.7%) asked friends for advice. The low knowledge of STI (X2 =19.287, df= 3, p= 0.000) accounts for the small percentage of respondents who reported symptoms of STI and the general poor health seeking behaviour elicited. There was good knowledge of relationships between common STI and mv being spread through sexual intercourse (89.3%). Chi-square test shows (X2 =8.766, df=3, p<0.05), that STI and IDV being spread through sexual intercourse; the presence of STI and IDV increases the chances of one acquiring IDV (83.6%) X2 =7.600, P< 0.05 did not agree with the working hypothesis. Knowledge of IDV infection prolonging the duration of STI was not significant (X2 =2.540, df=3, p> 0.05). The study revealed that knowledge of the relationship between STI and transmission of HfV was not significant with the level of education (X2 =1.360, df =3, p> 0.05) but only as individuals (X2 =1.360, df= 1, p< 0.05). The study therefore concludes that there is need to strategize on information, education and communication targeting adolescents on knowledge of STI as a measure of curbing the transmission of HIV.
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    Impact of Use of Biofuels on Respiratory Health among Workers in Food Establishments in Nairobi.
    (Kenyatta University, 2007-09) Ochieng, Caroline A.
    Indoor air pollution from biofuel use has been found to be responsible for more than 1.6million annual deaths and 2.7% of the global burden of disease. This makes it the second biggest environmental contributor to ill health, after unsafe water and sanitation. Respiratory system is the most affected. However, nearly all studies have been conducted in households, leaving out occupational environments where the same fuels are used. The main objective of this study was therefore to investigate the impact of use of biofuels on respiratory health among workers in food catering enterprises in Nairobi. A crosssectional design was employed, and data collected using structured questionnaires, observation checklist and interviews. Data was analysed using descriptive statistics and chi square tests. Of the 370 respondents in the 250 randomly selected enterprises, 56% were males and 44% females, mostly aged between 20 to 40 years. Majority (86%) had not gone beyond secondary school, and were mostly casual employees or own account workers. Most of the enterprises (71%) were unregistered, and 81% utilized biofuels because they were cheaper than processed fuels. The study found significantly higher .prevalence of respiratory symptoms among workers in enterprises using biofuels compared to those using processed fuels. p values were significant for cough (X2=38.16;df=l; P=O.OOO), phlegm (X2=6.46; df=l; P=O.OII), breathlessness (l=8.29; df=l;P=0.004) and wheezing (l=16.56; df=l; P=O.OOO). Within the biofuels, fuelwood users recorded higher prevalence of symptoms compared to charcoal users. Prevalence of respiratory health outcomes was also considerably higher in those who were aged 40 years and above and who spent longer hours indoors, similar to findings by Ezzati et at (2000) and Shrestha et at (2005) in household studies. Significantly higher prevalence was also recorded in respondents in unregistered enterprises (p=0.002), and those that were poorly ventilated (p=0.000). The study has demonstrated that biofuels are a major public health threat to workers in food establishments, and urgent intervention is required. It therefore recommends a switch from biofuels to processed fuels in order to protect the health of the workers. Other measures that can be employed include a switch from more polluting biofuels such as fuelwood to less polluting ones such as charcoal, ensuring adequate ventilation, spending less hours indoors and awareness creation. However, for such interventions to occur, the activities of the sector needs to be formalised, because this would encourage investments in the sector that would lead to adoption of cleaner fuels and healthy work environments. Targeted energy sector policies that would make processed fuels more affordable and financial support measures are also required.
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    Household Factors Influencing Child Mortality Levels in Kilifi District, Kenya
    (Kenyatta University, 2011) Maweu, Esther Nzilani
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    A survey of drinking water quality and community awareness of water related health risks in Nyeri town, Kenya
    (2011-07-15) Mungai, Njoki Helen
    Poor accessibility to safe water is a major cause of morbidity and mortality in developing countries where mechanisms to monitor and enforce regulations for quality water are inadequate or lacking. The aim of this study is to determine the microbial and chemical quality of water in Nyeri Town and assess the health risks associated with the water used and the preferred water. Water supply system in Nyeri Town consists of Municipal piped water, natural river and stream water running down some parts of town, roof catchment water and commercially available bottled water. The Town was divided into five study regions (Upper Town, Lower Town, Ruringu, Kin'gon'go and Majengo) on the basis of the social-economic conditions and in terms of the source of water supply. Basic information was obtained through a pre-tested questionnaire administered to the relevant personnel at the municipal water and health departments. Randomly selected adult members of community in each of the five study regions were interviewed to assess the levels of awareness on the health risks associated with the local water supply. Quality and safety of water was assessed following WHO established methods for determining microbial and chemical concentrations in the water. Water samples collected from each water source in the five study regions and samples of different brands of commercially bottled water purchased from the local markets were subjected to laboratory tests in the university food and water laboratories. Study on the health risks in the drinking water was based on environmental sanitation conditions including open field excreta disposal and disinfection toilets; water quality and the occurrence of water related diseases. Municipal piped water supply w-as Widely distributed in all five regions and it was the most used source of drinking and the preferred water. It was least used in Ruringu (78%) whereas this was above 90°/o in other regions. Water from roof catchment was also commonly used in the region. Majengo recorded the highest rate (97%) but this was the preferred source by only 79% of the residents. Microbial concentration in the tap water was within the WHO limits but the river and stream water samples collected after the slum exceeded the recommended levels of E. colt concentration. Some brands of the commercially bottled water (20%) exceeded the WHO recommended Zero count of E toll. Chemical concentration exceeded the KEBS and WHO standards for cadmium and iron. Fluoride was significantly high in the stream water. In regard to health risks in the drinking water, environmental contamination through poor excreta disposal especially by children was reported by 53% of respondents in Majengo and 45% in Ruringu, 39% in lower town, 37% in Upper Town and Kingongo. These were the same regions who reported significantly high occurrence of water related illnesses Majengo 60%, Lower Town 33%. Municipal piped water was mostly used and preferred water in all regions. Though river water was used should be encouraged to use municipal water instead of river or stream water which were found to contain faecal contaminant bacteria Microbial contamination observed in commercially bottled water shows the need to enforce and enhance KEBS regulations to the bottling companies.
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    The role of traditional birth attendants' training in "prevention of mother to child HIV transmission " programme in Tharaka district, Kenya
    (2011-07-15) Kagendo, Jane Francis
    Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) is a global pandemic and mitigation for spread is a global challenge. Though different mechanisms have been put in place to prevent Human Immunodeficiency Virus transmission, for the purpose of this study focus will only be on preventing perinatal transmission. Perinatal transmission of HIV occurs during three stages namely, pregnancy, delivery and after birth. Most of the services geared towards preventing this transmission are only available at the Antenatal clinics and are offered by professional health care workers. Most rural areas of Kenya lack this focused antenatal care services and traditional birth attendants (TBA) deliver most of the babies. In Tharaka South Division where the study was carried out, a section of TBA have been trained on prevention of mother to child transmission (PMTCT) of Human Immunodeficiency virus. In most other areas of the division TBA do not have any formal training on the same. The aim of this study was to establish the impact of training TBA on prevention of mother to child transmission of HIV and AIDS. To meet this goal data was collected from twenty eight trained TBA who formed the experimental group. Similar data was collected from twenty-eight untrained TBA who formed the control group. More data was collected from fifty postpartum mothers and fifteen clinicians working in the health facilities in the division. Data on type of training, knowledge acquired from training, attitudes and practices of the TBA after training was collected. The study found that there was a significant relationship between TBA training and their knowledge on perinatal transmission of HIV before birth (x2=31.5; df= 1; p<0.05), during delivery (x2 = 32.71 df=l; p<0.05) and after birth (x2 = 30.13; df=1; p<0.05). The study also found significant relationship between TBA training and their attitude towards measures taken in PMTCT of HIV. This includes attitude towards voluntary counseling testing (VCT) requirements for. mothers (x2= 25.92; df=l; p<0.05), safe infant formula (x2 = 16.84; df=l; p<0.05) and cesarean section mode of delivery (x2=30.86; df=l; p<0.05). The study also revealed a significant difference between the practice of the trained and that of the untrained TBA. This was evident in the key areas of PMTCT such as referral of their clients to health facilities (x2 =30.16; df= l; p<0.05) and in creating awareness on PMTCT related issues (x2=25.14; df =l; p<0.05). Based on the findings, the study recommended training of all TBA in PMTCT to equip them with the correct knowledge and positive attitudes to enable them practice PMTCT of HIV.
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    Assessment of knowledge, Attitude and practices regarding tuberculosis among adolescents in Kiswani- Mombasa district Kenya
    (2011-07-15) Yonge, Shadrack A; Otieno, F.M.; Sharma, Rekha R.
    Tuberculosis is a chronic infectious disease which is still a global health hazard. With the emergence of new more effective drugs, tuberculosis was expected to be completely eradicated; but global reports show results to the contrary. It seems that, in addition to drug regimens, individual health and social factors should be taken into consideration. This is not achievable except by increasing the knowledge and creating a positive attitude towards the disease. The aim of this study was to evaluate the level of knowledge, attitude and preventive practices of adolescents' in high school regarding tuberculosis. A cross-sectional study design was carried out in Kisauni Division, Mombasa District among the urban and sub-urban secondary schools. Qualitative data was obtained from key informant interviews while quantitative data was obtained from pre-tested structured questionnaires. A stratified of 384 respondents were used for the study. Descriptive statistics were used to summarize and analyze the data using the statistical package for social sciences (SPSS). Differences between independent and dependent variables were compared using Pearson's Chi-square and regression coefficient with the level of significance of p-values less than 0.05 (p<0.05 considered statistically significant. Some results were presented inform of tables, bar charts and pie charts. This study showed that 93.3% of the respondents had heard about T.B and medical workers were an important source of information. Knowledge about symptoms and transmission of T.B was 63.3%. Age was significantly associated with knowledge of T.B (x2=18.07; p<0.05; df=4). Knowledge of TB did not vary significantly by education level or gender (x2=0.4087; p>0.05; df=1). Tendency to discriminate TB patients was evident as 72.6% of the respondents opined to isolate TB patients from the family. Attitude towards TB patients did not vary significantly by age and gender. There was a positive relationship between the attitude and knowledge of adolescents towards TB. 50.3% of the respondents were on the opinion that TB can treated through directly observed treatments (DOTS). Mode of DOT delivery was significantly associated with knowledge (Z=9; p<0.05). Attitude towards DOT providers did not vary significantly by age or gender (x =6.553; p>0.05; df=5). Knowledge of tuberculosis (TB) had positive correlation with confidence in preventive practices (r=0.226, p<0.05) and behaviour change (r=0.274, p<0.05). Attitude had a positive correlation with beliefs of susceptibility to T.B (r=0.141; p<0.05) but negative correlations with preventive practices (r=-0.124; p<0.05) and behavioural change (r=-0.153, p<0.05). Considering the direct correlation of attitude and knowledge and also the important role of attitude in preventive behaviours, increasing the knowledge of adolescents about tuberculosis seems to be essential. This aim can be achieved by scheduling programs for general education of all students of the country in this regard. Establishing adolescents committees in the district by the Kenya government to prevent and control tuberculosis and other infectious diseases is of paramount. A national survey on the Kenyan adolescents who are in secondary schools knowledge of and attitudes towards tuberculosis should be conducted. More research is also needed on older adolescents to investigate their knowledge of TB changes as they mature and gain more exposure and knowledge
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    Factors contributing to delay in seeking treatment among pulmonary tuberculosis patients in Kibwezi district Kenya
    (2011-07-15) Mutisya, Redempta K
    Tuberculosis (TB) is a major global public health problem. The disease is a leading cause of morbidity and mortality in Kenya. TB control has remained a major challenge for the National Leprosy and TB Control Programme (NLTP) especially in this HIV/AIDS era and the emergence of multi-drug resistant TB (MDR-TB). Early identification of cases and commencement of effective chemotherapy is an effective method to control the spread of TB. Reliance by NLTP on passive case finding means that patients play a key role in reducing delay to diagnosis and treatment commencement. Patient delay (duration from onset of symptoms to first contact with a health care provider at a public health facility) is a major challenge to TB control and is dependent on several factors which may have an influence on each other. The purpose of this study was to determine the duration from onset of symptoms to seeking appropriate TB treatment among pulmonary TB (PTB) patients and factors associated with patient delay in the high HIV prevalence Kibwezi District in Kenya. A cross sectional survey of 133 PTB patients was carried out at five public health facilities over a period of 8 weeks. Data collected using- a semi- structured questionnaire were entered and analyzed using Epi - Info version 3.4. The mean patient delay and associations between length of patient delay and the various independent variables was determined. Multiple logistic regression was performed to determine the factors independently associated with patient delay. The mean patient delay was 54 days (1.8 months) and 65.4% of the study subjects had delayed for more than 30 days. Private clinics were more preferred (45%) to public health facilities (21 %) Delay in seeking the appropriate TB treatment among PTB patients in Kibwezi District was associated with poor perception of services in public health facilities (OR = 4.91; CI: 1.6-15.3; p = 0.0061), visiting a private clinic (OR = 4.24; CI: 1.5-11.6; p = 0.0052) and stigma (OR = 2.46; CI: 1.9-12.2; p = 0.0178). Most PTB patients in Kibwezi District present at public health facilities 30 days after the onset of major TB symptoms. Long delay was associated with having a poor perception of the quality of services in public health facilities, prior attendance at a private clinic and stigma. Delay was not found to be associated with the patients' socio-demographic characteristics, knowledge of TB, distance or transport cost to public health facility and perception of TB disease. Neither having a good TB knowledge score nor perceiving TB as a serious disease translated to early care seeking at a public health facility. The findings of this study underscore the need by the Division of Leprosy TB and Lung Disease (DLTLD) to integrate private clinics into the public sector TB control program. The DLTLD supervisory staff can be increased to ensure adherence to standards. Since TB services are integrated in the general health care system, the findings also highlight the need by the Ministry of Public Health and Sanitation (MoPH&S) to improve service delivery in public health facilities so as to correct the poor perception and reduce patient delays. Staff in public health facilities can be trained in communication skills. Educational campaigns should go beyond providing general information about TB to emphasize embracing a positive attitude to prevention of transmission through early treatment
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    Factors associated with water borne diseases among pupils in Kiganjo Location Nyeri District Kenya
    (2011-07-18) Kathugu, N. P.; Gicheru, M. M.; Kamau, L. M.
    School children are exposed to various types of water borne diseases. There are different factors that contribute to the occurrence of these diseases in different schools. Water borne diseases are intricately linked to quality water, sanitation and hygiene. Sanitation is an environmental factor that is associated to occurrence of diseases such as intestinal worms, and other water borne diseases, while hygiene is equally import in occurrence of water bome diseases. Deforestation of the water catchment's towers at the Aberdare, Mau and Mt. Kenya forests have reduced the water quantities in the region. This may have compromised the water quantity and quality as well as sanitation and hygiene standards of Nyeri district which lead to occurrence of water borne diseases. There is scarce information on water bome diseases in Nyeri district and more recent information needs to be documented. The study was conducted in Kiganjo location of Nyeri district to determine the factors associated with the infection of water borne diseases among the pupils in the location as well as the levels of infection. The study area, being disadvantaged by its aridity and dependency on the depleting water sources from Mt Kenya and Aberdares, was purposively selected to represent Nyeri district. A random selection of schools from this location was done using the random numbers to select schools across the location. Pupils were selected using the systematic random sampling from the school's registers. A total of 375 pupils were sampled for the study. Data was collected by recording of the results on stool examination done to the respondents, and by using an observation checklist in the selected schools. Data on water quality was collected by carrying out a bacteriological water analysis on all the water sources in the location and recording the results for comparison with the infection rates of respondents. Secondary information was gathered from the location's health centre where school children get their medical services. Data was processed using SPSS soft ware and then analyzed using chi-square test to determine the associations between age, sex and infection, as well as infection rate and independence of the school. The results of the study showed that prevalence of water bome diseases was 54.4%. Of this prevalence, 38% was infection by E. histolytica, 7.2% by G. lamblia, and 21.65% by intestinal worms, the rest being E. cold which is a normal flora in the gastro intestinal track. The infection by water borne diseases was independent of school (chi-square = 13.680, p = 0.033). There was a significant relationship between the class category according to age and the infection by parasites that are water borne. The lower age group of 5 - 10 years being more infected (chi-square = 5.953, p = 0.015). The schools with poorer water quality, sanitation and hygiene had more infections by the water bome diseases. There was a significant correlation in hand washing and the infection (r = -0.986, p = 0.005), indicating the leading factor associated with infection of water borne diseases in the region. The availability of toilets in relation to infection was significant (r = -0.9765, p = 0.005) and was next to hand washing. It was recommended that health workers provide prompt treatment to the infected and also undertake regular deworming. Schools should adhere to the sanitation and hygiene standards set by MOEST together with the Public Health Act CAP 242 L.O.K. NYEWASCO should extend the supply of treated water to all the primary schools in Kiganjo location and other schools in Nyeri district.
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    Determinants of insecticide treated bed-nets use by women for malaria control: a comparison of ndavaya and Kinango divisions, Kinango district, Kenya
    (2011-08-02) Kimathi, George
    Globally malaria results in 300 to 500 million clinical episodes and one million deaths annually. Malaria is caused by a protozoa of the genus Plasmodium. The disease is transmitted by the bite of an infected female Anopheles mosquito. In Kenya the disease leads to morbidity and mortality contributing to 30% of outpatient cases, 20% of admissions and 15 to 35% of hospital deaths. Kinango District records over 41% outpatient morbidity due to malaria. Malaria control measures include environmental hygiene practices, application of insecticides, intermittent presumptive treatment and prompt and effective case management. Use of Insecticide Treated Bed-Nets (ITNs) protects against mosquito bites including Anopheles gambiae and An. Funestus that harbour and spread the protozoa. The aim of the study was to investigate and compare the factors that influenced use of ITNs by women for malaria control in Ndavaya and Kinango Divisions of Kinango District. A cross-sectional survey design using systematic sampling was applied to collect data from 204 women selected randomly from the two divisions. Semi structured questionnaires, Key informant Interviews and Focused Group Discussions were used to gather data. Data for variables such as age, education level, incomes and source of nets were summarized in tables and figures. Chi-square test was applied to test whether the deviations (differences between observed and expected) were a result of chance or due to other factors. About 57% of women in Kinango slept under ITNs compared with only 32% in Ndavaya. Use of ITNs was significantly influenced by source (x2 = 79.01; P < 0.001). Over 51% of the respondents who had obtained ITNs from government health facilities did not use them. About 85% and 80% of the respondents in Ndavaya and Kinango respectively earning >Ksh. 12,000 used ITNs. Over 70% of women in both divisions who knew that malaria was transmitted through mosquito bites used ITNs. Kinango had approximately 30% of respondents' husbands supporting use of ITNs compared with only 13% for Ndavaya. More respondents (73%) in Kinango than Ndavaya (61%) who had been trained on use of ITNs indeed used them. Results indicated that the use of ITNs increased with the level of education and income. Shorter distances to health facilities were also associated with use of ITNs. The government should develop a communication package for malaria endemic areas. Community health workers should facilitate massive and systematic awareness creation on malaria transmission and ITNs use. Men should participate in interventions to scale up use of ITNs. Further research is required to establish the factors that influence use of ITNs by men and also determine the efficacy of indigenous malaria control mechanisms.
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    Substance abuse and vulnerability to HIV and AIDS among adolescents in public secondary schools in Meru Central district, Kenya
    (2011-08-03) Kinoti, Mboroki Silas
    A drug is any natural or artificially made chemical that changes the functions or structure of the body in some way. On the other hand drug abuse is the non-medical use of drugs. Most studies among young people have been done on relationship between injectable drugs and HIV and AIDS. However little has been done on relationship between HIV and AIDS and non-injectable substances such as alcohol, khat (locally called miraa), cigarette ad bhang among others. This study aimed to determine the relationship between substance abuse and vulnerability to HIV and AIDS among adolescents in public secondary schools in Meru Central District. Vulnerability was assessed on the basis of risky behaviour patterns of substance abusers. A descriptive cross- sectional survey was conducted and a sample size of 740 students selected. Simple stratified random sampling was used to select schools from various categories and proportional random sampling was used to select respondents from the selected schools. Qualitative data was obtained using focus group discussions and interviews while quantative data was collected using self-administered questionnaires. Data was analyzed using one way ANOVA to determine the most commonly abused substances among adolescents in public secondary schools and to test whether there were significant differences in substance abuse among adolescents in boys', girls' and co-education schools in the district. The t-test was used to determine whether there was significant difference in substance abuse between rural and urban schools. About 60% (n= 736) of the students in public secondary schools in Forms two to four admitted that they were involved in substance abuse such as alcohol, khat, cigarette, bhang or glue. There was a significant difference in substance abuse levels in public secondary schools (F=5.014, df=7, P<0.05, n= 736). A post ANOVA test (Tukeys HSD, P < 0.05) showed that commercial alcohol and khat were abused by significantly high number of students (P< 0.05) during school time. The number of boys abusing substances was significantly higher than that of girls (F=40.9, df =76, P<0.05, n=736). The t-test showed that there was a significant difference in the number of students taking substances in rural schools compared to urban schools (t38 = 5.019, p < 0.05). Tukeys test (P<0.05) revealed that students in rural schools mostly abused khat followed by alcohol while in urban schools more students abused alcohol followed by khat. Over 40 (n=736) of the students had experienced sexual intercourse at the time of the study. Nearly 40% (n= 294) of the students had sexual intercourse without any protection such as condom and over 17% (n = 294) of the students had multiple sexual partners by the time of the study. About 31.4% (n= 294) of the sexual abuse was attributed to people under the influence of substance abuse. The study revealed that abuse of substances such as khat, alcohol, cigarette and bhang contributed to high risks of vulnerability to HIV and AIDS. From the study it can be concluded that commonly abused substances that are non-injectable lead to high vulnerability of contracting HIV and AIDS. Therefore the government of Kenya and all stakeholders should endevour not only to control injectable drugs but also the commonly abused substances in order to fight HIV and AIDS effectively.
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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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    Perceptions and factors influencing accessibility and acceptability of the female condom among women in Kiambaa division, Kiambu district, Kenya
    (2011-08-08) Mativo, Nzioki
    dvocacy of the female condom emerged in the context of growing evidence that heterosexual intercourse was placing women at increased risk of HIV infection. Since the approval of the Female Condom (FC) in the United Kingdom and the United States of America in 1992 and 1993 respectively more than 90 developing countries have introduced the FC to the public. The study objectives were to identify the perceptions of the women in Kiambaa Division towards use of the FC, to establish their experiences with use of the FC and to establish the factors that influence accessibility and acceptability of the FC among the same group. This was a cross-sectional survey in which the calculated sample size (n) was 289. Data was collected using interview schedules and Focus Group Discussions. Quantitative data was analyzed statistically while thematic techniques were used to analyze qualitative data. The study revealed that the perceptions that influenced acceptability of the FC are; the FC is difficult to use (x2=71.36, df=2, p<0.05), the FC is uncomfortable to use (x2=81.022, df=2, p<0.05) , the FC is associated with prostitutes (x2=152.57, df=l, p<0.05), the FC reduces sexual pleasure (x2=4.461, df=1, p<0.05), use of FC means no trust to partner, (x2=59.47, df=2, p<0.05) and the Male condom (MC) is better than the FC (x2=127.02, df=l, p<0.05). There were four experiences that were found to influence acceptability of the FC which include; FC is difficult to use (x2=71.36, df=2, p<0.05), FC reduces sexual pleasure (x2=4.461, df=1, p<0.05), FC is uncomfortable to use (x2=81.022, df=2, p<0.05) and MC is better than FC (x2=127.02, df=1, p<0.05). High cost of the FC combined with lack of FC's in the local market were found to be significant factors that influenced accessibility of the FC (x2=11.916, df=2, p<0.05). Together with perceptions and experiences other factors that were found to be significantly influencing acceptability of FC among women of reproductive age include; high cost of FCs (Chi square=11.916, df=2, p<0.05), Spouse/partner consent (x2=3.026, df=2, p<0.05), preference of other contraceptives (x2=57.934, df=2, p<0.05), marital status (x2=3.875, df=1, p<0.05), FC's capacity to prevent HIV and other STIs (x2=22.124, df=2, p<0.05)and level of education (x2=2.390, df=2, p<0.05). The study concluded that there are wide spread perceptions that influenced uptake of the FC among women in Kiambaa Division, MC was more preferred than the FC, absence of the FC in the local market and high cost of the FC were two factors that influenced its accessibility, there were wide spread social-cultural and economic factors that influenced acceptability of the FC and the FC is not being effectively utilized among the same group (prevalence of use: 10.4%).This study recommended the Government of Kenya through the Ministry of Health to; allocate or source funds for implementation of a long term FC promotion program, identify and address weaknesses in the FC supply chain, subsidize the price of FC, target men in the promotion of FC and review lessons learned from findings of studies carried out in the global community on utilization of FC and use these findings as a basis to develop a strategic plan that will ensure effective utilization of the FC.
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    The influence of intestinal parasites on academic performance among primary school children in Nairobi province, Kenya
    (2011-08-09) Mwenji, Benedict M.; Kabiru, Ephantus W.
    The purpose of this study was to assess the influence of intestinal parasites on academic performance among primary school children in Nairobi Province, Kenya. Intestinal parasites belong to two main taxonomic groups: protozoa and helminths. Pathogenic protozoa are Entamoeba histolytica, Giardia lamblia and Balantidium coli while intestinal helminths comprise of nematodes hookworms (Ancylostoma duodenale and Necator americanus), Ascaris lumbricoides, Strongyloides stercoralis, Trichuris trichiura and Enterobius vermicularis, cestodes (tapeworms) and trematodes (flukes). Infected persons, especially children, suffer sub-optimal arousal levels that undermine intellectual and academic development and impaired general health. The objectives of this study were to determine the prevalence and types of intestinal parasites affecting school-age children, factors contributing to prevalence and to establish effects of intestinal parasites on academic performance. A cross-sectional design was used to investigate children in classes three to seven drawn from five primary schools. Hospital Hill school was highcost, Parkroad and St. Teresa Girls' were medium cost and Kiboro and Daniel Comboni were low-cost schools. Data was collected using Ridley's method of stool concentration and end-of-term scores for three preceding terms and one immediate term. Data was analyzed using the SPSS software, the correlation coefficient, the Chi square, the Odds Ratio, Analysis of variance and the t-test. The highest number of infections was from Daniel Comboni (99) and lowest from Hospital Hill school (5). The highest infection rate was from Daniel Comboni (9.0%) and lowest from Hospital Hill (0.5%).The highest number of infections were caused by Entamoeba histolytica (7.4%) and lowest by hookworms (0.1%). The Odds Ratio showed pupils had 87.4 times higher risk of infection with E. histolytica than with hookworms. The factors predisposing children to infections included children's status on knowledge of intestinal parasites, attitudes towards infections, prevailing practices and unhygienic environmental factors. The highest mean performance score was from Hospital Hill (83.0) and the lowest from Kiboro (44.4). Positive association between academic performance and intestinal infections was noted in Kiboro but not in other schools. The type of school attended significantly affected performance (F=246.9, a < 0.0001) than infection by E. histolytica. Mean performances were significantly different between boys and girls (F = 14.17 ; df = 1 ; a < 0.001). Mean score for boys (60.6) was significantly lower than for girls (62.8). Females performed better than males at an average score of 4.849 (t = 3.8, a < 0.0001). Generally, uninfected children performed significantly better than the infected by an average of 9.109 ( t = 6.2, a = 0.0001). Overall prevalence was 16.4%. The most prevalent parasites were E. histolytica (7.4%) and T. trichiura (7.3%). The highest number of infections was by E. histolytica (7.4%) across all age groups. The most prominent factors predisposing to infections were failure to wash hands before meals and infrequent cleaning of toilets which attracted Fannia scalaris (latrine flies). Mean performance scores decreased from high-cost schools to low-cost schools. Infected children were two times at higher risk of performing poorer than uninfected children. The M Ministry of Public Health and Sanitation and Ministry of Education should mount regular treatment programmes in schools. Public Health Education programmes should be emphasized in all schools high level of sanitation maintained. The impact of Public Health Education in primary schools should be further investigated.
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    An investigation into the preparedness for disasters in secondary schools in Ruiru division, Thika district, Kenya
    (2011-08-09) Mururi, Wangui Susan; Afullo, A.; Ouma, J. H.
    Disaster is an overwhelming event that involves the destruction including injury and loss of lives and they become common events that pose serious threats to Public health. The objective of the study was to establish preparedness in disaster management in Secondary Schools in Ruiru Division in Thika District, Kenya. The study targeted the students, teaching staff and the supportive staff from Ruiru Division Secondary Schools. The findings of the study were designed to benefit the school administrators, disaster managers, researchers, scholars, policy makers and the funding Agencies with an aim of improving the health and safety of the Secondary School community and those living in the schools environs and spare the already strained economy of this country. To achieve a desired representation from the various Secondary School, a stratified simple random sampling technique was employed where a sample size of 120 was realised and participated in the study voluntarily. To assess disaster preparedness in the selected secondary schools, the researcher gathered detailed, descriptive information from the respondents by use of simplified and closed ended questionnaire, in-depth interview and observation check list. The data obtained was entered and analyzed using statistical package for social sciences (SPSS) and confirmed lack of provisions for disaster management in secondary schools. The respondents did not know how to use the first aid kit elements(x2=835.263, p = 0.000, df =1). Lack of knowledge on use of first aid elements was significantly high among the respondents which also reflected lack of skills to manage minor incidences ( X2 =835.1, P= 0.000, df = 1)Lack of knowledge on where to keep the first aid kit was significantly high among the respondents(x2=474.386, p=0.000, df=1). The respondents confessed the lack of preparedness for disasters in their schools. (x= 840.8, P= 0.0, df = 2).The level of knowledge where information was highlighted in the media and the daily nations like the collapse of the building along Ronald Ngala in 2006 street was significantly high among the respondents (x2=0.175, p=0.675, df =1). Therefore information education and communication (IEC) played a big role disaster management because there was a significant relation on (IEC) and knowledge about this particular disaster. The respondent knew the common disasters in Ruiru Division ( x2 =571.482, p = 0.000, df =2). Analysed data were presented in tables, figures, graphs and statements. There was lack of preparedness in the secondary schools in Ruiru division. The Ministry of Education should adopt a wide range of strategies to mitigate and prepare for disasters in schools by increasing the knowledge and skills of the communities within the secondary schools and their environs. Those in authority should also ensure the necessary tools for disaster management are available and operational at all times.
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    Assessment of factors determining the choice of birth attendant in Kisau division, Makueni district, Kenya
    (2011-08-09) Mutea, Nduku Lilian
    The Kenya Demographic Health Survey (KDHS) 2008 showed that maternal mortality in Kenya is estimated at 488/100,000 live births, and that pregnancy related complications are the leading cause of death (27%) among women of childbearing age (CBS, 2008). Although 92% of women receive antenatal care at least once during pregnancy, a skilled attendant assists only 44% of mothers during childbirth. Therefore, the purpose of this study was to assess the factors determining the choice of birth attendant in Kisau Division, Makueni District. The specific objectives of the study were to: establish the level of utilization of Skilled Birth Attendants (SBAs) and Traditional Birth Attendants (TBAS) in the study population, examine the effects of socio-economic and demographic characteristics on choice of birth attendant, establish the role of TBAS in choice of a birth attendant and determine strategies that can be used to improve skilled birth attendance in the study population. The study adopted a descriptive survey design and the eligible respondents were women who had delivered in the previous 12 months. All women who delivered in health facilities and at homes in the previous 12 months were listed down in a sequential order from the latest to the oldest date of delivery, using records from the health facilities, chiefs, assistant chiefs, Community Health Workers (CHWs) and TBAs. Systematic random sampling method was used to identify participants for the study. Data was collected using interview schedules and Focus Group Discussions (FGD). CHWs, TBAs, religious leaders and the provincial administration assisted the researcher in tracking the study participants in their homes. A total of 315 women from Kisau division were interviewed, and 3 focus group discussions composed of health professionals, TBAs and local opinion leaders conducted. Secondary data was also obtained from health facility records in the study population. Data analysis was done using descriptive statistics and by applying Statistical Package for Social Sciences (SPSS). Data was then organized and presented by use of tables, bar graphs, pie charts and prose forms. The study established that majority of women (52.7%) in the study population delivered with TBAs assistance, and that utilization of SBAs was low (42.9%). A Chi-square test to establish if there was a relationship between household income and choice of birth attendant generated x2 =4.229 and a P value of 0.004 at 3 degree of freedom. Education level was also found to be a determinant of choice of birth attendant as the chi square test generated x2 =9.886 and a P value of 0.001 at 2 degree of freedom. The study also established a relationship between distance to health facility and women's choice of birth attendant. The chi square test generated x2 =2.905 and a P value of 0.001 at 2 degree of freedom. The study established that higher utilization of TBAs was because they (TBAs) lived closer to the women, charged lesser fees and allowed different modalities of payment, including payment in kind. SBA utilization was mainly due to perceived safety for both mother and baby. The study also established that TBAs and husbands to married women influenced the women's' decision on choice of birth attendant. The study recommends that government and other stakeholders introduce intense awareness programmes on the benefits of skilled birth attendance and reinforce the policy or, free maternity services at lower levels. The government should also bring maternity services closer to the community and support empowerment of girls and women through education.
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    Effect of an emergency care training on the management of acute childhood diarrhoea in Nakuru district, Kenya
    (2011-08-09) Ndedda, Ouma Crispin
    Every year there are approximately 1.5 billion acute diarrhoea episodes and 4 million deaths in children less than five years of age (most from 6 months to 12 months). Acute diarrhoea accounts for approximately 7% of all paediatric admissions in the under 5 age group. Appropriate secondary prevention would reduce these deaths considerably however, studies done in resource rich and poor settings confirm that the management of this common illness by health professionals remains sub-optimal. The aim of this study was to determine the effect of a five day emergency care training namely-Emergency Triage Assessment and Treatment plus admission care (ETAT+) on the case management of acute childhood diarrhoea in a busy public hospital in Kenya. This training has been conducted in most Provincial General Hospitals. Nakuru PGH is one of the health facilities where training has been undertaken and there are plans to roll out to district hospitals. The study design was cross-sectional with historical controls of acute diarrhoea episodes managed without ETAT+ training compared to episodes managed with ETAT+ training in a paediatric out patient setting. The assessment, classification and treatment of acute childhood diarrhoea episodes in children aged 2months up to 59 months was observed and documented using the basic paediatric protocols as the "Gold standard". A total of 334 acute childhood diarrhea episodes were assessed. The primary outcomes were the proportions of acute childhood diarrhoea episodes appropriately assessed, classified and treated for shock and dehydration. The study found out that ETAT+ training improved the assessment of signs of dehydration --checking AVPU from 37.1% to 69.6% p=0.001, RR 0.511 - 0.811 at 95% CI); checking for sunken eyes from 55.0% to 80.9% p=0.010, RR 0.700 - 0.961 at 95% CI); checking skin pinch reaction increased from 40.7% to 70.6% p=0.0.001, RR 0.561 - 0.863 at 95% CI) and checking ability to drink which was least practiced, also significantly rose from 11.4% to 34.5% p=0.001, RR 0.243 - 0.651 at 95% CI). In. regard to treatment practices, selection fo the correct treatment plan for dehydration improved from 26.45 to 67.55 p=0.001, RR 0.353 - 0.631 at 95% CI); correct fluid therapy rose from 44.3% to 69.1% p=0.01 1, RR 0.631 - 0.948 at 95% CI); prescription of vitamin A was poor and had no improvement 37.1% to 43.3% p=0.819, RR 0.794 - 1.350 at 95% CI); while prescription of zinc supplements was poor but improved from 0.7% to 26.6% p= 0.001, RR 0.006 - 0.286 at 95% CI) following ETAT+ training. The results suggest that ETAT+ training resulted in improved overall case management practices. It resulted in significantly higher proportions of acute diarrhoea episodes appropriately assessed for dehydration (27.9% without ETAT+ training compared to 67.0% after ETAT+ training p= <0.001, RR 0.448 - 0.658 at 95% CI), correct classifications of dehydration status documented using the terms to describe the severity as recommended in ETAT+ (45.7% without ETAT+ training compared to 78.4% with ETAT+ training p=0.03, RR 0.582 - 0.851 at 95% CI) and appropriate treatment (42.1% without ETAT+ training compared to 54.1% with ETAT+ training, p=0.001, RR (0.710 - 0.992 at 95% CI). In conclusion, ETAT+ training significantly improved the management of childhood diarrhoea however; the treatment of diarrhoea is still sub-optimal. Training alone cannot therefore be relied on to change case management practices. It has to be augmented with intensified support supervision and structured internal and external quality of care audits by embracing such strategies as Standards Based Management and Recognition (SBM-R).
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    Factors influencing the provision of community- based health services for people living with HIV and AIDS in Nakuru Municipality, Kenya
    (2011-08-10) Soy, Cherono Betty
    HIV and AIDS has become the world's most devastating epidemic in developing countries. More than 25 million people have died has a result of AIDS related illness since the disease was first diagnosed in 1981. A total of 33.2 million people were living with HIV worldwide in 2007. Everyday, over 6800 persons become infected with HIV and over 5700 persons die from AIDS related illnesses, mostly because of inadequate access to HIV prevention, care and support services. The HIV epidemic remains the most serious of infectious disease challenges to public Health. The estimated number of deaths due to AIDS in 2007 was 2.1 million worldwide, of which 76% occurred in sub-Saharan Africa. Bed occupancy in the public health institutions by AIDS related cases averages 60% and AIDS has taken a toll on health professionals as well. Community health workers (CHW) provide basic primary healthcare (PHC) services to the people living with HIV and AIDS (PLHIV) in the community a continuum of care extended from the facilities to the community. This study sought to establish the factors influencing provision of community based health services for the 30,000 PLHIV in Nakuru municipality with the aim of determining the sociodemographic profiles and variety of community based services for PLHIV.This was a descriptive cross-sectional study that mainly targeted PLHIV and CHW in the municipality. Data was collected through questionnaires, focus group discussion, key informant interviews and observation checklists. SPSS was used for analysis and Chisquare tests were used to test the relationship between certain variables. At 95% confidence interval, the study found no significant relationship between age of the CHW and the trend of efficiency in the past one year (k2=12.738: df. p<0.175), though there had been an increase in the proportion of PLHIV. There is a significant relationship between the presence of HBC and the rating of efficiency of CHW. (X2=7.520: df 2: p<0.023). The results further showed that training of CHW directly affects the quality of services they offer to PLHIV (k2=12.355 df=6; p<0.05 ). Other key variables influencing the efficiency of CHW are the presence of HBC programme (43%) referrals (16%) and support (44%). Challenges in provision emerge such as transportation (26.7%), financial support (30%) and stigmatization of PLHIV (13%). The null hypothesis was therefore rejected. This study therefore recommends that interventions be put in place by the government and other stakeholders to address the challenges in order for the PLHIV to attain access to prevention, treatment, care and support services in the community
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    Assessment of factors influencing adherence to antiretroviral therapy at Nyeri provincial hospital in Central Kenya.
    (2011-08-10) Sumbi, Muthiani Victor
    The Nyeri Provincial General Hospital (PGH) was one of the five pilot sites at which the Government of Kenya started providing antiretroviral therapy (ART) to HIV-infected patients in 2003. At this hospital, as in the other pilot sites, there was an increasing number of patients requiring a switch from first line to second line ART drug regimens due to treatment failure. There was little information available on levels of adherence to ART as well as the factors that influence adherence among patients to guide adherence promotion strategies and thus reduce the incidence of virologic and treatment failure. The objective of this study was to assess factors that influence adherence to ART at Nyeri PGH. The study was retrospective and cross-sectional. Two hundred and twenty nine patients were selected from a total of 705 patients who had been active on ART for at least one year and who were on solid drug dosage forms. Stratified random sampling was used to obtain the same relative proportions of adults, paediatrics, male and female respondents in the sample population as in the study population. Semi-structured interview schedules were used to obtain demographic information and patients' views on various dimensions of ART services at the hospital. Pill count data of patients collected over a period covering 3 clinic appointments was used to determine the percentage adherence levels of the patients to ART. For 13% of the patients for whom pill count data was not available, pharmacy refill dates were used to estimate adherence levels. Univariate analysis of various factors was undertaken to examine the odds of adherence and non-adherence to ART with respect to the various factors. Response values and categories were assigned to questions. Patient responses on ART services at the hospital were grouped into four categories: ART Acceptability, ART Accessibility, ART Affordability and ART Availability. The response scores were aggregated per statement and averaged to get mean scores for each category. The mean scores for each category of questions were subjected to correlation analysis to check for the influence of patients' views on their adherence level to ART. The mean adherence rate for all the patients was 92.7% ± 8.5%. The number of patients exhibiting optimal adherence (greater than 95%) to ART was 125, representing 55% of the total patients interviewed. 197 (86%) of the patients exhibited greater than 85% adherence to ART. Only 11 (5%) of the patients sampled had less than 75% adherence to ART. Being busy with household chores and job-related tasks (39%) as well as travelling (21%) were cited by the respondents as the most important factors affecting adherence. Occupation of patient was found to influence adherence with employed patients exhibiting a higher rate of non-optimal adherence (Odds Ratio of non-optimal adherence: 2.64, 95% Cl, 1.3863 to 4.8708, P < 0.005). Age, gender, level of education, marital status and knowledge of HIV disease were not found to significantly affect adherence. On correlation analysis, patients' views on ART availability and ART acceptability were significantly correlated with percentage adherence to ART (Spearman's r = -0.157, P < 0.05 and Spearman's r = 0.255, P < 0.01 respectively). Based on the adherence levels established in this study showing that about 14% of the study population was at an elevated risk of virologic failure, there is urgent need to institute measures to identify those patients with non-optimal adherence to ART and work out strategies to improve their adherence. Particular effort should be made to prepare practical medication taking plans for employed patients initiating ART therapy.
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    Factors influencing Utilization of dental conservation methods in adults in Gatanga Division Thika District, Kenya
    (2011-08-18) Kanyi, Winnie W.; Simbauni, Jemimah; Wilson A. P. Otenga
    Like most other diseases, oral diseases affect all people irrespective of nationality, race, colour and creed. Despite great achievements in the oral health of populations globally, problems still remain in many communities around the world. Dental conservation methods are those methods that can be utilized to maintain good oral health. They can be instituted at both individual and professional levels. Good oral health is an essential and important component of general health. Some of the conservation methods include amalgam fillings, tooth coloured fillings, crowns and inlays. While these conservation methods are available to Kenyans in the event of pain from dental caries, most of the teeth are reportedly extracted rather than filled. The Kenyan population has received relatively few fillings. Dental caries has been cited as the most common cause of tooth mortality. As the prevalence of dental caries increases due to the use of refined sugars which are cariogenic in nature, tooth mortality also increases. The main objective of this study was to determine factors that influence utilization of dental conservation methods. An analytic cross-sectional study was carried out in Gatanga Division of Thika District. Gatanga Division was selected purposively. Random sampling technique was used to get one location. Individual study participants were sampled using systematic random sampling method with a desired sample size of 384 individuals. Data were collected using structured interview schedules and key informant interviews. Data were analyzed using SPSS Version 11.5. Chi-square test was used to determine the strength and significance of the association between the variables. The study findings revealed the prevalence of dental extractions as 73.9% and that of utilization of professional dental conservation methods as 7.9%. The significant factors associated with utilization of dental conservation methods included; age (x2=70.991, df=50, p=0.027), level of formal education (x2 = 13.635, df=4, p=0.009), earlier fillings (x2=24.260, df=1, p=0.0001) and social cultural beliefs (x2=83.539, df=68, p=0.047). The study shed light on some of the reasons behind continuous loss of teeth among Kenyans when dental conservation methods are available. With the dissemination of the study findings and recommendations to the Ministry of Health, the oral health policy may be improved to the benefit of the Kenyan society
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    The impact of alcohol use on health and academic performane of students in Kenya Medical Colleges in Central Province
    (2011-08-18) Kibui, Mary Muthoni; Keraka, M.; James O. Ayugi
    Alcohol is the most widely used and misused substance in the world. For many decades it was perceived as a moral weakness but in recent times, alcohol use and misuse has begun to be viewed as a disease. Attitudes and moral notion of alcoholism still prevail, resulting in missed diagnosis and lack of treatment of the affected persons. The impact of excessive alcohol use in human health and well being is substantial and no one is immune from the complete range of medical, social, family, legal and economic problems that are brought by the uncontrolled use of alcohol. However, marketing of alcohol and tobacco has contributed to increased health related problems; especially in developing countries. Alcohol continues to be the psychoactive substance most frequently used and abused by young people along side tobacco. Efforts to reduce students from drinking alcohol have largely been unsuccessful, because research based on prevention strategies, have not been consistently applied. The prevalence of alcohol by students in Kenya's central province is 26.3%. Accordingly, the purpose of this study was to understand the factors associated with alcohol use and its impact on health and academic performance of students in medical training colleges in the Central Province of Kenya. The study used survey design and data were collected from six medical training colleges in central province. In this study it was hypothesized that there was no significant association between academic performance, health and demographic characterists of students who used and those who didn't use alcohol. The study site was conveniently selected because the researcher works in the area. Data were collected through self-administered questionnaires given to 250 respondents' selected using snowballing method (a non-probability sampling technique). Data were tabulated using Microsoft Excel spreadsheet and comparisons were analyzed and tested. Chi-Square test was also done using the Statistical Package for Social Sciences (SPSS). This was to assess whether there was any significant association between academic performance, health, demographic data and alcohol use. Chi- Square statistical test indicated that there was a significant association between academic performance, Chi = 240.249, df. = 3, p< 0.001, immediate health problems such as hangover Chi = 428.430, df. = 6 p<0.0001, injury Chi =113.425, df. = 4, p<0.0001, demographic characteristic, multiple drug use and alcohol use. This study found out that academic performance, demographic characteristics, immediate health problems, other drugs use were all significantly related to alcohol use by college students. It was also found out some of the students who used alcohol were at risk of developing alcohol dependence while others tested positive for alcohol dependence in that they had signs and symptoms of alcohol dependence. This study recommended that college administration through the services of trained college counselors, should offer counseling services to students especially those found using, abusing or are already dependent on alcohol. Colleges' academic committees to strengthen academic achievement requirements by giving students regular exams and supplementary tests to students who did not meet the minimum grade of 50%