RP-Department of Family Medicine, Community Health and Epidemiology

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Access to reproductive health services by female survivors of sexual gender-based violence: a descriptive cross-sectional study of Nairobi City County, Kenya
(International Journal of Community Medicine and Public Health, 2024-03) Oredo, Pascal O.; Kimani, Harun M.; Mugo, Judy
Background: Sixty percent of women globally are exposed to reproductive health problems related to sexual gender based violence. In Kenya, sexual violence is one of the top 10 risk factors for disease burden. The study aimed to determine access to reproductive health services by female survivors of sexual gender-based violence in Nairobi city county, Kenya. Methods: The study adopted descriptive cross-sectional design using pretested questionnaires. Study population was 269 female survivors of sexual gender-based violence. Data was analysed thematically and presented by use of percentages and frequencies distribution tables. Binary logistic regression model was used to determine relationships between dependent and independent variables. Odds ratios were evaluated for significance by considering the 95% confidence interval at p value ≤0.05. Results: Access to reproductive health services by female survivors of sexual gender-based violence was 26%. Service availability for survivors in the facilities had a 3 times likelihood of access sexual, knowledge on failure to seek immediate medical attention had 4 times likelihood to increase access while awareness of the period to have prophylaxis had 4.66 times likelihood to increase access. Services provided to survivor had 39% likelihood to increase access, survivors screened for sexually transmitted disease before admission had 10% more likelihood to access and survivors who received post exposure prophylaxis had 0.62 times likelihood of access to sexual reproductive health services. Conclusions: Availability of comprehensive sexual reproductive health services at the facility and good knowledge would increase access to reproductive health services.
Accessibility of Anal Cleansing Materials for Public Primary School Pupils in Kajiado County, Kenya
(ajol, 2022) Umuro, Sabla Abduba; Karama, Mohammed; Akunga, Daniel Nyagetiria
INTRODUCTION Anal cleansing is the hygienic practice of cleaning the anal area after defecation. Inaccessibility to anal cleansing materials leads to inappropriate methods resulting in faecal hand contamination. This study assessed the accessibility of anal cleansing materials for public primary school pupils in Kajiado County, Kenya. MATERIALS AND METHODS The researchers used a descriptive cross-sectional study approach, applying a cluster sampling technique to sample eighteen (18) schools to the study. Three hundred and eightyfour (384) pupils were selected from the schools using simple random sampling. The Headteacher and a teacher in charge of school health were purposively sampled due to their knowledge of school resources about hygiene. A total of thirty-six teachers participated in the key informant interviews. Data were analysed using SPSS version 21, and Chi-square was used to test the hypothesis at p<0.05 significance level. RESULTS Accessibility to anal cleansing materials was low at 22.9%. Pupils' class (p-value = 0.036) and level of material awareness (p-value <0.001) influenced accessibility. For Institutional factors, material sensitisation was associated with accessibility (p-value = 0.001). The following sustainability measures were proposed; sensitisation on anal cleansing materials, provision through cost sharing, management of the materials by class teachers and prefects, and continued support by government ministries of health and education. CONCLUSION Anal cleansing materials access was low; pupils' predisposing characteristics and institutional factors influenced access. RECOMMENDATION We recommend that school management and ministries of health and education improve access to anal cleansing materials in schools and develop sustainability measures
Antibiotic Prescribing Practices for Upper Respiratory Tract Infection among Clinical Officers at Kiambu County
(Journal of Family Medicine, 2024-03-21) Murigi, Kevin; Thigiti, Joseph; King’ang’a, Muiruri
Background Antibiotics are the most prescribed medications worldwide. Global consumption rose by 65% in 76 low and middle-income countries between the years 2000 and 2015. According to the World Health Organization, improper administration of antibiotics occurs in over 60% of people with upper respiratory tract infections. Inadvertent antibiotic use has been identified as a contributor to antimicrobial resistance. Outpatient antibiotic use accounts for around 80-90% of all antibiotic use in patients. Clinical officers are non-physician healthcare workers who have received less training, have a more restricted scope of practice than physicians. Clinical officers are key service providers in this country especially at the primary healthcare level. Objective The study assessed the factors that influence antibiotic prescribing for upper respiratory tract infections by clinical officers. Method A prospective study was carried out at 20 public hospitals in Kiambu County, on 36 clinical officers and 600 patient prescriptions. The parameters measured were patient factors, prescriber factors, institutional factors and how they affected the antibiotic prescribing practices by either being rational or irrational. Rational prescribing was identified as prescribing the right drug, at the right frequency, in the right duration, right dose for the right indication. Prescriptions were considered irrational if they did not satisfy any of the rational indices. Data was collected via a questionnaire from the clinical officers while WHO prescription checklist was used to collect data from patient encounters. Data was analyzed using Statistical Package for Social Sciences version 22.0 (SPSS v22.0) with P-value, Confidence Interval and Odds Ratio. Results A total of 600 patient encounters were recorded and 79.8% of the 479 encounters had an antibiotic prescription for URTI, 91% of the antibiotic the right dose, 98% had the right frequency, 75% had the right duration, and only 23% had the right indication. Patients above 65 years were more likely to receive an antibiotic prescription OR 3.98 CI 0.91,17.41 P=0.17 compared to children under 12 years old. Males were more likely to receive an antibiotic, but this was not significant OR 1.06 CI 0.70, 1.59 P=0.79. A total of 28 (4.6%) patients had fever, and all received antibiotics. A total of 36 clinical officers were sampled and only 5 (13.8%) were found to have rational prescriptions (P=0.63), prescriber age (P=0.92), prescriber level of education (P=0.99) and prescriber work experience (P=0.22) were not associated with antibiotic prescription. As per institutional factors, availability of antibiotics (P=0.026) and availability of prescription guidelines (P=0.012) were associated with rational prescription of antibiotics. Conclusion The study indicated that there was a high antibiotic prescription rate deviating from the WHO standard. It demonstrated that most antibiotic prescriptions were irrational.
Assessing the Main Risk Traits Associated With Motorcycle Accidents among the Motorcycle Riders in Kiambu County, Kenya
(Journal of Medicine, Nursing & Public Health, 2024-07) Maru, Michael; Osero, Justus; Kimani, Harun
Motorcycles are increasingly popular as a mode of transport, particularly in rural areas of Kenya, due to affordability and accessibility. However, the rise in motorcycle usage has led to numerous fatal accidents, making it a major cause of death and injuries. This study aimed to determine the main risk traits associated with motorcycle accidents among riders in Kiambu County. The conceptual framework examined the relationship between risk traits as independent variables (over speeding, riding under influence, rider fatigue, experience, motorcycle defects, road conditions, regulatory non-compliance) and motorcycle safety as the dependent variable measured by accident occurrence. The study adopted a quasi-experimental research design, with motorcycle taxi riders in Kiambu County as the target population. Using simple random sampling, a sample of 140 riders was achieved. Questionnaires were used for primary data collection and analyzed quantitatively using SPSS. The findings indicate majority of accidents occurred in bends (32%), roundabouts/junctions (28%), entrances (13%), bumps (12%) and crossings (11%). The main causes were rider misjudgement/inattention (42%), steering issues around bends/junctions (21%), potholes/uneven surfaces (15%), wet/slippery surfaces (10%), motorcycle faults (9%) and intimidation by other vehicles (3%). Majority had little knowledge in riding skills enhancement (42.9%), first aid (45%), health/safety (43%) and accident avoidance (45.7%). T-tests showed knowledge gaps in riding skills (F=8.320, p=0.005), accident avoidance (F=4.131, p=0.018), bike maintenance (F=4.223, p=0.042) and road craft (F=5.416, p=0.012) were significantly related to accident occurrence. The study concludes the main risk traits are linked to accident-prone locations, rider inattention/misjudgement, and lack of crucial safety knowledge. Recommendations include comprehensive training on navigating risk areas, improving judgment/steering, motorcycle maintenance, first aid, and partnering with authorities to enhance road conditions and implement safety measures through the licensing process.
Association between Diastolic Blood Pressure and Diabetic Kidney Disease: Insights from a Cross-Sectional Study in Kenya
(PASJ, 2025-05) Nelly Kebeney; Kimani Harun; Moturi Morara George; Kabinga Samuel K; Otieno George; Kusienya Benard; Mugo Onesmus
Abstract: Diabetic kidney disease (DKD) is a major complication of type 2 diabetes (T2D) and a leading cause of end-stage renal disease. While systolic blood pressure (SBP) has been widely studied, the role of diastolic blood pressure (DBP) in the development of Diabetic kidney disease remains unclear. This study assessed the association between DBP and DKD incidence in patients with T2D, adjusting for confounders. We also examined DKD risk factors and evaluated the discriminative ability of SBP and DBP via area under the receiver operating characteristic curve (AUROC) analysis. This study provides insights into the association between DBP and DKD among patients with type 2 diabetes. This cross-sectional study was conducted at a public referral hospital in Kiambu County, Kenya, from October 2023 to February 2024. Adults (≥20 years) with T2D and at least one year of follow-up were enrolled. We analysed the association of DBP with DKD and compared blood pressure parameters between those with and without DKD. The results indicated that among the 326 adults with T2D, 31.6% had DKD. DBP and SBP were significantly greater in the DKD group (p<0.05). DBP ≥90 mmHg was associated with increased DKD incidence (54.2% vs. 26.6%, p<0.001) and severe albuminuria (p<0.001). Through analysis, a DBP ≥90 mmHg remained independently associated with DKD (AOR: 4.17, 95% CI: 1.49–11.59, p=0.006). SBP showed better DKD discrimination (AUROC: 0.646) than DBP did (AUROC: 0.582). The study concluded that elevated DBP was significantly associated with DKD, albuminuria, and CHD, although SBP had a stronger association. These findings highlight the importance of comprehensive blood pressure management in mitigating DKD risk.
Conformity to the Baby Friendly Hospital Initiative among Tier Two Health Care Facilities in Nairobi City County
(EANSO, 2025-01) Matheka, Judy Mwikali; Orago, lloys; Mugo, Judy
The Baby-Friendly Hospital Initiative (BFHI), founded on ten steps to successful breastfeeding, was introduced to promote exclusive breastfeeding globally. However, over time, factors such as limited commitment by health officials have hindered the achievement of its objectives. This study evaluated the extent of conformity to the BFHI’s ten steps, assessed the level of knowledge among health care workers (HCWs), and identified institutional factors influencing compliance within tier two health care facilities (HCFs) in Makadara and Embakasi East SubCounties, Nairobi City County. A cross-sectional, analytical, mixed-methods study was conducted between March and May 2021 across public, faith-based, and private HCFs. A total of 142 HCWs participated through semi-structured questionnaires, while 30 facility heads were interviewed in-depth. Additionally, six focus group discussions (FGDs) with mothers were held to validate HCWs’ responses. Quantitative data were analysed using SPSS version 23.0. Findings revealed that 80% of HCWs in public facilities could mention at least one step of the BFHI policy, compared to 74% in faith-based and 46% in private facilities. Only 26.3% of all HCWs reported having received formal training on the breastfeeding policy. The designation of HCWs significantly influenced conformity levels. Overall, tier two HCFs demonstrated partial adherence (70%) to BFHI standards. Inadequate and irregular training, coupled with limited access to educational materials, were identified as major barriers to full implementation. These findings underscore the need for continuous, structured BFHI training programs and equitable distribution of breastfeeding education resources across all facility types. Strengthening institutional capacity and staff engagement will be essential to achieving full compliance and sustaining the goals of the BFHI in Kenya.
Defaulting Rate and Associated Factors among Patients Attending Methadone Maintenance Clinics in Nairobi City County, Kenya
(International Journal of Community Medicine and Public Health, 2024-10) Owuor, Sharon Akoth; Mwanzo, Isaac J. M.; Orago, Alloys S. S.
Background: Defaulting from MMT clinics is a major public health problem affecting people globally resulting in high transmission of HIV, hepatitis B and C, increased crime rate, and reduced productivity of an individual. However, defaulting rate in the MMT clinics in Nairobi City County in Kenya remains understudied. This study was aimed at determining the defaulting rate and its associated factors from MMT clinics in Nairobi City County, Kenya. Methods: A cross-sectional analytical study design was employed. Simple random sampling, purposive sampling and stratified sampling were utilized in this study. A sample size of 388 patients was randomly selected. A semistructured questionnaire was used for data collection. SPSS V.24 was used for data analysis. Results: A response rate of 95% (369) was achieved. Most were youths aged 18-35yrs (60.7%, n=224), male (76.4%, n=282), married (39%, n=144), Christians (51.8%, n=191). The defaulting rate was 53% with marital status, religion, education level, and income source being significantly associated with defaulting (p
Distribution of Cardiovascular Disease Risk Factors between Hypertensive and Normotensive Adults in Garissa County, Kenya
(Kenyatta University, 2024-08-08) Osman, Bdihakim M.; Kimani, Harun M.; Gitahi, Mary W.
Background:Cardiovascular diseases (CVDs) are diseases affecting the heart and the blood vessels. Globally hypertension is the leading cause of cardiovascular disease and premature death, affecting 26% of the world population with prevalence expected to rise to 29% by 2025. The main study outcome was the distribution of cardiovascular disease risk factors. Secondary outcomes were the knowledge and socio-economic factors and their impact on distribution of cardiovascular disease risk factors.Methods:This was a retrospective case control study. Information regarding the sociodemographic, cardiovascular disease risk factors, knowledge and socioeconomic factors were collected from 140 adult patients (70 hypertensives and 70 normotensives) seeking outpatient services in Garissa County, Kenya. The 95% confidence limit was used and findings whose p≤0.05 was considered statistically significant.Results:Majority of the participants were aged >65 years (28.6%), followed by 56-65 years (24.3%) with a range of 25-75 years and were mainly male (57.1%), had attained at least a primary school education level (39.3%) and employed (53.6%). The prevalence of increased cardiovascular disease risk factors (>3CVD risk factors) was 72.1% among the study participants with the hypertensive arm having 14.9% higher prevalence. There was statistically significant association between BMI and knowledge with distribution of cardiovascular disease risk factors (p=0.01) and (p=0.05) respectively.Conclusions:The hypertensive arm had marginally higher cardiovascular disease risk factors. High BMI and low knowledge were both associated with increased cardiovascular disease risk factors. Prospective studies with larger sample size and encompassing more counties are recommendable
Evaluation of the Relationship between Perceived Social Support and the Prevalence of Postpartum Depression (PPD) among Young Mothers at Thika Level Five Hospital, Kiambu County, Kenya
(EANSO, 2026-01) Mwongera, Megan Kanja; Musili, Phelista Marura
A considerable percentage of women experience postpartum depression (PPD), commonly known as the "baby blues," which is characterised by mood swings, episodes of crying, heightened anxiety, and disruptions in sleep patterns. PPD is a more severe condition that lasts longer after a mother has delivered compared to normal ‘baby blues’, which is less severe and lasts for a short time after delivery. Based on these revelations, this study sought to examine the relationship between PPD and Perceived Psychosocial Support from significant others, family members and friends among young women aged between 20 and 30 years at Thika Level Five Hospital in Kiambu County, Kenya. The study utilised a correlational research design and the Social Cognitive theory. The target population was 400 mothers at the hospital, from which a sample of 120 young mothers was chosen using purposive sampling. Data collection was done by use of a questionnaire. A pilot study was conducted in Ruiru Level Four hospital in Kiambu County. The Pearson product-moment correlation coefficient was used to evaluate the relationship between perceived psychosocial support and PPD. The study found that all three forms of perceived social support were significantly and negatively associated with PPD among young mothers. The study concludes that perceived social support plays a crucial protective role against PPD among young mothers. The findings of this study have far-reaching implications for mothers, their social circles, and mental health practitioners, providing important insights into the genuine experiences of mothers who have recently given birth. As a result, this information offers pertinent individuals with an enhanced comprehension of how to efficiently attend to and assist mothers who are demonstrating indications of PPD.
Exploring HIV Self-Testing: Barriers and Facilitators among Undergraduate Students
(IJGP, 2024-04) Muendo, Nicholas; Thigiti, Joseph; Tembu, Osborn
Introduction: Globally, 36.7 million individuals live with HIV/AIDS, with 2.5 million new cases annually. Youth (14-25 years) account for 45% of these new infections. Those aged 15-24 years are less likely to be aware of their HIV status and engage in HIV care compared to older adults. This study explores the use of HIV self-testing to improve access to HIV care among Kenyatta University undergraduates. Objective: To identify barriers and facilitators to HIV self-testing in this group. Methodology: Employing multistage cluster sampling, 398 students were surveyed using a self-administered questionnaire. Results: Of the participants (median age 21 years, 1:1.03 male-to-female ratio), 91.7% understood HIV's seriousness, with sexual intercourse as the primary transmission mode. Self-testing usage was 28.8%. Key barriers included fear of partner reaction, stigma, and lack of confidence. Significant facilitators were being female, knowledgeable about HIV, and sexually active. Conclusion: Only 24% had prior HIV testing experience. The study highlights the importance of addressing fears and misconceptions while leveraging knowledge and sexual activity awareness to promote HIV self-testing.
Exploring the Interplay of Socio-demographic Enablers in Sustaining Open Defecation-Free Status among Households in Kakamega County, Kenya
(AJOL, 2023) Okumu, Maitabel Achieng’; Mwanzo, Isaac; Nyambura, Anthony
This study aimed to explore the interplay between socio-demographic enablers and the sustainability of post-open-defecation-free status among households in Butere Sub-County, Kakamega County, Kenya. The research adopted a cross-sectional survey to assess the sustainability of the open defecation-free status at the household level, surveying 6286 certified Open Defecation Free (ODF) households through stratified random sampling. A sample size of 376 households across three wards was selected for the study. Both quantitative and qualitative data were employed; quantitative data was analysed using SPSS Version 28.1, summarized using descriptive statistics, and presented in tables, pie charts, and frequency tables, whereas qualitative data was analysed thematically. Data analysis involved three stages; univariate, bivariate and multivariate analyses. Chi-square tests analysed the statistically significant association between dependent and independent variables. Binary logistic regression predicted the probability of post-ODF status (whether the ODF status was sustainable or not), and 2x2 contingency tables were used to compute the odd ratio. Results revealed that only 9% of households sustained post-ODF status. The chi-square tests revealed a significant association between respondents' gender (χ² = 0.124, p = 0.009*), age distribution (χ² = 6.471, p < 0.05), presence of children under 5 years old in the household (χ² = 1.884, p = 0.004*), level of education (χ² = 5.726, p = 0.006*), employment status (χ² = 9.602, p = 0.006*), and monthly earning brackets (χ² = 11.783, p<0.001*). However, there was no statistically significant association between marital status (χ² = 10.409, p = 0.94>0.05), household size (χ² = 1.782, p = 0.56>0.05), and the sustainability of ODF. On the other hand, the odds ratio for employment status suggests that significant association (OR=1.333; p = 0.007*<0.05; 95% CI: 1.082-1.642), where employed individuals were 1.333 times more likely to sustain ODF status. Further analysis revealed that employment status was a statistically significant predictor of post-ODF sustainability (aOR=1.837 P=0.011; 95% CI: 1.132-2.980). The study concluded that most households (91%) did not sustain post-ODF status after the ODF declaration. It was recommended that health practitioners improve door-to-door monitoring and develop post-ODF tracking tools at the household level, focusing on important parameters from Ministry of Health guidelines. The government and other Water sanitation and hygiene (WASH) stakeholders should support communities in establishing and enhancing economic empowerment programs to increase household income and encourage investments in sanitation infrastructure and hygiene promotion activities
Factors Influencing Women’s Knowledge at Scheduled Postnatal Visits: A Multi-Centre Study in Kakamega, Kenya
(magonline library, 2021) Kiragu,Charles; Osero,Justus SO; Wanyoro,Anthony K
Background/Aims Postnatal care is offered to mothers and their babies from birth and across the postnatal period. Visits are spread over the postnatal period, and a minimum of four visits is recommended. In many studies, postnatal visits in Africa have been reported to be low compared to antenatal visits. As a result of low postnatal visits, mothers are not able to utilise postnatal care services, resulting in delayed detection of and interventions for maternal and neonatal health problems, leading to high rates of maternal and neonatal morbidity and mortality. In Kenya, only 53% of mothers attend postnatal clinics; in Kakamega county, only 34% of mothers attend. This study aimed to establish factors influencing postnatal knowledge among mothers in selected hospitals in Kakamega, Kenya. Methods The study was a descriptive cross-sectional study involving 320 postnatal mothers recruited from four sub-counties. Systematic sampling was used to select eligible study participants. Data were collected using questionnaires that assessed the participants’ knowledge of postnatal care in terms of what postnatal care is, recommended postnatal care, when to attend a clinic and the services offered at postnatal care clinics. The data were entered into a database and analysed using the Chi-squared test to assess how sociodemographic and socioeconomic characteristics were associated with knowledge of postnatal care. Results The majority of participants (73.1%) had poor or no knowledge of postnatal care and 89.7% had poor or no knowledge on when postnatal visits should be carried out. Most postnatal mothers (71.9%) received postnatal health information from health workers. Occupation (P<0.000), income (P<0.000), transport (P<0.000) and time taken to travel to hospital (P=0.034) were significantly associated with postnatal knowledge. Conclusions Knowledge on postnatal care is poor among postnatal mothers in Kakamega. The majority of participants obtained postnatal care information from health workers, and so it is recommended that Kakamega establishes other strategies for giving information on postnatal care, such as pamphlets to mothers
Impact of Community-Led Enhanced Structured Health Education on Youths' Knowledge of Alcohol's Effects in Kiambu County, Kenya: A Quasi-Experimental Study
(PAMJ, 2025-06) Mukui,Antony Kimata; Oyore,John Paul; Gitahi,Mary Muiruri
Introduction: alcohol is the most widely consumed substance globally, contributing to 2.6 million deaths annually, including 320,000 involving youths. In Africa, alcohol is linked to high mortality rates and increased Disability-adjusted Life Years. In Kiambu, Kenya, youth alcohol consumption stands at 28.9%, surpassing the national average of 11.2%. This study explores the impact of community-led, enhanced, structured health education on youths' awareness of alcohol's effects. Methods: a quasiexperimental study was conducted in Gatundu South (intervention) and Kabete (control) subcounties in Kiambu from May 2022 to May 2023. Fourteen Community Health Promoters delivered monthly one-hour sessions in Gatundu South, totaling 12 sessions, covering 12 topics. Quantitative datasets were collected using the WHO's Alcohol AUDIT and questionnaire, while qualitative datasets were gathered through focus group discussions (FGDs) and key informant interviews (KIIs) and analyzed thematically. Kenyatta University's ethics committee granted study approval. R software supported data analysis, including mean knowledge scores, Chi-Square, ordinal logistic regression, Difference-in-Difference analysis, and Cohen's d. Results: youth in the intervention group experienced a significant increase in "very high knowledge" from 57% to 92.6%, compared to a smaller rise in the control group from 26.1% to 39.5%. Post-study, Kabete had 2.6% of participants in the very low knowledge category, versus 0% in Gatundu. The intervention showed a significant impact (DiD: 1.8, Cohen's d: 1.161). FGDs and KIIs indicated limited awareness and access to screening services. Conclusion: the intervention improved knowledge of alcoholrelated harm, encouraged healthier behaviors, and reduced adverse effects.
Intimate partner violence among women of reproductive age during COVID-19 pandemic in Bungoma County, Kenya
(Medip Academy, 2024-01) Simiyu, Rose Nakhumicha; Kanini, Caroline; Owaka, Isaac; Ojwang, Nicholas Mado
Background: Intimate partner violence includes all forms of aggression by former or current intimate partner. It accounts to 1.3 million deaths annually. Women of reproductive age, 18% globally have experienced physical and sexual forms of IPV. IPV cases ranges from 55% and 46% respectively in Africa and South Asia.COVID-19 has seen increase of IPV by 5% among WRA. IPV among WRA increases incidence of suicide, abortion and depression.Methods:Descriptive cross-sectional study design was used. Stratified 2 stage random sampling and simple random sampling techniques were used. Sample size was 229 WRA.Primary data was collected using a self-administered questionnaire, KIIS and FGDS. Data analysis was carried out through both descriptive statistics and inferential analysis findings were presented in percentages and pie charts.Results: Age category of 26 -33 years, participants who are casual workers, alcohol consumption by partner, length of relationship, level of education and culture were significantly associated with physical, psychological, sexual and economic violence.66.80%of the participants did not know about the policies on IPV and the available community level services to combat IPV was majorly reconciliation of couples by the local chiefs.Conclusions:The health system factors that facilitates support of IPV was not in line with SDGs Goal 5: Gender equality and SDGs Goal 16: Peace, justice and strong institutions. A large number of respondents (79.5%) reported unavailability of health facilities linked to social, health and legal services to support victims of IPV.
Patient-Related Factors Associated with Non-Adherence to Psychotropic Medication among Patients with Mental Disorders attending Clinic Follow-Up at Mathari National Hospital, Nairobi City County, Kenya
(Journal ofMedicine, Nursing and Public Health, 2025-03) Makau, Ruth Mwikali; Kabue, Priscilla; Ambani, Elizabeth
Non-adherence to psychotropic medication among persons with mental disorders prevents the sick persons from getting the full advantages of medication which affects them and their families negatively besides putting unnecessary pressure on the already overstretched health care system. Recent research findings show that non-adherence is a worldwide phenomenon among mentally sick persons leading to poorer outcomes such as increased hospital admissions, suicides, and deaths. This study aimed to examine patient-related factors associated with non-adherence to psychotropic medication among patients with mental disorders. This research employed a descriptive cross-sectional design. A total of 230 respondents were identified through simple random sampling in that all patients with a history of missing drug therapy as documented in the clinic notes or observed by the referring clinician were included. The correlation analysis results revealed that economic status and family support had a significant negative association with non-adherence to psychotropic medication. Moreover, side effects, beliefs and perceptions, and comorbidity had a significant positive association with non-adherence to psychotropic medication among follow-up patients with psychiatric disorders at Mathari National Teaching and Referral Hospital. Regression results indicated that comorbidity had a significant positive effect on non-adherence; while family support had a significant negative effect on non-adherence to psychotropic medication among follow-up patients with psychiatric disorders at Mathari National Teaching and Referral Hospital. The families of patients with mental disorders should continually support them in their recovery journey and particularly encourage them to keep taking the treatment as instructed.
Predictors of Antiretroviral Therapy Interruption on Community Viral Load among People Living With HIV in Siaya County, Kenya
(International Journal of Community Medicine and Public Health, 2024-12) Ombagi, A. Jared; Oyore, John; Nyamache, Anthony
Background: Community viral load (VL) suppression is essential for assessing HIV treatment effectiveness, uptake, and impact on new HIV infections. Siaya is among the highest HIV burdens County in Kenya, with a prevalence rate of 13.2%, representing 96,297 estimated people living with HIV (PLWHIV). Among retained clients, 90% were virally suppressed, accounting for 51% of estimated PLWHIV. Methods: This cross-sectional, retrospective, and qualitative study was conducted in Gem sub-County of Siaya County, Western Kenya, among re-engaged PLWHIV who interrupted treatment. Data was collected from 13 facilities with highest rates of treatment interruption between January 2017 and December 2022. Participants with shorter appointments were interviewed during clinic visits. Their prospective and retrospective data were merged and analyzed using Chi-square, Fisher’s exact tests, Kaplan–Meier, and Cox proportional hazard models to evaluate associations between demographic, cultural, and socioeconomic characteristics and VL suppression. Results: Of 311 participants assessed, median was age 45 years (IQR: 37–52) and VL suppression rate of 55%. Clients with primary education had lower non-suppression rates than those with university education (HR 0.45; 95% CI, 0.26–0.76), and non-suppression was higher among those in formal employment compared to business (HR 1.95; 95% CI, 1.07–3.53). PLWHIV on ART for over 24 months had lower non-suppression rates (HR 0.5; 95% CI, 0.35– 0.73) than those on ART for under 12 months. Conclusions: University education, formal job, or being on ART for less than 12 months increased the risk of attrition. Implementation of client-centred HIV services may improve community VL suppression.
Predictors of Stunting among Children Aged 6-59 Months in Kitui County, Kenya
(African Health Sciences, 2024-12) Chui, Morris K.; Osero, Justus O.; Mugo, Judy W.
Background: Stunting in children below the age of five is a significant public health problem in Kenya. Stunting has transitory and lifelong effects on people and communities, including high risk of morbidity and death, lowered mental and physical growth, and decreased productivity. Objective: To investigate the predictors of stunting in children aged 6 to 59 months in Kitui County, Kenya. Methods: This was a cross-sectional analytical survey that used multistage cluster sampling. Data were gathered through questionnaires, interviews with key informants and discussions with focus groups. Anthropometric measurements were taken to assess the rate of stunting. Results: The stunting rate was 26.6%. The independent predictors of stunting included birth weight < 2500 grams (AOR = 2.302; 95% CI: 1.027-6.150; p: 0.043), having secondary education (AOR = 5.404; 95% CI: 1.607-18.173; p: 0.006), mother’s MUAC < 23 cm (AOR = 2.845; 95% CI: 1.125-7.192; p:0.012), and having no access to a latrine/toilet (AOR = 0.008; 95% CI: 0.009-0.561; p: 0.013). Conclusions: Stunting was high and was influenced by sociodemographic factors, and the household environment.
Prevalence and Predictors of Arthritis among Adults in a Rural Set-Up in Kenya: A Cross-Sectional Study
(Pan African Medical Journal, 2024-04) Kinara, Shem Nyarunda; Kimani, Harun Mbugua; Ogweno, Gordon Oluoch
Introduction: arthritis is a significant public health problem affecting many people globally. Exposure to various risk factors puts individuals at risk of developing arthritis. Therefore, this study aimed to assess the prevalence and predictors of arthritis among residents of a rural set-up in Nyamira County, Kenya. Methods: a community-based cross-sectional study design was employed. Simple random sampling was utilized to select households from a household list. All the residents of the sampled household above 40 years were included. Descriptive analysis was done to describe the study population. Bivariate and multivariate analysis was also done to identify statistically significant arthritis-related variables. Results: the prevalence of arthritis was 44.6%. Previous joint injury/infection [AOR=2.74; 95%CI=1.59-4.77; p<0.001], being unemployed [AOR=2.77; 95%CI=1.50-5.21; p=0.001], age above 51 years, and hypertension [AOR=1.90; 95%CI=1.03-3.53, p=0.040] were associated with an increased risk of arthritis. Conversely, being male [AOR=0.42; 95% CI=0.22-0.75; p=0.005], standing for > 2 hours [AOR=0.48; 95%CI=0.29-0.81; p=0.006], and constant shifting from sit to stand positions [AOR=0.45; 95% CI=0.26-0.76; p=0.003] were associated with a lower risk of arthritis. Most participants (75%) had an arthritis knowledge score of more than 66%. Conclusion: the study found a high prevalence of arthritis in the community. Arthritis was strongly associated with various risk factors under study. Therefore, there is a need to take preventive measures for modifiable factors to enhance a reduced prevalence of arthritis.
Prevalence of Chronic Kidney Disease among the Hypertensive Patients in Wajir County, Kenya
(MDIP, 2024-06) Ali, Abdirahman M.; Kimani, Harun M.; Ogweno, Gordon O.
Background: Chronic kidney disease (CKD) is public health burden and rising rapidly in prevalence in developing countries especially in Sub-Saharan Africa. CKD increases with advancing age and comorbidities like hypertension, diabetes and obesity. However, there is no data on CKD the prevalence and risk factors associated among the hypertensive adult patients in Wajir county. This study aimed at estimating the prevalence and establishing risk factors associated with CKD among hypertensive patients in Wajir county and sought to recommend viable preventive measures. Methods: Analytical cross-sectional study design utilized, non-probability consecutive sampling was adopted to obtain sample size of 293 respondent attending medical outpatient clinic at Wajir county referral hospital between September to December 2023. The study utilised primary data that were collected using structured questionnaires and secondary data from the laboratory result. Results: Key findings revealed majority of hypertensive patients have CKD (45.40%), highlighting a critical health concern in the region. The study found most CKD cases were in early stages (stages 1 and 2), some had progressed to severe stages (stages 4 and 5). Regression analysis identified several demographic and clinical factors associated with CKD development, including age, gender, and education, and employment status, family history of CKD and difficulty in medication compliance. Conclusions: there is high prevalence of chronic kidney disease among hypertensive adults in Wajir county. With nearly half of hypertensive patients also suffering from CKD, there is an undeniable public health crisis at hand in Wajir county. Study recommended initiation of targeted screening programs.
The Impact of Behavioral Training Interventions on Motorcycle Accident Prevalence: A 6-Month Pre-Post Study amongMotorcycle Riders in Kiambu County, Kenya
(Journal of Medicine, Nursing & Public Health, 2024-07) Maru, Michael; Osero, Justus; Kimani, Harun
Motorcycle accidents have become a leading cause of fatalities and injuries in Kenya, with a significant impact on families, communities, and the healthcare system. This study aimed to establish the impact of behavioral training interventions on motorcycle accident prevalence among motorcycle riders in Kiambu County over a 6-month period. The study employed the Epidemiological Model for Non-infectiousDiseases as its theoretical framework. A quasi-experimental research design was adopted, with a sample of 140 motorcycle riders randomly selected from Kiambu County. The participants were divided into a control group and an experimental group, with the latter undergoing a 2-week behavioral training intervention conducted by a Cognitive Behavioral Therapist (CBT). The Motorcycle Rider Behavior Questionnaire (MRBQ) was used to assess the effectiveness of the intervention. The findings revealed that during the post-training period, the experimental group experienced a reduced prevalence of motorcycle accidents at 23% (16 out of 70 observations), compared to the control group's prevalence rate of 48% (34 out of 70 observations). A paired sample t-test showed a significant difference between pre-training and post-training periods (p=0.000), and a Chi-square test indicated a significant association between behavioral training interventions and motorcycle safety (X^2^=22.308, df=15, p<0.010). The study concludes that behavioral training interventions have a statistically significant impact on improving motorcycle safety among riders in Kiambu County. It is recommended that the National Transport and Safety Authority (NTSA) incorporates behavioral training as a standard component of the motorcycle licensing process and that policymakers, road safety organizations, and motorcycle rider training programs prioritize the implementation and expansion of these interventions to promote motorcycle safety in Kenya.

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