RP-Department of Public Health

Permanent URI for this collection

https://repository.ku.ac.ke/handle/123456789/1493

Browse

Now showing 1 - 20 of 41

A Study of awareness of malaria among Kibera population; implication for community based intervention
(2002) Karanja, J.; Wambari, E.; Okumu, D.; Odhiambo, E.; Karuri, I.; Muthwii, S. M.; Kibe, M.; Osawa, N.; Osaki, Y.
Maternal Use of Insecticide-treated Nets in the Prevention of Malaria among Children under Five Years in Nyamira district, Kenya.
(East African medical journal, 2005-10) Osero, O.J.S.; Otieno, Micheal Frederick; Orago, A. S.
BACKGROUND: Insecticide treated nets (ITNs) have been proved as one of the most effective ways of reducing malaria morbidity and mortality in children and pregnant women. Proper use and care of insecticide treated nets reduce malaria health risk to children. OBJECTIVE: To determine maternal use of insecticide treated nets in the prevention of malaria among children under five years in Nyamira district. DESIGN: Cross-sectional, descriptive study. SETTING: Eight health centres in Nyamira district. SUBJECTS: Four hundred mothers bringing their children aged five years and below to the child health clinics between August and October 2003. RESULTS: There was very low usage of mosquito nets (33.8%) with the proportion of under five using bed nets and insecticide treated nets being 33.3% and 23.8% respectively. The possibility of a mother having an insecticide treated net was significantly related with the level of education of the mother (p = 0.003), occupation (p = 0.001) and knowledge (p = 0.000). Among the reasons given by mothers regarding non usage of insecticide treated nets included lack of money, they were expensive, ignorance and carelessness. CONCLUSION: There was low use of ITNs (23.8%) among children. There is need for health information, education and communication campaigns to sensitise the mothers on most risk groups from malaria so as to create awareness of who needed more protection through use of ITNs. There is need for ITNs intervention projects for malaria prevention in the area.
Knowledge, Attitude and Practice Towards HIV/AIDS in a Rural Kenyan Community
(Cambridge University Press, 2006) Karama, Mohamed; Yamamoto, Taro; Shimada, Masaaki; Orago, A. S.; Moji, Kazuhiko
The aim of this research was to explore people’s knowledge, attitude, behaviour and practice towards HIV/AIDS and sexual activity in rural Kenya, where HIV is widespread. The study community was located in south-eastern Kenya, 50 km north of Mombassa, and had an estimated population of 1500. Subjects aged between 16 and 49 were recruited using a stratified cluster-sampling method and they completed self-administered questionnaires.Almost all respondents knew the word ‘HIV’. Around 50% knew of a person living with HIV. About 80% gave ‘death’ or ‘fear’ as words representing their image of AIDS. With regard to sexual activity, the distribution of answers to the question ‘how many partners have you ever had in your life’ was bimodal in males but had only one peak in females, indicating that some men have a large number of sexual partners in their lifetime. First sexual intercourse was at around 12–13 years for both sexes, but female teenagers were more sexually experienced than their male counterparts.
Antimicrobial Resistant Pattern among Foodhandlers in Nairobi (Kenya)
(2007) Otieno, Micheal Frederick; Hussein, Ahmed Abdulrahman; sharma, R. R.; kombe, Y.
Antibiotic resistance represents a serious problem for clinicians, veterinarians, community and government at large. This involves cost implications as far as treatment is concerned. Multiple drug resistance as a result of empirical treatment have rendered most drugs ineffective. In view of the above, this descriptive cross-sectional study, aimed at isolating resistant entero-bacteria E. coli from food-handlers working in both high and low budget hotels. Specimens in the form of stool were collected from 297 food-handlers in their respective hotels were considered and analyzed for resistant E. coli bacteria at KEMRI-Centre for Microbiological. Research (CMR), in Nairobi. Besides, questionnaires were administered in order to assess health-seeking behaviour of the study subjects prior to medical examination. Antibiotics used in this study were amoxicillin-clavulanic acid, co-trimoxazole,ampicillin tetracycline, kanamycin, gentamycin, cefuroxime and chloramphenicol. These antibiotics were chosen on the basis of their use in the management of enteric bacterial nfections. The results from high budget hotels (i.e. three, four hotels ( i. e two stars and below) indicates high frequency of resistance in both hotel categories was seen in co-trimoxazole.and five stars) and low budget resistance. The highest level of 66.3% in high budget hotels and 66.4% in low budget hotels. Resistance difference between high budget hotels and low budget hotels was not statistically significant (P=0.56681). This was followed by ampicillin showing resistance of 55% in high budget hotels and 46% in low budget hotels, (P=0.8235). Tetracycline showed a resistance level of 34% in high budget hotels and 58% in low budget hotels, (P=0.2835) and co-amoxyclav showed resistance of 37% in high budget hotels and 38% in low budget hotels, (P=0.5074). The P-value results clearly indicate no significant relationship between taking medication by food-handlers prior to medical examination and the pattern of antibiotic resistance. Comparatively, the resistance pattern for the antibiotics tested is somehow the same for low and high budget hotels, indicating that, irrespective of the hotel category, if those working in hotels are potential carriers of drug resistant E. coli, then the category of hotel is irrelevant and either has a potential of transmitting resistant E. coli.
Environmental Covariates of Anopheles Arabiensis in a Rice Agroecosystem in Mwea, Central Kenya
(2007) Mwangangi, J. M.; Muturi, E. J.; Shililu, J. I.; Muriu, S.; Jacob, B.; Kabiru, Ephantus W.; Mbogo, C. M.; Githure, J. I.; Novak, R. J.
Water quality of aquatic habitats is an important determinant of female mosquito oviposition and successful larval development. This study examined the influence of environmental covariates on Anopheles arabiensis mosquito abundance in the Mwea Irrigation Scheme, Central Province of Kenya, prior to implementation of a malaria vector control program. Experimental rice plots were used to examine the environmental covariates responsible for regulating abundance and diversity of the aquatic stages of malaria vectors. Mosquito larval sampling and water quality analysis were done weekly from the flooding stage to the rice maturation stage. Sampling for mosquito larvae was conducted using standard dipping technique. During each larval collection, environmental covariates such as pH, temperature, conductivity, salinity, dissolved oxygen, water depth, and rice stage were measured. Anopheles arabiensis larval density was highest between 1 wk before transplanting and 4 wk after transplanting with peaks at weeks 0, 3, and 8. The fluctuation in values of the various environmental covariates showed characteristic patterns in different rice growth phases depending on the changes taking place due to the agronomic practices. Using a backward linear regression model, the factors that were found to be associated with abundance of An. arabiensis larvae at any of the rice growing phases included the following: dissolved oxygen, pH, turbidity, water depth, rice height, number of rice tillers, salinity, conductivity, and temperature. The environmental covariates associated with abundance of An. arabiensis were associated with early vegetative stage of the rice growth. For effective control of developmental stages of mosquito larvae, the application of larvicides should be done at the vegetative stage and the larvicides should persist until the beginning of the reproductive stage of the rice.
Recycling of wastes as a strategy for environmental conservation in the Lake Victoria Basin: The case of women groups in Kisumu, Kenya
(Academic Journals, 2008) Subbo, Wilfred K.; Moindi, Margaret N.
This paper examines the roles, opportunities and challenges that women groups in Kisumu City face as they recycle polythene papers and water hyacinth plant materials to make various saleable products such as bags, mats and baskets. The study objectives were: To analyze the roles of women groups in environmental conservation; To examine the opportunities that the women groups had in the recycling of polythene papers and water hyacinth plants; To examine the challenges faced by the women groups in their recycling efforts; To analyze the policy implications of the recycling effort of the women groups involved in environmental conservation. The study utilized the following methodologies, structured interviews, participant observations, Key informants, focus group discussions. Thirty-five women groups were analyzed. The findings indicate that recycling of polythene papers and water hyacinth plants contribute to environmental conservation, as well presenting opportunities for the creation of wealth among women in the groups.
Occupational Noise- Induced Hearing Loss (NIHL) among Workers at Jomo Kenyatta International Airport, Nairobi
(2010-02) Afullo, A.; Anino, J.O.; Otieno, F.
BACKGROUND: Occupational noise induced hearing loss (NIHL) occurs among workers exposed to excessive amounts of noise for long durations. The average level of noise in some locations at Jomo Kenyatta International Airport (JKIA) was above the safe limit of 85dB hence workers were thought to be at risk. OBJECTIVE: To determine the occurrence and socio demographic attributes for NIHL at JKIA. DESIGN: Cross sectional descriptive study. Setting: Jomo Kenyatta International Airport, Nairobi, Kenya. RESULTS: Mean age of respondents was 37 years with range 22 to 62, SD 8.98. Mean duration of exposure to noise was 10.7 years with range 1 to 40, SD 8.15. Prevalence of NIHL was 15.3%, with ground crew at 14.8% and air crew 16.1%. Ground crew had significantly poorer mean hearing threshold level at 3, 4 and 6 kHz than air crew (p = 0.015). Male workers were affected more than female counterparts with a male to female ratio of 4:3. 97% of those affected were non-managers, 3% managers while 68% of those affected resided in Embakasi Division close to the airport. Hearing threshold level at 4 kHz deteriorated with increasing age whereby those aged 50 years and above had a 13.7 times higher relative risk than those aged 20 to 29 years. Duration of exposure more than 10 years also had significantly higher risk (p < 0.01) for hearing loss at 4 kHz. CONCLUSION: Occupational noise induced hearing loss occurs at JKIA and that ground crew and older workers are more vulnerable. We recommend that prevention programmes be put in place.
Water Risk Factors Pre-Disposing the Under Five Children to Diarrhoeal Morbidity in Mandera District, Kenya.
(PubMed, 2010-12) Simiyu, S.
OBJECTIVE: The main causes of mortality and morbidity in Mandera are conditions related to inadequate water and sanitation such as diarrhoea, which has led to malnutrition and mortality among children under five years. This paper highlights the main sources of water in the district and identifies the water risk factors associated with diarrhoeal morbidity among these children. METHODS: A cross sectional descriptive study was carried out within the district, specifically in Khalalio, Central, Malkamari and Hareri divisions, the main respondents being caregivers from households where there was one or more children under the age of five. A sample size of 350 respondents from the households was interviewed using interview schedules. Other methods used were focus group discussions, observation and key informant interviews. Results: Most of the respondents used the river as the main water source; however, there were differences in the divisions on the water sources. Often times, the water sources were not available throughout the year and the residents mainly depended on the river during times of drought. The river was as a result a major avenue for contamination. Most of the water sources were close to the households, but they used crude methods in transporting the water to the households, such as rolling jerricans on the ground. Less care was given to handling water at the household level, even after the poor means of transport, resulting in more children suffering from diarrhoea. CONCLUSIONS: The significant water risk factors as identified were the mode of water transportation, and the poor handling of water at the household level, including lack of or inappropriate water treatment methods. These, combined with the low education level further pre dispose the under five children to diarrhoea, thus calling for increased health education on safe water handling.
Determinants OF HIV-vct utilization among secondary schools teachers in Thika District, Kenya.
(2011) Keraka, M.; Marita, Enock Oburi; Mwanzo, I
Background: HIV/AIDS is a global health problem whose emergence has introduced new dimensions to health care delivery worldwide including Voluntary Counselling and Testing (VCT). Despite its proven benefits, high knowledge of VCT and its availability, its uptake is varied and often poor. It is commonly argued that teachers in Sub-Saharan African (SSA) countries have relatively high HIV prevalence rates than the general population. AIDS is claiming teachers more quickly than they can be trained in many countries and is the leading cause of death among teachers in the SSA countries. Objective: To identify determinants of HIV-VCT uptake amongst secondary schools teachers. Method: A cross-sectional survey involving 246 secondary school teachers randomly selected in Thika district, central Kenya. Results: HIV-VCT utilization among secondary school teachers was 30.5%. The younger and less experienced teachers were more likely to utilize HIV-VCT services than the older and more experienced ones (Likelihood ratio, P = 0.004). Private school teachers were more likely to utilize HIV-VCT services than those of the public schools (OR = 2.356, 95% CI limit, 1.082-5.128). Teachers who were scared by the HIV prevalence in their area were three times less likely to utilize HIV-VCT services (OR = 0.312, 95% CI, 0.104- 0.936). The teachers who had not sought HIV-VCT service were less likely to perceive HIV-VCT services as beneficial (Likelihood ratio, P =0.027). Various factors were identified as barriers to HIV-VCT uptake; most of them were post test implicated. A number of factors that made some teachers to seek HIV-VCT services were also identified; HIV/AIDS awareness campaigns and urges ‘to know status’ were most cited factors. Conclusion: Although HIV-VCT utilization among secondary school teachers was higher than that of the general public, at 30.5% was still low. Various factors were found to influence HIV-VCT uptake
Barriers to antiretroviral initiation in HIV-1-discordant couples.
(JAIDS Journal of Acquired Immune Deficiency Syndromes, 2011-11-01) Gatuguta, A.; Guthrie, B. L.; Choi, R. Y.; Liu, A. Y.; Mackelprang, R. D.; Rositch, A. F.; Bosire, R.; Manyara, L.; Kiarie, J. N.; Farquhar, C.
BACKGROUND: In Kenya and much of sub-Saharan Africa, nearly half of all couples affected by HIV are discordant. Antiretroviral therapy (ART) slows disease progression in HIV-1-infected individuals and reduces transmission to uninfected partners. We examined time to ART initiation and factors associated with delayed initiation in HIV-1-discordant couples in Nairobi. METHODS: HIV-1-discordant couples were enrolled and followed quarterly for up to 2 years. Clinical staff administered questionnaires and conducted viral loads and CD4 counts. Participants with a CD4 count meeting ART criteria were referred to a nearby US President's Emergency Plan for AIDS Relief-funded treatment center. Barriers to ART initiation among participants with a CD4 count eligible for ART were assessed by Cox regression. RESULTS: Of 439 HIV-1-infected participants (63.6% females and 36.4% males), 146 met CD4 count criteria for ART during follow-up. Median time from meeting CD4 criteria until ART initiation was 8.9 months, with 42.0% of eligible participants on ART by 6 months and 63.4% on ART by 1 year. The CD4 count at the time of eligibility was inversely associated with time to ART initiation (hazard ratio = 0.49, P < 0.001). Compared with homeowners, those paying higher rents started ART 48% more slowly (P = 0.062) and those paying lower rents started 71% more slowly (P = 0.002). CONCLUSIONS: Despite access to regular health care, referrals to treatment centers, and free access to ART, over one-third of participants with an eligible CD4 count had not started ART within 1 year. Factors of lower socioeconomic status may slow ART initiation, and targeted approaches are needed to avoid delays in treatment initiation.
Health Insurance Education Strategies for Increasing the Insured among Older Population – A Quasi Experimental Study in Rural Kenya
(PubMed, 2012-05-13) Nyagero, J.; Gakure, R.; Keraka, M.
INTRODUCTION: The older population in most developing countries are uninsured and lack access to health services. This study assessed the extent to which a multi-strategy health insurance education intervention would increase the number of insured among the older population in rural Kenya. METHODS: The quasi-experimental study prospectively followed 1,104 unpaired older persons (60 years or more) in a 10-month health insurance education and enrollment intervention. The adjusted odds ratios computed at 95% confidence interval using a binary logistic regression tested the association between being insured and the multi-strategies. RESULTS: At baseline, the lack of adequate knowledge on health insurance (52.9%) and high premiums (38.1%) were the main reasons for being uninsured. The insured older persons increased three-fold (from 7.7% to 23.8%) in the experimental site but remained almost unchanged (from 4.0% to 4.6%) in the control. The computed adjusted odds ratio for variables with significance (p < 0.05) show that the older people who obtained health insurance education through the chief's public meeting, an adult daughter, an adult son, a relative-sister/brother, an agent of the National Hospital Insurance Fund, and a health insurance beneficiary were 2.6, 4.2, 2.8, 2.3, 2.5 and 2.5 times respectively more likely to be insured. Access to health insurance education using a combination of 1-3 strategies and >3 strategies predisposed the older people 14.3 times and 52.2 times respectively to being insured. CONCLUSION: Health insurance education through multiple strategies and their intensity and frequency were pivotal in increasing being insured among the older population in rural Kenya.
Factors Influencing Behaviour Change for the Prevention of the Spread of HIV/AIDS among Students in Githunguri Division, Githunguri District, Kiambu County, Kenya
(International Journal of Social Science, 2012-08) Ndegwa, I. N.; Wanderi, P. M.; Mwisukha, A.
The Human Immunodeficiency Virus (HIV) continues to spread in most countries of the world including Kenya. Since HIV / AIDS has no cure yet, behavior change has been fronted as the most likely scientific basis for the reduction in HIV prevalence. The virus is spread mainly by behaviors such as sexual behavior and drug taking that are generally private and sometimes difficult to discuss openly. This study looked at behavior change for the prevention of the spread of the Human Immunodeficiency virus (HIV) among students in Githunguri Division, Kiambu East District, Kenya. It was a descriptive survey. Out of the 28 public secondary schools in Githunguri Division, seven of them were randomly selected using the stratified sampling method, while one school was purposively selected as it was the only one of its kind, making a total population of 8 schools as the study population. Data was collected using a questionnaire. A pilot study was carried out to determine the feasibility of the research instrument. Descriptive and inferential statistics (chi-square at a significance level of 0.05) were utilized for analysis of data. Behavior change had occurred as 56% of the respondents had abstained from having sex as compared to 36% of the respondents who had not abstained. Out of the 36% of the respondents who had engaged in sex, 50.8% of them had used condoms as compared to 49.2% of the respondents who had not used condoms. Females reported an average of 1.48 sexual partners, while the male respondents reported an average of 2.03. Behavior change was influenced by religion, knowledge of HIV / AIDS, influence from HIV / AIDS prevention methods and gender. The study further revealed that there was a significant relationship between gender and HIV / AIDS, with more males engaging in risky sexual behavior placing them at risk of contracting HIV. HIV prevention efforts had a significant influence on behavior change for the spread of HIV / AIDS among students. The study recommends the need to have prevention efforts that focus more on males so as to enhance their behavior change as nationally, some 400,000 students graduate from secondary schools every year. These young people represent a key cohort for behavior change communication and character formation.
A supervised land cover classification of a western Kenya lowland endemic for human malaria: associations of land cover with larval Anopheles habitats
(2012-10-16) Mutuku, F. M.; Bayoh, M. N.; Hightower, A. W.; Vulule, J.M.; Gimnig, J.E.; Mueke, J. M.; Amimo, F.A; Walker, E.D
A supervised land cover classification was developed from very high resolution IKONOS satellite data and extensive ground truth sampling of a ca. 10 sq km malaria-endemic lowland in western Kenya. The classification was then applied to an investigation of distribution of larval Anopheles habitats. The hypothesis was that the distribution and abundance of aquatic habitats of larvae of various species of mosquitoes in the genus Anopheles is associated with identifiable landscape features.
Utilization of Insecticide Treated Nets amongst Pregnant Women in Thika District
(Nature Conservators, India., 2013) Keraka, M.; Sharma, R.R.
The aim of this study was to assess factors influencing ITN utilization amongst pregnant women in Thika district. Malaria in pregnancy is linked to adverse consequences for the mother and foetus. Prevention of malaria using insecticide-treated nets during pregnancy is extensively advocated. Evidence of the benefits of ITN use is however not consistent from one area to another. The Government of Kenya has distributed 1,000 ITN s to pregnant mothers, under 5 years children and ewe. The district was chosen purposively since malaria is one of the leading causes of morbidity and mortality. Further, no study has been carried out to establish factors influencing ITN utilization among pregnant women. The broad objective of the study therefore was to assess factors that affect ITN utilization among pregnant women in the study area. Researchers accessed available secondary data and information at the global, regional and country levels, respectively through the internet, AMREF library and from Thika District Hospital. A systematic sampling procedure was used to select the sample size. Sources of primary data were derived from a semi-structured questionnaire which researchers administered on respondents, focus group discussions and in-depth interviews with key informants. Researchers analyzed data using SPSS. Findings from the study show that level of income, marital status, occupation did not affect the utilization of ITNs. However, accessibility of mosquito nets was found to be significant y affected by the distance to health facility and level of income. Based on the findings, it was recommended that appropriate mechanisms be put in place to improve distribution and ensure accessibility and availability of ITNs to pregnant women.
Detection and Management of Adverse Drug Reactions Related to Antiretroviral Drugs among HIV/AIDS Patients in Kiambu Sub-County, Kenya
(African Journals Online, 2013) Nderitu, F. W.; Gikonyo, N. K.; Sinei, K. A.
The objective of this study was to establish the detection, prevalence and management of various adverse drug reactions associated with antiretroviral drugs occurring in patients attending Comprehensive Care Centre (CCC) of Kiambu District Hospital. The study was a cross sectional survey where the patients included were those attending the CCC on a monthly basis. The results revealed that 65.2% of the patients had experienced symptoms suggestive of adverse drug reactions (ADRs). Of these, 67.2% did not associate the symptoms to the medicines they were taking but rather to the AIDS syndrome. The most prominent reaction was peripheral neuropathy at 0.395 (0.344-0.447 at 95% confidence interval) while the least common was hepatotoxicity. Whereas 71.5% could tell the frequency of the daily dosage, 92.1% did not know the names of the medicines they were taking but could describe them by shape and colour. There was a significant association between occurrence and reporting of ADRs and age (P<0.001), weight (P=0.001), marital status (P=0.016), occupation (P<0.001), religious participation (P<0.001) and education level (P<0.001). Although the health care providers displayed adequate knowledge in management of these reactions, they complained of inadequacy of the current reporting tool (MOH 257) in capturing ADRs. The patients were ill equipped in recognising the ADRs.
Short-Term Mobility and the Risk of HIV Infection among Married Couples in the Fishing Communities along Lake Victoria, Kenya
(Public Library of Science, 2013) Kwena, Zachary A.; Camlin, Carol S.; Shisanya, C.A.; Mwanzo, I.; Bukusi, Elizabeth A.
Objective: Mobility has long been associated with high HIV prevalence. We sought to assess sex differences in the relationship between mobility and risk for HIV infection among married couples in the fishing communities. Methods: We conducted 1090 gender-matched interviews and rapid HIV testing with 545 couples proportionally representing all the different sizes of the fish-landing beaches in Kisumu County. We contacted a random sample of fishermen as our index participants and asked them to enrol in the study together with their spouses. The consenting couples were separated into different private rooms for concurrent interviews and thereafter reunited for couple rapid HIV counselling and testing. In addition to socio-economic and behavioural data, we collected information on overnight travels and divided couples in 4 groups as follows both partners not mobile, both partners mobile, only woman mobile, and only man mobile. Other than descriptive statistics, we used X2 and U tests to compare groups of variables and multivariate logistic regression to measure association between mobility and HIV infection. Results: We found significant differences in the number of trips women travelled in the preceding month (mean 4.6, SD 7.1) compared to men (mean 3.3, SD 4.9; p,0.01) and when the women did travel, they were more likely to spend more days away from home than their male partners (mean 5.2 [SD 7.2] versus 3.4 SD 5.6; p = 0.01). With an HIV prevalence of 22.7% in women compared to 20.9% among men, mobile women who had non-mobile spouses had 2.1 times the likelihood of HIV infection compared to individuals in couples where both partners were non-mobile. Conclusion: The mobility of fishermen’s spouses is associated with HIV infection that is not evident among fishermen themselves. Therefore, interventions in this community could be a combination of sex-specific programming that targets women and combined programming for couples.
Prevalence of Hepatitis B and C Viral Co-Infections among HIV-1 Infected Individuals in Nairobi, Kenya.
(PubMed, 2013) Gicheru, M. M.; Muriuki, B. M.; Wachira, D.; Nyamache, A. K.; Khamadi, S. A.
BACKGROUND: Hepatitis B virus (HBV) and Hepatitis C virus (HCV) co-infections among HIV-1 infected individuals are growing worldwide health problems characterized by lack of effective vaccines, need for expensive treatment, chronicity of morbidity and associated mortality. Their prevalence and distribution patterns continue to vary across geographical locations with high prevalence being detected among high risk populations. To determine the prevalence of HBV and HCV among HIV-1 infected individuals, blood samples were collected from consenting study subjects visiting comprehensive HIV clinics in Nairobi during the period between October and December 2009. METHODS: Blood samples from volunteers were screened with ELISA tests for detecting HIV, HBV surface antigen (HBsAg) and anti-HCV antibodies. RESULTS: In a total of three (300) hundred infected individuals consisting of 129 (43%) males and 171 (57%) females 15.3% (46/300) were HIV-1 co-infected with either HBV or HCV or both, 10.3% (31/300) with HIV-1 and HCV and 6% (18/300) with HIV-1 and HBV infections. However, only three individuals (1%) were coinfected with the three viruses (HIV/HBV/HCV). CONCLUSION: Though, low levels of co-infection with all three viruses were reported, there could be higher prevalence rates than reported here especially among high risk populations.
Evaluation of the Health-related Quality of Life of Children in Schistosoma Haematobium-endemic Communities in Kenya: a Cross-sectional Study.
(PLOS Neglected Tropical Diseases:, 2013-03-07) Terer, Carolyn Chebet; Mutuku, F. M.; Bustinduy, A. L.; Magtanong, R. V.; Muhoho, N.; Mungai, P. L.; Muchiri, E. M.; Kitron, U.; King, C. H.
BACKGROUND: Schistosomiasis remains a global public health challenge, with 93% of the ~237 million infections occurring in sub-Saharan Africa. Though rarely fatal, its recurring nature makes it a lifetime disorder with significant chronic health burdens. Much of its negative health impact is due to non-specific conditions such as anemia, undernutrition, pain, exercise intolerance, poor school performance, and decreased work capacity. This makes it difficult to estimate the disease burden specific to schistosomiasis using the standard DALY metric. METHODOLOGY/PRINCIPAL FINDINGS: In our study, we used Pediatric Quality of Life Inventory (PedsQL), a modular instrument available for ages 2-18 years, to assess health-related quality of life (HrQoL) among children living in a Schistosoma haematobium-endemic area in coastal Kenya. The PedsQL questionnaires were administered by interview to children aged 5-18 years (and their parents) in five villages spread across three districts. HrQoL (total score) was significantly lower in villages with high prevalence of S. haematobium (-4.0%, p<0.001) and among the lower socioeconomic quartiles (-2.0%, p<0.05). A greater effect was seen in the psychosocial scales as compared to the physical function scale. In moderate prevalence villages, detection of any parasite eggs in the urine was associated with a significant 2.1% (p<0.05) reduction in total score. The PedsQL reliabilities were generally high (Cronbach alphas ≥0.70), floor effects were acceptable, and identification of children from low socioeconomic standing was valid. CONCLUSIONS/SIGNIFICANCE: We conclude that exposure to urogenital schistosomiasis is associated with a 2-4% reduction in HrQoL. Further research is warranted to determine the reproducibility and responsiveness properties of QoL testing in relation to schistosomiasis. We anticipate that a case definition based on more sensitive parasitological diagnosis among younger children will better define the immediate and long-term HrQoL impact of Schistosoma infection.
Level of blood pressure control among hypertensive patients on follow-up in a Regional Referral Hospital in Central Kenya
(the African Field Epidemiology Network (AFENET), 2014) Maingi, T.; Mutua, E.M.; Gitonga, M.M.; Mbuthia, B.; Muiruri, N.; Cheptum, J.J.
Introduction: Uncontrolled hypertension is a leading modifiable risk factor for cardiovascular disease morbidity and mortality. Data on adequacy of blood pressure control in Kenya is scarce. This study aimed at assessing the level of blood pressure control among hypertensive patients on follow-up in a regional referral hospital. Methods: Data regarding blood pressure, antihypertensive medication use, and comorbidities was abstracted from medical records of 452 hypertensive patients seen in Nyeri Provincial General Hospital between January and March 2013. Adequate blood pressure control was defined as a systolic pressure < 140 mmHg (< 130 mmHg for diabetic hypertensive patients) and a diastolic pressure < 90 mmHg (< 80 mmHg for diabetic hypertensive patients). Data was entered and analyzed using STATA 9 (StataCorp, Inc, Texas, USA). Results: Only 33.4% of patients had a blood pressure within the recommended limits. In multivariate analysis, using a calcium channel blocker was significantly associated with good blood pressure control (OR, 2.1; 95% CI, 1.4, 3.3). On the other hand, old age (≥ 60 years), being diabetic, and the use of three or more antihypertensive drugs were associated with reduced odds of good blood pressure control (OR, 0.64; 95% CI, 0.43; OR, 0.54; 95% CI, 0.36, 0.81; and OR, 0.41; 95% CI, 0.26, 0.64, respectively). Conclusion: Poorly controlled blood pressure is an important public health concern among hypertensive patients in this region. Elderly patients, those with diabetes, and those on multidrug regimens are at higher risk for poor blood pressure control and warrant closer attention.
The challenges fraughting isoniazid prophylaxis as a child tuberculosis prevention strategy in high burden settings in Nairobi, Kenya
(Kenyatta University School of Medicine, 2015) Okwara, F.N.; Oyore, J.P.; Were, F.
Background: Paediatric Tuberculosis (TB) is rapidly becoming a major public health concern among the urban poor. Though contacts' tracing and Isoniazid Prophylaxis Therapy (lPT) is an effective prevention strategy, its benefits have not been realized in many resource poor settings. Barriers to its uptake have not been fully elucidated. Objectives: To evaluate the challenges that fraught the implementation of' contact tracing and IPT, as a TB prevention strategy in children in household contact with adults with TB from informal settlements in Nairobi, Kenya. Metbodology: A prospective longitudinal multicenter cohort study was done, where 366 recently diagnosed TB smear positive source cases were asked to enroll their child contacts for IPT. Consent was sought. Structured standard questionnaire was used to get information on source case TB treatment, socio-demographics, TB knowledge and perceptions. Baseline screening was done to exclude those with TB and/or other chronic illnesses. Contacts were then put on daily isoniazid for 6 months and followed up monthly for one year for new TB disease. Adherence, safety and challenges were monitored. Focused group discussions and key informant interviews were used to provide secondary data. Results: All the 366 source cases interviewed were on first line anti- TB treatment. IPT acceptability was 87.3%. A total of 428 child contacts were screened, but 14(3.2%) had TB disease hence excluded. Compliance rates were 93% (95% CI 90.1 - 96.2%) and 85% (95% CI 80.2%- 88%) after 1'1and 6th months respectively. Challenges reported included; side effects in 22%, programmatic concerns in 86%, drug related issues in 70.1 %, and various health system challenges. The leading programmatic challenge was too many hospital visits (65.2%) and the drug related challenge was difficulty in administering tablets to children (44.3%). IPT completion rate was 368 out of 414 (88.8%). By endpoint, IPT failure was documented in 6( 1.6%), hence the relative risk of new TB disease in contacts on IPT was 0.49 (95% CI 0.21 -0.86). Conclusion: IPTwas an effective and safe child TB prevention strategy in informal settlements, but it's implementation had been hampered by relatively low acceptability, sub-optimal adherence, programmatic challenges, and high defaulting rates and by limited benefits realized.

Browse

Browsing RP-Department of Public Health by Issue Date

Results Per Page

Sort Options