MST-School of Pure and Applied Sciences

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This collections contains bibliographic information and abstracts of Master theses and dissertation in the School of Pure and Applied Sciences held in Kenyatta University Library

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Browsing MST-School of Pure and Applied Sciences by Subject "Adolescents"

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    Establishment of Reference Ranges for Biochemical Parameters in Children and Adolescents of Ages 1-17 Years in Meru County, Kenya
    (Kenyatta University, 2019) Kainyu, Munene Rhoda; Eliud N. M Njagi; George o. Orinda; Silas Kiruki
    Clinical Biochemistry (Clinical Chemistry/Chemical Pathology) is the study of the biochemical basis of disease, and the application of biochemical and molecular techniques in diagnosis. An understanding of the biochemical mechanisms of disease provides modern medicine with a rational basis for diagnosis and therapy. A reference range is a set of values used by a health professional to interpret a set of medical test results. The range is usually the set of values in which 95% of the normal population falls. Clinical chemistry reference ranges vary due to factors such as age, sex, diet, race, climate, altitude and genetics. As a result, International Federation of Clinical Chemistry (IFCC) recommends that every laboratory establishes its own reference intervals for biochemical parameters and not rely on those obtained from a different population. There is little information in the literature on biochemical reference values for children in Kenya and in particular those from Meru County. This study was aimed at determining age and sex-based reference ranges for thirteen routinely analyzed biochemical parameters for liver and renal function for the children population in Meru County. This was a population based cross-sectional study carried out at the Meru Level Five Hospital. 768 healthy males and females were recruited in this study and only 740 whose serum samples tested negative for HIV, hepatitis B, syphilis were used in the final analysis; 380 males and 360 females. 28 samples were excluded, out of which 6 were HIV positive and 22 " It were hemolyzed. DRI-CHEM NX 500r Clinical Chemistry analyzer (Fujifilm, t Europe) was used to analyze thirteen clinical chemistry parameters, including serum proteins, bilirubin, tissue enzymes and electrolytes. Clinical and Laboratory Standards Institute (CLSI) guidelines were followed to create study consensus intervals. Determination of reference ranges was done in order to estimate the lower 2.5 and upper 97.5 percentiles of distribution by use of parametric methods. The determined percentiles were considered as the lower and upper reference limits respectively. There were significant differences in relation to sex in children reference values for potassium (p = 0.009), total protein (p = 0.039) and sodium (p = 0.003). Other parameters did not"show significant differences across the age groups and by gender. In conclusion, the findings of this study provide sex and age specific reference range values for children from Meru County in Kenya. From the study findings, recommendation is made to health care practitioners and facilities in Meru County to adopt the new reference values developed, particularly for the three parameters that exhibited significant differences in sex and for. other regions in Kenya to carry out a similar study to determine their own reference values.
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    Reference Intervals for Commonly Requested Hematological Parameters in Adolescents Living in Kilifi County, Kenya
    (Kenyatta University, 2020-11) Awino, Duncan
    Clinicians require hematological reference measure that they can use to compare with the results presented to them by laboratories in order to make medically correct decisions because Peoples’ laboratory sample analysis results are not the same. These reference measures are derived from a healthy group of people for each hematological parameter and can be affected by age, sex, previous exposure to environmental pathogens, genetic makeup, and nutritional status of individual, pregnancy, ethnicity, and altitude, the choice of various techniques, machines, and reference samples. Clinical Laboratory and Standards Institute approved guideline-third edition recommends that medical laboratories develop their own individual reference intervals from their local population they serve or carry out validation before effectively using the ones found from different regions. The objective of this study was to develop the hematological reference intervals for healthy adolescents living in Kilifi County, Kenya. 600 volunteers aged between 13 and 17 were recruited for this cross-sectional study. However, only 314 volunteers {52.3(%)} were enrolled, furthermore only 242 volunteers 40.3(%) got inclusion space in the final analysis to develop the hematological reference limits. Reference sample population was divided into two groups of 121 each based on gender to permit 95(%) confidence intervals to be non-parametrically enumerated in the establishment of lower and upper limit of the confidence intervals. The methods used for the electronic auto hematology analyzer were: Flow cytometry, colorimetric and electrical impedance. A medical statistical software was used to calculate, lowest and highest values, Median, Standard deviation, Arithmetic mean, Coefficient of kurtosis and Coefficient of Skewness. Mann-Whitney tests for independent samples, was used to find out if there were significant differences between the developed male and female hematological values in adolescents living in Kilifi. Statistically significant differences between females and males was accepted where ρ<0.05. This study determined Kilifi adolescents hematological reference values for twenty three commonly requested parameters in Hemoglobin concentration, Red blood cells count, Hematocrit levels, Red blood cells indices, White blood cells count and Platelet count, based on the blood analysis. Test for normal distribution indicated that: in males; out of the 23 parameters measured in 121 samples, 4.35% parameters were normally distributed whereas 95.65 (%) parameters were not normally distributed. In females, out of the 23 parameters measured in 121 samples: only 39.13 (%) parameters were normally distributed whereas 60.87 (%) parameters were not normally distributed. Based on gender, out of the 23 parameters analysed 39.13 (%) showed significant differences among males and females whereas 60.87 (%) showed comparable results. From the study findings, there were both comparable and significant differences between the developed hematological values in adolescents living in Kilifi County and the commonly used published data developed from Africa and other parts of the world. The established age and sex specific reference intervals for adolescents’ haematological parameters and their indices for Kilifi County, Kenya should be adapted for use in the Health Institutions within the county. In future, studies should also focus on paediatric and geriatric populations in Kilifi County, and other regions of Kenyan.