RP-Department of Nursing Sciences

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    Determinants of Chronic Kidney Disease among Diabetes Mellitus Patients at Gatundu Level 5 Hospital, Kiambu County, Kenya
    (EAS Journal of Nursing and Midwifery, 2022) Mwega, Bernard; Masika, Jacob; Meng’ayi, Lucy
    The prevalence of chronic kidney disease (CKD) is rising alarmingly throughout the world, and it is one of the major public health menace due to the significant morbidity and mortality it is associated with. The burden of CKD inexplicably affects low-income nations like Kenya, where the two main public health concerns for the CKD growth rate are hypertension and diabetes mellitus. The aim of this study was to identify the determinants of chronic kidney disease diabetes mellitus patients and also assess their awareness, perspectives and prevalence of CKD. A hospital based cross-sectional study design was conducted at a rural hospital in central Kenya among adult (≥18 years) diabetes mellitus patients. Sample size was determined using Yamane Taro formula. Informed written consent was obtained from each participant and data was collected by interview and chart review; Glomerular filtration rate (GFR) was estimated from serum creatinine using modification of diet in renal disease (MDRD) formula, while CKD was defined as eGFR of less than 60mls/min/1.73m2 for more than three months. Multivariate logistic regression was used to identify independent determinants of CKD and a p-value of <0.05 was considered to be statistically significant. Majority of the participants (43.42%) were aged between50-60 years and 95 (62.5%) of them were females. Participants with history of high blood pressure had a 129.4 %(AOR;1.29495% CI, 2.401-.698) risk of having CKD, while those who did not perform physical exercises were found to be 123.3% (AOR 1.233, 95% CL,1.889-.805) times more likely to have CKD Only 39 (25.8%) of the participants had average awareness about CKD and its risk factors. The overall unadjusted prevalence of CKD among diabetic patients was 78.2% (n= 119, 95% CI). The researcher found that existing history of hypertension, lack of physical exercises, family history of kidney disease, rural residency and low levels of education were independent determinants associated with CKD. The researcher also found low levels of patient awareness (25%) and high prevalence of CKD (78.2%).
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    Determining the Levels of Technical Efficiency Changes in Bomet County Before and After Devolution
    (Stratford Peer Reviewed Journals and Book Publishing, 2018) Kipronoh, Victor Sang; Yitambe, Andre; Kosimbei, George; Rucha, Kenneth
    The study aimed at determining the levels of technical efficiency changes in Bomet County before and after devolution. A cross-sectional study design was used where secondary and quantitative data was collected using a data checklist from the ministry of health and the county’s information platforms. ‘Ex-ante’ and ‘ex-post’ data from the devolution periods were used to calculate the technical efficiencies using a non-parametric econometric technique, Data Envelopment Analysis (DEA). Key informant interviews were done after analyses of data to get the views of the county’s health managers on the results. The mean constant returns to scale technical efficiency (CRS TE) scores for the county increased from 92.4% in 2012 to 96.1% in 2015, while the varied returns to scale technical efficiency (VRS TE) score showed an increase of 3.4% from 96.6% to 100%. The county mean scale efficiency scores increased from 95.7% before devolution to 96.1% after devolution. Bomet County ought to create more demand for its health services and therefore increase the utilization of its resources. This could be done through the use of community units, which is responsible for bringing out the unmet needs in the population and linking the populations to the health facilities.
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    Patient-Related Factors that Influence Adherence to Post-Kidney Transplant Treatment Among Kidney Allograft Recipients at a National Referral Hospital, Kenya
    (Numid Publishers, 2021) Nyambura, Anne Mumbi
    Introduction: The purpose of this study was to describe patient-related factors that influence adherence to post kidney transplant treatment among kidney allograft recipients at a national referral hospital in Kenya. Adherence to long term immunosuppressive medications determine the success of kidney transplantation. However, non-adherence is a global health concern among this special population. Methods: Descriptive cross-sectional hospital-based study, census sampling method was used with a sample size of 106 kidney allograft recipients. Findings: Almost half 49(46%) of the respondents were non adherent to medication. Majority 43(88%) pointed out that cost of the medicines was the main reason for non- adherence. Among those who adhered, 102(96%) indicated that they had adhered because the quality of their life had improved after kidney transplantation. Age was found to be a statistically significant factor in influencing outcome of adherence as indicated by body mass index (BMI) (x 2(15) = 30.09, p =.012, p<.005). Conclusion: There exists a gap in adherence to medication among the kidney allograft recipients. Cost of medication is an important factor in non-adherence. Recommendations: The health care providers should develop sustainable strategies to curb medication non-adherence. Government should consider National Hospital Insurance Fund cover to all post kidney transplant medicines. Non-governmental organizations should offer financial support to this special population by donating drugs.
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    Quality of Life of Kidney Donors at a National Teaching and Referral Hospital in Kenya
    (Numid Publishers, 2021) Nyarera, Diviner Kemunto; Githemo, Grace; Onsongo, Lister
    Introduction: Kidney transplantation is the best renal replacement therapy for patients with end stage kidney disease. Living kidney donor transplant has better graft and recipient outcome. Information regarding quality of life of kidney donors has a positive influence on a potential donor’s attitude towards kidney donation. The aim of the study was to examine kidney donors’ quality of life in Kenya. Methods: This was a cross-sectional descriptive study design that aimed at examining kidney donors’ quality of life at a national teaching and referral hospital in Kenya. A total of 99 donors participated in the study. Descriptive and inferential statistical tests were used to analyze data. Predictors of quality of life were determined using Multiple regression models. Findings: The findings revealed that majority of the respondents had high quality of life. There was a strong significant relationship between donor’s Body Mass Index and Health Functioning component of QoL r (0.835), p<0.05 with a moderate relationship in Psychological factors r (0.492), p 05. Also there was a statistically significant association between, current monthly income, =24.793, (p 0.05), marital status =10.261 (p 0.05) and employment status =11.474 (p 0.05) and quality of life of kidney donors. Multiple regression analysis revealed that Health functioning quality of life component explained 27.5% of the total variance of quality of life while psychological factors explained 12.5%. Conclusions: The overall quality of life of kidney donors was high. Kidney donor’s employment status had a significant predictive association with their quality of life.
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    Acute Medical Conditions in under Five Year Old Children at a Public Hospital in Kenya.
    (East African Medical Journal, 2010-08) Makworo, D.; Laving, A. M.
    OBJECTIVE: To determine the prevalence of childhood preventable and treatable medical conditions and the parent's/guardian's knowledge about the conditions and their management. DESIGN: A descriptive cross-sectional study. SETTING: Paediatric medical wards at Kenyatta National hospital SUBJECTS: All children aged 0-60 months with preventable conditions (that included pneumonia, malaria, diarrhoea/dehydration, meningitis and malnutrition) in paediatric wards who had stayed in the ward for 24 to 48 hours. RESULTS: Two hundred and fifty six parents/guardians staying with their children were recruited into the study. The vast majority (85.5%) of the children were aged less than two years. The prevalence of the acute treatable and preventable medical conditions was 88.6% over a one month period. The leading cause of admission for most children was pneumonia (31.6%) followed by malnutrition (16.8%) and gastro-enteritis (16%). Other conditions included neonatal sepsis (9.1%), measles (6%) and malaria (4.8%). The parents'/guardians' mean and median age was 26 years and the majority (89.8%) were mothers. A great proportion (46.5%) of the parents/guardians had attained at least some primary education. More than 70% of the parents/guardians were found to lack knowledge about their children's health problems and the drugs they were using. This was regardless of the parent's/guardians level of education and the frequency of admission of the child. CONCLUSION: Acute preventable and treatable medical conditions at KNH are highly prevalent, and the leading conditions include pneumonia, malnutrition and gastroenteritis. Most parents/guardians did not understand their children's health problems regardless of their level of education.