RP-Department of Community Health

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12-Month Substance Use Disorders among First-Year University Students in Kenya
(PLOS ONE, 2023-11) Jaguga, Florence; Mathai, Muthoni; Ayuya, Caroline; Francisca, Ongecha; Musyoka, Catherine Mawia; Shah, Jasmit; Atwoli, Lukoye
Objectives The period of entry into university represents one of vulnerability to substance use for university students. The goal of this study is to document the 12-month prevalence of substance use disorders among first year university students in Kenya, and to test whether there is an association between substance use disorders and mental disorders. Methods This was a cross-sectional online survey conducted in 2019 and 2020 as part of the World Health Organization’s World Mental Health International College Student (WMH-ICS) survey initiative. A total of 334 university students completed the survey. Descriptive statistics were used to summarize the demographic characteristics of the participants. Multivariate logistic regression was used to assess the association between substance use disorder and mental disorders after adjusting for age and gender. Results The 12-month prevalence for alcohol use disorder was 3.3%, while the 12-month prevalence for other substance use disorder was 6.9%. Adjusting for age and gender, there was an association between any substance use disorder and major depression, generalized anxiety disorder, bipolar 1 disorder, intermittent explosive disorder, social anxiety disorder, suicidal ideation, suicide attempt, and non-suicidal self-injury. Conclusion These findings highlight the need to institute policies and interventions in universities in Kenya that address substance use disorders and comorbid mental disorders among firstyear students
Accessibility to Integrated Community Case Management of Childhood Pneumonia Services Among Caregivers in Kisii County, Kenya
(Journal of Advances in Medicine and Medical Research, 2022) Mwambi, Dennis Oroo; . Osero, Justus O. S; Mwanzo, Isaac; Cheboi, Solomon
Pneumonia is the leading cause of childhood illness and mortality worldwide. The number of children under five with pneumonia in Kisii County, Kenya, was 10% compared to the national average of 9% despite the integrated Community Case Management (iCCM) roll out. In order to identify factors associated with caregivers' access to iCCM services, a study was conducted. Materials and Methods: Qualitative and quantitative approaches were used in this descriptive cross-sectional study. Purposive sampling was utilized to choose 10 informants while multistage and random sampling was applied to select 330 caregivers. Thematic content analysis and discourse analysis techniques were used to analyse qualitative data, while Statistical Package for Social Science (SPSS) version 22 was used in quantitative data. Results: Only 33.6% of caregivers accessed iCCM for childhood pneumonia services. In 49% of cases, CHVs was the first point of contact after onset of pneumonia symptoms, with only 31.2% seeking help within 24 hours. 96% of CHVs did not follow the recommended iCCM diagnostic protocols, and only 34.8% prescribed antibiotics. Age (0.011), religion (0.007), and marital status (0.024) were significantly associated with access to iCCM. Business persons were 2.97 times (OR 2.972; CI 1.232,7.167; P= 0.015) more likely to access iCCM than farmers. Caregivers who perceived pneumonia to be severe were 3.03 more likely to access ICCM (OR 3.039;CI 1.703,5.424; P< 0.001) than opposite peers. Respondents who didn't think pandemics affected access were 10% (OR 0.119; CI .058,0.246; P<.0.001) more likely to access iCCM. Conclusion: Access to iCCM was low and Community health volunteers (CHVs) were not the first point of care for pneumonia in children. Evidence of poor performance by CHVs in the areas of diagnosis, treatment, and the administration of antibiotics suggests that iCCM needs more monitoring and oversight.
Across-sectional survey of prevalence and correlates of couple sexual concurrency among married couples in fishing communities along Lake Victoria in Kisumu, Kenya.
(Sexually Transmitted Infections, 2013-10) Mwanzo, I.J.; Kwena, Z.A.; Bukusi, E.A.; Achiro, L.F.; Shisanya, C.A.
OBJECTIVE: Sexual concurrency has been associated with HIV infection. Since HIV in sub-Saharan Africa is mostly spread within the context of heterosexual couples, it is necessary that intervention is focused on such couples. We sought to establish the correlates of couple sexual concurrency in Kisumu, Kenya. METHODS: We conducted 1090 gender-matched interviews in 545 couples in a cross-sectional survey. A random sample of fishermen and their spouses from 33 fish-landing beaches along the shores of Lake Victoria in Kisumu were asked to enrol in the study. Couples were separated into different private rooms for simultaneous interviews that documented socioeconomic and behavioural characteristics, and information on number of sexual partnerships in the preceding 6 months and their status. Based on reported concurrency status of the spouses, a couple was categorised as either concurrent when at least one spouse reported a concurrent sexual relationship or non-concurrent. RESULTS: Overall, 32.1% of the men and 6.2% of the women had concurrent sexual relationships in the 6 months preceding the study, resulting in 37.6% of the couples being sexually concurrent. Unmet sexual desire, intra-spousal suspicions of infidelity, male dominance scripts, domestic violence, couples' children and women's age were the correlates of couple sexual concurrency. CONCLUSIONS: Unmet sexual desires, inter-spousal infidelity suspicions, male dominance scripts and domestic violence were the main correlates of couple sexual concurrency in these fishing communities. KEYWORDS: Prevention, Sexual Behaviour, Sexual Networks
Adherence to exclusive breastfeeding among HIV-positive women in Nairobi, Kenya
(Mark Allen Healthcare, 2014-04) Kimani, H.; Koima, Winnie; Mwaniki, Peter
In developing countries, exclusive breastfeeding (EBF) remains the best and safest source of nutrition and a recommended method of prevention of mother-to-child transmission of HIV in combination with use of prophylactic anti-retrovirals. Other feeding options could be detrimental to the infant if the mother cannot afford the recommended replacement feeds and expose the infants to diarrhoeal diseases and malnutrition, which could lead to early mortality. Despite this evidence, EBF ranges from 3.2 to 13% in Kenya. The aim of this study was to identify knowledge, attitude and practice in adherence to EBF among 188 HIV-positive women with children aged 6-12 months in Nairobi, Kenya. This was a descriptive cross-sectional study using quantitative and qualitative approaches. Participants were interviewed using semi-structured questionnaires. In addition, two focus group discussions were conducted and key informants from the health facility were also interviewed. The results showed that 69.1% of women EBF. The following factors influenced adherence to EBF positively: presence of main breadwinner (OR=3.44, P=0.003), food availability (P=<0.001), mastitis (P=0.002), knowledge of mother-to-child transmission of HIV (P=<0.001), being taught about EBF in antenatal and postnatal classes (OR=7.78, P=0.002), expressing breast milk (P=<0.001), disclosure of HIV status to husband (OR=2.46, P=0.007) and relative (OR=2.29, P=0.033). In conclusion, information sharing of mother-to-child transmission of HIV antenatally and postnatally should be strengthened in the health facilities. Additionally, mothers should also be taught how to express breast milk
Adherence To Pulmonary Tuberculosis Treatment In Murang’a County, Kenya
(International Journal of Current Aspects, 2020) Gitonga, Charles Muthui; Nyamari, Jackim; Mugo, Judy
Non-adherence to Tuberculosis treatment is a major barrier for TB control programs because incomplete treatment may result in prolonged infectiousness, drug resistance, relapse and death. Successful treatment of TB involves taking anti TB drugs for at least six months as per the doctors advise. Currently, Tuberculosis has become a resurgent public Health problem in developing countries and is the leading cause of death from any single infectious agent. The purpose of the study was to identify factors contributing to non-adherence to TB treatment amongst pulmonary TB patients in Maragua Sub-County of Murang’a County. The objectives included were to determine the social-economic related, healthcare-related, patient-related and disease and medicine related factors associated with non-adherence of TB treatment amongst patients in Murang’a County. The study was guided by the Health Belief model as the theoretical framework. A cross-sectional survey study design was used. Census method was used and all 270 people were considered. Data was collected using a mixed method approach of interview guides, questionnaires and Focus Group Discussions. A total of 270 adult Pulmonary TB patients, amongst whom 59 (47%) were adherents and 67(53%) non adherents with TB treatment, who received treatment in 2017 and had completed treatment, Community Health workers, and Health Personnel in the TB clinic participated in the study. Data was entered to EPI INFO version 3.5.3 and analysed using Statistical Package for Social Sciences (SPSS) version 22. Multiple logistic regressions was used to identify associations and to control potential confounding variables. Chi Square was used to test independence of categorical variables with p value of less than 0.05 at 95% confidence interval being considered significant. Data presentation was done using figures and tables. From the results of the study only the distance taken to collect drugs in the health facility was found to be associated with non-adherence to TB treatment (n=9 ,13%). The study recommends that measures should be undertaken so as to reduce the non-adherence level to TB treatment by ensuring anti-Tb treatment is accessible to patients at the nearest Health facility from their residence. Additionally, the study proposes that the patients should be sensitized on the importance of adherence to TB drug mediction. Interventions with Health promotion initiatives emphasizing the benefits of treatment adherence should be enhanced in the communities by further large scale multicentred studies and that an enabling environment which is conducive for good patient interactions should be created. The study concludes that there are challenges facing adherence of TB treatment which ought to be addressed. The study, suggests that measures to improve drug adherence such as improving health conditions, increasing the availability of drugs and conducting health educations to the patients is essential in minimizing the drug non-adherence to TB drugs.
The Age Specific Practices and Outcomes in Women Undergoing Unsafe Abortions in Rural Communities of Kenya
(Journal of Medicine and Biomedical Sciences, 2013-05) Osur, J.; Orago, A. S.; Mwanzo, I.; Bukusi, E.
Unsafe Abortion is common among young women. It is not however known whether the young women decide on their own to terminate the pregnancies, whether the methods they use are similar to those of older women, and whether the outcomes of their unsafely procured abortions are different from those of older women. This study therefore set to establish the age specific practices and outcomes of unsafe abortion. It was a cross-sectional survey and the setting was Siaya County, Kenya in East Africa. A sample of 320 women aborting unsafely and reporting to health facilities for completion of the process and management of complications were interviewed to determine their reproductive health profiles, decision making process for unsafe abortion, unsafe abortion methods they had used and outcomes making them seek healthcare. The study found that 76% of women aborting unsafely were between 10 and 24 years with 62% being nulliparous. 84% of them had undesired pregnancy. Younger women were likely to consult with a variety of people before making a decision to abort unsafely. Women with wanted pregnancy and aborting unsafely were likely to be of a younger age. The younger person was also more likely to use a wide variety of unsafe abortion methods resulting in more complications. Overall
Anopheles larval abundance and diversity in three rice agro-village complexes Mwea irrigation scheme, central Kenya
(Malaria Journal, 2010) Mwangangi, J. M.; Shililu, J.; Kabiru, Ephantus W.; Muturi, E. J.; Muriu, S.; Jacob, B.; Mbogo, C. M.; Githure, J.; Novak, R. J.
BACKGROUND: The diversity and abundance of Anopheles larvae has significant influence on the resulting adult mosquito population and hence the dynamics of malaria transmission. Studies were conducted to examine larval habitat dynamics and ecological factors affecting survivorship of aquatic stages of malaria vectors in three agro-ecological settings in Mwea, Kenya. METHODS: Three villages were selected based on rice husbandry and water management practices. Aquatic habitats in the 3 villages representing planned rice cultivation (Mbui Njeru), unplanned rice cultivation (Kiamachiri) and non-irrigated (Murinduko) agro-ecosystems were sampled every 2 weeks to generate stage-specific estimates of mosquito larval densities, relative abundance and diversity. Records of distance to the nearest homestead, vegetation coverage, surface debris, turbidity, habitat stability, habitat type, rice growth stage, number of rice tillers and percent Azolla cover were taken for each habitat. RESULTS: Captures of early, late instars and pupae accounted for 78.2%, 10.9% and 10.8% of the total Anopheles immatures sampled (n = 29,252), respectively. There were significant differences in larval abundance between 3 agro-ecosystems. The village with 'planned' rice cultivation had relatively lower Anopheles larval densities compared to the villages where 'unplanned' or non-irrigated. Similarly, species composition and richness was higher in the two villages with either 'unplanned' or limited rice cultivation, an indication of the importance of land use patterns on diversity of larval habitat types. Rice fields and associated canals were the most productive habitat types while water pools and puddles were important for short periods during the rainy season. Multiple logistic regression analysis showed that presence of other invertebrates, percentage Azolla cover, distance to nearest homestead, depth and water turbidity were the best predictors for Anopheles mosquito larval abundance. CONCLUSION: These results suggest that agricultural practices have significant influence on mosquito species diversity and abundance and that certain habitat characteristics favor production of malaria vectors. These factors should be considered when implementing larval control strategies which should be targeted based on habitat productivity and water management.
Appreciating the Essence of Post Natal Care Services from Mothers’ Perspective in Kiambu, Kenya
(Sciencedomain International, 2017) Njoka, Nancy Mugure; Otieno, George Ochieng’; Mwaniki, Peter; Cheboi, Solomon Kemoi
Introduction: The first 42 days after delivery is a critical period in the lives of mothers and newborn babies. Most maternal and infant deaths occur during this time. The government of Kenya has recommended that all mothers and newborns receive three postnatal (PNC) checkups this period. These are; within 48 hours before discharge from post-natal ward, at 2 weeks and again at 6 weeks. Nonetheless, uptake of postnatal services particularly visit two remains low. For instance 25% of mothers in Kiambaa Sub County access PNC at two weeks. Study Design: A cross sectional descriptive study design was conducted among 399 mothers to determine the factors that influence utilization of PNC services. Study Area and duration: This research was undertaken in Kiamba, Kiambu County between August and September, 2013. Original Methodology: This was a mixed qualitative and quantitative study. Simple random sampling was used to select participating administrative units and respondents selected systematically. Sample size distribution was by probability proportionate to size. Quantitative data was analyzed using Stata version 13, while qualitative data was analyzed manually based on themes. Results: Utilization of PNC services was at 45.1%. Over half (53%) of the respondents made their first PNC post-delivery visit after 14 days, 11% and 36% within 7 and 14 days respectively. The health care workers had informed only 15 % of the women, to attend the PNC services. College education (OR=12.292, p<0.001); high household wealth status (OR=3.6211, p<0.001); formal employment (OR=2.705, p=0.008); delivery at a private facility (OR=2.9269, p< 0.000) and high knowledge of PNC services (OR=2.2307, p=0.008) were synonymous with utilization of PNC services. Perceived good quality of care (OR=5.2607, p< 0.000), and a positive attitude (OR=3.6507, <0.000) were other determinants. Conclusion: Uptake of postnatal care services remains a challenge among mothers and is predicted by several overt and covert constraints. Quality of delivery services and providers respective care practices were key predictors. Nevertheless, close to half of the women sought postnatal care at least twice in the post-natal period. The services were mainly accessed at or after 6 weeks. The timing of first PNC, post- delivery visit varies. Uptake of PNC visit two remains low.
Assessing Long-Acting and Permanent Family Planning Methods Uptake among Women of Reproductive Age in Kilifi Sub-County, Kilifi County
(IJRIS, 2014-11) Mambo, S.N.; Oyore, J.P.; Obare, F.O.
Family planning is the intentional prevention of conception through use of the various available devices, sexual practices or surgical procedures and medications followed in order to deliberately prevent or reduce likelihood of pregnancy. Family planning methods comprise modern methods (short acting methods and long-acting and permanent methods (LAPM) and traditional methods. This study focused on the Long acting/Permanent methods (IUCD, Implants and sterilization) which have comprised a very small percentage of the methods used by women over the years. Kilifi district has a bigger population which is rural, with a quarter of the population twenty five percent being WRA. Kilifi district contraceptive prevalence rate (CPR) currently stands at twenty three percent, however, the LAPM share of this is not known. The aim of the study was to assess the determinants of uptake of long acting/permanent methods of family planning among the women of reproductive age in Kilifi sub-county of Kilifi county, Kenya. Cross sectional exploratory study was used which was employing both qualitative and quantitative designs. The study was done in public health facilities only where ten percent of the total facilities in the sub-county were randomly selected: Kilifi district hospital, Bamba sub district hospital and Vipingo health centre were selected. A total of three hundred and fifty respondents drawn from the three facilities were sampled: 150 respondents from KDH; 120 respondents from Sub-district hospital and 80 respondents from the health centre. Two phases of data collection were used where in phase one, data was collected through client-exit interviews using questionnaires administered to WRA visiting family planning clinic at the three health facilities that were selected for the study between October 2011 and June 2012. Phase two involved conducting key informant interviews (KIIs) with the service providers which was done around the same time. Uptake of LAPM among the respondents WRA in Kilifi was found to be forty percent (40%). The major socio-cultural and demographic factors that were found to determine uptake of LAPM of family planning were age, education level, marital status, intention to have more children, partner support, LAPM previous knowledge and use, as well as the previous source of these methods. Major health facility determinant was found to be the mode of transport to facilities. Other barriers to LAPM uptake as indicated by key informants were partner approval, myths and perceptions, commodity stock outs and shortage of trained personnel.
An Assessment of Health Provider Related Factors Influencing Utilization of Health Facility during Child Birth by Women Aged 15-49 Years in Matinyani Sub-County in Kitui County
(International Peer Reviewed Journal and Book Publishing, 2018) Maingi, Nancy Nyambura; Keraka, Margaret
Purpose: This study was aimed at identifying health provider related factors influencing utilization of health facility during child birth by women aged 15-49 years in Matinyani Sub- County in Kitui County. Methods: It was a facility- based study conducted in Matinyani Sub county where 376 women and 6 health facilities were included. It was a descriptive cross-sectional study. The variables tested were utilization of health facility during child birth and provider related factors. Data collection was done using focused group discussions guide, interview schedule guide, observation and analysis was done using SPSS version 17. Chi test was used to show association between the variables. Results: Majority of health workers were trained on FANC but not trained on comprehensive RH. Unique contribution to theory, practice and policy: All health workers to be educated on drug storage to avoid expiry hence wastage of drugs.
An Assessment of Knowledge, Utilization, and Perceptions On Antenatal Care Services among Women in Nimba County, Liberia
(Stratford, 2022) Smythe, Edwina; Kabiru, Ephantus; Osero, Justus O.S
Liberia registers an exponential mortality rate in developing Sub-Saharan countries in Africa. Inadequate utilization of antenatal care is a leading cause of the higher infant mortality rates recorded in Liberia. Thus, this study seeks to assess knowledge and socio-demographic factors that thwart the utilization of ANC services among women between 15 and 49 years in Nimba County, Liberia. The study applied quantitative and qualitative research design. A sample of 167 was selected using a systematic sampling technique. The SPSS Software Version 23.0 was used to analyze the data collected statistically. Results indicated that 54.5 % of the sample were between 15 – 25 years. Socio-demographic characteristics such as age (χ 2= 0.902), df= 3, P= 0.825), were not significant with ANC attendance and the level of knowledge was significant (χ 2=5.653 df =1 P=0.017). Further, 150 women in the sample had adequate knowledge of ANC services. The high level of knowledge among respondents was significant (χ 2=5.653 df =1 P=0.017) with ANC attendance. In addition, 83.8% attended ANC services, and 77.8% delivered their babies at health centres. One of the noticeable challenges cited by respondents in this study was the distance to facilities with 64%. Most people were knowledgeable about ANC services, which affected their decision to utilize ANC services, while demographic factors were not significant. However, the study has established inadequate medication and distance to the nearest facility foiled the utilization of ANC services. Therefore, this study recommends that the government ensures that rural Liberia’s health facilities are equipped with medicines and accessible and aggressively conducts civic education or campaigns to create awareness about the ANC services
Assessment of Patient Satisfaction and Perception of Quality of Antenatal Care Services Among Pregnant Women Attending Antenatal Clinics at a Secondary Health Care Facility in Anambra State, Nigeria.
(Magna Scientia, 2021) Chigozie, Joseph Ezeoke; Onyeka, Chukwudalu Ekwebene; Tyotswam, Simeone Yanmeer; Chioma, Favour Ekwebene; Chigbo C, hisom God’swill; Eleje, George Uchenna
Introduction: Prenatal care is an important component of maternal care worldwide more so in sub-Saharan Africa. Methodology: This work is a cross-sectional descriptive study carried out among 170 pregnant women attending antenatal clinic in health facilities in Ekwulobia, Anambra state. Convenience sampling technique was used in this study. The study instrument was a semi structured interviewer administered questionnaire which was developed according to the objectives of the study. In this study we evaluated patient waiting time, pregnancy outcome, quality of care, attitude of staff and facility neatness as parameters for measuring patient satisfaction, we also evaluated quality of service, attitude of staff, proximity to ANC centre, waiting time and cost as determinants of ANC use. Result: The study showed a demonstration of good knowledge of ANC and its importance in maternal and child health, 65.6% were aware of first trimester has the most appropriate time for ANC booking. A high level of satisfaction was recorded among the participants, 65.6% rated the ANC services as very good and 30.3% rated the service as good. Conclusion: Pregnant women in rural areas in eastern Nigeria receive quality and accessible antenatal care services and majority of the women are satisfied with the quality of service. Efforts to improve maternal and child health status in Eastern Nigeria is yielding fruit especially in rural areas. It is recommended that similar studies studies be conducted in other parts for the country to discover the conditions of ANC use and i effects and compare the factors that influence ANC use
Assisted Partner Services (APS) among Patients Attending HIV Comprehensive Care Clinic in Kenya: Randomized Controlled Trial (RCT)
(International Journal of Medical Science and Health Research, 2018) Kimani, Harun; Bukusi, David; Maingi, Peter; Macharia, Peter; Otieno, Felix A.; Muiruri, Peter; Farquhar, Carey
Introduction: Assisted Partner Services (APS) for HIV involves interviewing HIV infected individuals about their sexual partners and then locating these partners to offer HIV testing and inform them about the exposure. Several studies have shown APS to be effective and acceptable among newly diagnosed individuals, however few have studied APS among individuals with chronic HIV infection. Methods: HIV-infected individuals receiving care at Kenyatta National Hospital Comprehensive Care Center (CCC) were randomized to community versus health facility based notification. Index case in the Health facility arm were offered standard of care which is contract testing where they were encouraged to bring their partners for testing. In the community arm which was the intervention arm, the index cases were offered immediate assisted partner notification where health advisers consented the index cases for their partners to be confidentially contacted and tested for HIV. Smart phone tablet with a Open Data Kit questionnaire was used to collect data. The two approaches were compared using the ODDS Ratio with 95% confidence intervals and the results given below. Results: Index cases randomized to health facility arm were 201 while 218 index cases in the community arm of whom 262 (62.5%) were women and majority aged between 40-49 years 87 (39.9%). The community based assisted partner notification yielded 1 partner per index and among these 113 partners were traced (51.8%) and 101 partners were HIV tested (89.3%). Of those tested, 35 of 101 were HIV-positive. When compared to facility passive referral, there was a 2.6-fold increase in partner testing with 58 (28.9%) of 201 testing for HIV in the health facility arm (Odds ratio [OR] 2.65; 95% confidence interval [CI]: 1.77, 3.98 p<0.001). Discussion or conclusion: Community based partner tracing has high potential of reaching HIV exposed partners of a HIV infected index case. It is acceptable to both index cases and their partners and enables health workers provide services that enable partners to be enrolled into care.
Association of Birth Companionship by Former Traditional Birth Attendants with Birthing Experiences of Parturient Women in Kakamega County, Kenya
(ijhss, 2021-07) Ndedda, O. Crispin; Orago, Alloys S; Oyore, John Paul; Gichangi, Peter
The current model of maternity care is institution-centred, rather than woman-centred. Women's experiences illuminate midwives' efforts to maintain power and control by situating birth as a medical event and to secure status by focusing on the technical elements of care, including controlling bodies and knowledge. A study conducted in Kenya, India and Ghana concluded that regardless of the setting, women are not getting adequate person-centred maternity care and that such care varied by socioeconomic status, type of provider and type of facility. Most women in Kakamega county labour alone. As a result, women in labour experience ‘emotional distress’, ‘stressful circumstances’, ‘lack of social support’ and may not open up to service providers contributing to unfavourable birth outcomes. To investigate the association between supportive companionship provided by traditional birth attendants and birthing experiences of parturient women during labour and childbirth in Kakamega County, Kenya. A quasi-experimental cross-sectional mixed method design was adopted involving 2367 parturient women in Kakameg a county, Kenya. Former traditional birth attendants were trained and deployed as birth companions providing emotional support in the form of encouragement, advice, information, comfort measures and physical support to women during labour and childbirth in intervention health facilities. Measurements were taken at baseline and after implementation of the birth companion intervention from control and intervention health facilities using a questionnaire capturing data on client satisfaction, anxiety and selfesteem. Data was summarized using frequency distributions and cross tabulations and presented in the form of tables and graphs. Associations were determined using Pearson’s correlation and independent sample t-test. The study found traditional birth attendant as birth companions significantly improved birthing experiences of parturient women. Supported women they had higher levels of satisfaction, lower anxiety and higher self-esteem than those who were not supported.
Association of Children’s Nutritional Status with Caregivers’ Hygiene and Sanitation Conditions in Kiandutu Informal Settlements, Kiambu County, Kenya
(IJHSR, 2019) Mwangi, Peris; Oyore, John Paul; Njogu, Eunice
Introduction: Childhood malnutrition increases the risk of infections, morbidity and mortality in association with decreased mental and cognitive development. Poor conditions of WASH lead to infectious disease, especially diarrhoea, causing nutrient malabsorption and poor appetite and consequently undernutrition. Methods: the study was a cross sectional analytical study design with a sample size of 165 caregivers with their children aged 6-59 months. The caregivers were randomly within the Kiandutu Informal Settlement. Semi-structured questionnaire was used to gather hygiene and sanitation information from the caregivers. Children’s height, weight and MUAC measurements were obtained. Data was analyzed using SPSS version 22. Results: the nutritional status prevalence for the children was 33.3%, 15.1% and 8.8% for stunting, underweight and wasting respectively. The study results showed that the caregivers had low (88.1%) and moderate (11.9%) knowledge in WASH. Caregivers’ WASH practices were also poor: only 23.9% got drinking water from piped water, 61.6% did not treat drinking water before consumption, 71.9% did not have access to a latrine and 55% of those who washed hands used water only. Conclusion: the study established association between WASH knowledge and some practices among the caregivers with the child’s nutritional status. In addition, the nutritional status prevalence was also high above the national rates, this indicated that undernutrition is a major public health problem in informal settlements.
Bacteriological and Physico-Chemical Quality of Household Drinking Water in Kisii Town, Kisii County, Kenya
(Elsevier, 2021) Ondieki, J.K; Akunga, D.N; Warutere, P.N; Kenyanya, Omanga
Water is a basic human need which is required in many operations especially in households. However, this essential commodity in most cases does not meet the generally accepted safety standards. The study was designed to investigate the physico-chemical and bacteriological quality of drinking water used in households in Kisii town, Kenya. Analytical cross-sectional study was conducted to obtain information concerning household drinking water quality and safety. Stratified random sampling was used to obtain 422 drinking water samples at the point of consumption from the 4 zones of Kisii town for analysis. From the study it was revealed that TDS and electrical conductivity of the analyzed water samples were within the recommended standards of less than 1000 ppm and 1500 μSCM 1 respectively. Further, it was found that 69.4% of the samples had pH range of between 6.5-8.5, 91.9% had turbidity of less than 5NTU, 3.8% had temperature below 15 C and 31.2% of the chlorinated samples had chlorine residue above 0.2 ppm. In terms of bacteriological analysis, 39.3% of the samples were contaminated with total coliforms and 17.5% with E. coli. The main finding from the study was that the household water samples were contaminated with bacteria and unfit for human consumption because both total coliforms and E. coli exceeded the recommended Kenya Bureau of Standards (KEBS) and WHO standards. Therefore, public health officers should not only collect water samples from sources but also from households regularly to ascertain its quality and provide water safety promotion education to the general public. There was a strong relationship between bacterial contamination and temperature as well as chlorine residue. The study recommends Gusii Water and Sanitation Company (GWASCO) whose treatment and distribution capacity is expected to increase 4.5 times the current capacity to improve on their chlorine dosage at the treatment plant to ensure a minimum chlorine residue of 0.2 ppm at the household and community taps.
Bacteriological Contamination Level of Foods and Water Sold With Escherichia Coli, Salmonella spp, Staphylococcus Aureus, Coliforms and Vibrio Cholera in Food Establishments in Nairobi City Kenya
(IPRJB, 2024-01) Kinyua, Peter Muriithi; Gicheru, Michael Muita; Mugo, Judy; Gitahi, Nduhiu
Purpose: Food borne illnesses are major health burden leading to high morbidity and mortality. It is a growing public health concerns worldwide resulting from food and water contaminated by pathogenic microorganism, toxins or chemical hazards. It is estimated that 10 to 20% of food borne illness are contracted from food establishments. The main aim was to determine bacteriological contamination levels of foods and water sold with Escherichia coli, Salmonella spp, Staphylococcus aureus, coliforms and Vibrio cholerae in food establishments in Embakasi South Nairobi City County Kenya. Methodology: The study design was descriptive analytical design. The Samples were collected in selected food establishments (Cafeteria, Hotels, Restaurants and food Kiosks) in Embakasi South Sub county Nairobi City County. The study collected 274 samples of food and water randomly sampled and collected using sterile food bags and water bottles within selected establishments and transported to the laboratory in cool boxes packed with ice packs. The samples were analyzed within 6 hours after collection. Microbiological analysis of food and water were borrowed from WHO and bacteriological analytical manual of foods to identify and isolate coliforms, Staphylococcus aureus, Vibrio cholera, Escherichia coli and Salmonella spp. Results: It was found that some foods and water sold and consumed in the selected food establishments was contaminated with food borne microorganisms. Escherichia coli isolated in 137 food samples were at 24.1%, Vibrio cholera at 23.4%, Staphylococcus aureus at 32.8%, and Salmonella spp at 4.4%. Total coliforms detected in 137 samples of water were at 43.8% where 32.8% of them were Escherichia coli. Unique Contribution to Theory, Practice and Policy: The study concluded there was high level of bacterial contamination of foods and water consumed in selected foods establishments. Nairobi City County health officers should enhance regular sampling of foods and water for microbial quality, health education on sources of food contamination at food eateries and establishments to prevent food and water contamination which later lead to food borne illness outbreak.
Bloodfeeding behavior of Anopheles gambiae s.l. and Anopheles funestus in Kilifi District, Kenya.
(J Am Mosq Control Assoc., 1993-06) Mbogo, C. M.; Kabiru, Ephantus W.; Muiruri, S. K.; Nzovu, J. M.; Ouma, J. H.; Githure, J. I.; Beier, J. C.
Blood meal samples were tested by ELISA for 534 Anopheles gambiae s.l. and 76 Anopheles funestus collected from 25 sites in Kilifi District, Kenya. Human IgG was detected in 94.4% of the An. gambiae s.l. and in 90.8% of the An. funestus. No samples were positive for cow and only a few were positive for goat. Both species fed predominantly on humans irrespective of host availability. At these sites on the Kenyan coast, the high degree of human-feeding by malaria vectors contributes to the efficiency of malaria parasite transmission and the high incidence of severe malaria.
Bridging the Gap in Implementation Science: Evaluating a Capacity-Building Program in Data Management, Analysis, Utilization, and Dissemination in Low- and Middle-Income Countries
(Mary Ann Liebert, Inc., 2018) Memiah, Peter; Mu, Tristi Ah; Penner, Jeremy; Owour, Kevin; Gituathi, Carol Ngunu; Prevot, Kourtney; Mochache, Vernon; Wekesa, Paul; Oyore, John; Komba, Patience
Building capacity in implementation science within health programs is dependent on training in theory and practice of epidemiology, statistics, and research in addition to high self-efficacy toward application of training. This article describes a training program providing technical assistance to more than 300 health facilities in Kenya and Tanzania, its evaluation results, and its ability to improve participants’ knowledge, competencies, and self-efficacy on data management, analysis, and dissemination among health care professionals. Two months prior to the training, participants (n = 98) were emailed a pre-course survey including 19 questions using a Likerttype response for planning the content of the workshop. Six to 12 weeks after the training, a post-course survey was emailed to all participants. Five different trainings were conducted indicating 5 participant cohorts. The questions posed involved course satisfaction, course impact on knowledge and skills, and self-efficacy in data analysis and utilization. Post-course survey results revealed that the participants had confidence in data analysis, which was significantly different from the pre-test results (0.05 a). Qualitative commentary complemented the findings of the impact of the workshop. Four manuscripts and 13 abstracts have been submitted post training. Results suggest that a short-term training program can achieve immediate gains in data and research self-efficacy among health care professionals. Although increasing self-efficacy is a necessary first step in developing skills, educators should engage in continuing education for sustainable dissemination practices. There is an urgent need to determine the current infrastructure to promote scientific dissemination. This will assist countries to produce better evidence to support their programs, policies, and overall health programs.
Care Provision Challenges and Capacity Enhancement of Family Caregivers of People Living with HIV and AIDS in Thika District.
(2013) Kathuri-Ogola, L. N.; Kerre, F. P.; Mugenda, Olive M.
People Living with HIV and AIDS (PLWHA) often require specialized care especially from those closely related to them. The task of caregiving to PLWHA can be a daunting undertaking in view of the fact that there is no validated cure yet to HIVIAIDS. Most of this care for the PLWHA takes place in the home and is likely to be done by afamily member. However, very little is understood about the challenges these caregivers encounter and their proposed strategies to enh ance their care provision capacity. The study therefore, sought to investigate the challenges of care provision and capacity enhancement strategies of family caregivers (FCGs) of PLWHA in Thika District. Data collection was done using interview schedules for a sample of 177 FCGs and Focus Group Discussion (FGDs) with 40 Community Health Workers (CHWs). Data was analyzed both quantitatively and qualitatively. The results showed that over four fifths (93%) of the FCGs experienced care provision challenges. Th ese challenges included inadequate finances (83%), food provision (56%), stress (52%), stigma and isolation (32%), inadequate medicine and supplies (24%), difficult care recipient (19%) and strain on children education (13%). The FCGs proposed strategies which they felt could enhance their capacity namely; economic empowerment (69%), regular training (58%), psychological support (42%), stigma reduction (30%) and sustained provision of medicine and supplies (17%). In order to enhance the FCGs capacity as will as improve the quality of care provided to PLWHA the FCGs would need an effective and sustained implementation of these strategies.

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