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Item Comparison of Pap-Smear and Modified-Amsel’s Criteria in Screening for Bacterial Vaginosis among Women at Kiambu Level-V Hospital, Kiambu County, Kenya(Kenyatta University, 2025-02) Omwono, Susan AkinyiBacterial vaginosis is a commonly experienced vaginal infection in reproductive age group women between 15 and 44 years old. Globally, 5-70% of women are affected. In Kenya the prevalence is between 10-50%. Bacterial vaginosis is a public health concern implicated in premature rupture of membranes, low birth weight, pelvic inflammatory disease, infertility and urogenital infections. Several methods exist for BV screening, among them Gram staining, Amsel‘s criteria, Papanicolaou smear, and Polymerase Chain Reaction. These methods require highly skilled microscopists, are not easily accessible, and they are expensive. The study’s’ main objective was to compare performance of the Modified Amsel‘s criteria and Pap smear to the gold standard method, Gram stain, to determine if the former which is simple and readily available is more suitable for bacterial vaginosis screening. A cross-sectional study involving 196 females between 18-55 years old was undertaken at the gynaecology Clinic in Kiambu level-V hospital, Kenya. A Pap smear and two high vaginal swabs were obtained from each participant. The Pap smear was evaluated as per the Bethesda system 2014 and smears positive for BV reported. In modified Amsel‘s criteria, the vaginal discharge was evaluated for homogeneity, pH, existence of clue cells and a fishy odour. For Gram stain method, smears were made on a slide and Gram-stained. Ten microscopic fields were observed for lactobacillus and Gardnerella morphotypes and rounded Gram rods. The bacteria were counted, scored and summed to get a full score within the range of 0-10. Purposive sampling method was used to recruit participants. The inclusion criteria was females between 18-55 years old who signed consent to be involved in the study. Exclusion criteria was pregnancy, menstruation and failure to give consent. Nominal and categorical data of the two methods was compared using Chi-square test. Statistical significance was determined by a p-value less than 0.05 at 95 percent Confidence Interval. Cohen’s Kappa statistics was used to determine the level of agreement of the two methods. Out of the 196 participants 46 (23.5%) were positive for BV by the Gram’s standard method, 60 (30.6%) by Modified Amsel’s criteria and 18 (9.2%) by Pap smear method. Sensitivity, Specificity, Positive Predictive Value and Negative Predictive Value of Pap smear was 32.6%, 98.0%, 83.3% and 82.5% respectively, while that of modified Amsel’s criteria was 82.6%, 85.3%, 63.3% and 94.1% respectively. There was slight agreement between Pap smear and modified Amsel’s criteria k=0.195 and p=0.063. Out of the analysed risk factors for Bacterial vaginosis, only age had a statistical association with BV (p=0.03). Prevalence of BV was 23.5%. Modified Amsel’s criteria was more accurate in screening for BV than Pap smear. These findings will inform policy makers on the most reliable method for BV screening in the absence of the gold standard.Item Smear Findings and HPV Infection among Women Presenting with Chronic Leucorrhoea at Kenyatta National Hospital, Nairobi City County, Kenya(Kenyatta University, 2025-04)Chronic leucorrhoea is among the most common gynecological symptoms encountered in clinical settings and is often a manifestation of underlying infections of the vagina or cervix. These infections are frequently caused by Candida species, the protozoan Trichomonas vaginalis, and/or Human Papillomavirus (HPV). According to the Global Cancer Observatory, cervical cancer remains a significant global health burden, with an estimated 348,874 women succumbing to the disease annually, ranking it as the ninth leading cause of cancer-related mortality as of 2022. A substantial proportion of these cases—nearly 70%—are attributed to high-risk HPV subtypes, particularly genotypes 16, 18, 45, 31, 33, 39, 51, 52, 56, 58, 59, 66, and 68. While most HPV infections tend to resolve spontaneously within two years, the persistence of oncogenic strains continues to drive high global incidence rates, with 662,301 new HPV-related cases reported in 2024 alone.In many healthcare facilities in Kenya, diagnostic approaches for women presenting with chronic leucorrhoea often rely on routine tests such as high vaginal swabs, urinalysis, urine culture, or abdominal-pelvic ultrasound, which may fail to detect underlying HPV infections or cervical lesions. This study therefore sought to evaluate the correlation between Pap smear findings and high-risk HPV infection in women presenting with chronic leucorrhoea at Kenyatta National Hospital in Nairobi City County, within the Gynecology and Obstetrics department. A total of 107 participants were recruited through convenience sampling for this prospective cross-sectional study. Participants were screened for cervical lesions, sexually transmitted infections, and high-risk HPV using conventional Pap smear cytology and the Cepheid Xpert HPV Assay. Pap smears were initially reviewed by the Principal Investigator, followed by a cytologist and a final pathologist's review. In instances of interpretative discrepancies, the Roche Automated Slide Scanners Module 16 was employed for diagnostic confirmation. The results revealed a 24.3% prevalence of cervical lesions, with High-Grade Squamous Intraepithelial Lesions (HSIL) being the most common (20.6%). High-risk HPV was detected in 35.5% of participants, with genotype 16 being the most prevalent (42.1%) and genotype 18 the least (21.1%). Candidiasis was the most frequent STI (25.2%), followed by Trichomonas infection (7.5%) and bacterial vaginosis (5.6%). A positive high-risk HPV test significantly increased the likelihood of cervical lesions (p = 0.039). Socio-demographic variables such as employment status (p = 0.032), age at coitarche (p = 0.038), and contraceptive use (p = 0.030) were significantly associated with cervical lesion presence. The majority of participants exhibited a Vaginal Discharge Score (VDS) of 3, characterized by over 50% white or off-white purulent discharge, recorded in 67.3% of cases. This study underscores the clinical value of integrating Pap smear screening with HPV testing for women presenting with chronic leucorrhoea. Beyond early detection of pre-malignant changes, these findings highlight the need for public health interventions focusing on education, prevention, and community outreach to reduce the burden of HPV-related cervical pathology in KenyaItem Reproductive Tract Bacterial Infections among Women of Reproductive Age Attending Homabay County Teaching and Referral Hospital in Homabay County, Kenya.(Kenyatta University, 2025-04) Mwendwa, Alice KamonyaReproductive tract bacterial infections (RTBIs) are a leading cause of morbidity among sexually active women worldwide. Female reproductive tract infections can affect either the upper reproductive tract, which includes the fallopian tubes, ovaries, and uterus, or the lower reproductive tract, comprising the vagina, cervix, and vulva. Although studies have been conducted on the incidence, bacterial causative agents, and antibiotic susceptibility patterns of RTBIs in Kenya and other developing countries, gaps remain in comprehensive and up-to-date data. These gaps limit the effectiveness of diagnosis, treatment, and prevention strategies, posing an ongoing challenge to improving women’s reproductive health. To address this, the study aimed to assess the incidence of bacterial infections in the female reproductive tract and evaluate their antibiotic susceptibility. The research focused on women of reproductive age attending the antenatal, gynecological, and outpatient clinics at Homabay County teaching and referral hospital. Women of reproductive age seeking care at the hospital who consented to participate were enrolled in the study. A cross sectional study design was adopted, and a systematic sampling technique was employed. The minimum sample size was determined using Fisher et al.'s formula, based on a 37.4% incidence of reproductive tract bacterial infections. The patients were interviewed using a structured questionnaire, and subsequently, blood and high vaginal swab samples were obtained from each patient for the analysis of bacterial infections. Sample analysis was done at Homabay County Teaching and referral hospital laboratory. High vaginal swabs were examined for bacterial vaginosis, and grading was performed using Nugent’s criteria. The analysis identified Lactobacillus, Gardnerella, Bacteroides, Mobiluncus sp, and Neisseria gonorrhoea. Culture was performed to analyze Neisseria gonorrhoea using the King and Martin method. All gonorrhoea isolates were tested for antibiotic sensitivity using the disc diffusion method, and CLSI 2024 guidelines were used. Blood samples were examined for Treponema pallidum using a non-treponemal antigen test. The Chi-square test of association was used to assess the association between reproductive tract bacterial infections and socio-demographic factors. Fisher’s exact test was employed to assess the sensitivity of Neisseria gonorrhoea to various antibiotics commonly prescribed for treatment. The study employed Statistical Package for Social Sciences (SPSS) version 28, with a significance level set at P < 0.05. Findings on reproductive tract infections among 360 women showed 3.6% incidence. Treponema pallidum (10.8%), Neisseria gonorrhoea (3.6%), and bacterial vaginosis (5.3% Amsel, 3.1% Nugent) were identified. N. gonorrhoea exhibited 100% resistance to tetracycline, 34% resistance to penicillin, and 100% sensitivity to ceftriaxone. The study concludes that reproductive tract infections at Homabay County Hospital, driven by bacterial vaginosis, T. pallidum, and N. e, pose a public health challenge. N. gonorrhoea shows full resistance to tetracycline, partial to penicillin, and complete susceptibility to ceftriaxone. The study recommends prioritising ceftriaxone for gonorrhoea, enhancing screening, and monitoring resistance.Item Spectrum, Antimicrobial Susceptibility Profiles, and Molecular Characteristics of Bacterial Pathogens from Severely Ill Covid-19 Patients in Kenyatta National Hospital, Kenya(Kenyatta University, 2023-06) Mutua, Jeniffer MunyivaBacterial infections are among the leading causes of morbidity and mortality among patients with viral respiratory infections. Because it is difficult to differentiate viral from bacterial pneumonia based on clinical presentation and bacterial pathogens’ epidemiology varies geographically, Coronavirus Disease 2019 patients are prescribed antibiotics frequently, even without laboratory-based evidence of bacterial infection. This has a serious negative implication on antimicrobial resistance situation that is expected to worsen causing approximately 10 million deaths and 100 billion USD economic loss by 2050. Information on bacterial infections among Coronavirus Disease 2019 patients in many developing countries, including Kenya, is limited. This study aimed to determine the spectrum, antimicrobial susceptibility profiles and molecular characteristics of pathogenic bacteria among patients with COVID-19 at Kenyatta National Hospital, Kenya. An analytical cross-sectional study design was adopted and a total of 120 participants purposively recruited among laboratoryconfirmed severely ill Coronavirus Disease 2019 patients who gave informed consent through a legally authorized representative. Socio-demographic, clinical and outcome data were gathered using case report forms and structured sample collection forms. Nasopharyngeal and oropharyngeal swabs, tracheal aspirates and blood samples were collected, transported to KNH microbiology laboratory, and analyzed following the standard bacteriological methods. Bacterial isolation was done on selected culture media, whereas isolates identification and susceptibility testing were done using MALDI-TOF (VITEK ® MS) and VITEK® 2 COMPACT system, respectively. The AST data was interpreted based on 2021 CLSI standards. The screening for ESBLproduction was conducted using the Double-Disc Synergy Tests, which was subsequently confirmed through Phenotypic Confirmatory Disc Diffusion Test. ESBL-resistant genes were PCR-detected from all ESBL-producers at the Centre for Microbiology Research, KEMRI. An overall prevalence of 44.2% (53/120) bacterial infections was found among the study participants, with a 31.7% (38/120) mortality rate. Isolates of Gram-negative bacteria (GNB) exhibited greater prevalence, (73.1%, 49/67). Majority (69.6%, 32/46) of multidrug resistant (MDR) bacteria were GNB. K. pneumoniae (45.5%, 15/33) was the dominant ESBL producer and most of MDRGNB harboring the TEM (83%, n=10/12) and SHYV resistance gene (100%, n=7/7) were' resistant to beta lactamase inhibitors including amoxicillin/clavulanate but susceptible to piperacillin/tazobactam (60%, n=6/10). Male patients were more likely to have bacterial infections (aOR =2.61, 1.2 - 5.65), including those caused by ESBL producing bacteria (aOR=0.21, 0.06 - 0.68). Individuals with pre-existing comorbidities were found to have a five-fold increased likelihood of harboring ESBLproducing bacteria (¢COR=5.46, 1.37 - 21.67). Patients: aged 25 to 44 years (aOR = 0.13, 0.02 — 0.6), hospitalized in the IDU ward (aOR=3.27, 1.08- 6.89), vaccinated for Coronavirus Disease 2019 (aOR = 0.2, 0.05 — 0.83) and hospitalized for short duration (0 -5 days) (ROR=14.28, 3.25 - 62.76) had a positive hospitalization outcome. These results highlight a significant burden of bacterial infections among Coronavirus Disease 2019 patients, with males at higher risk. Those: not vaccinated, admitted to CCU, aged over 60 years, and with pre-existing comorbidities had poor outcome. There is urgent need for systematic and continuous AMR surveillance at KNH and beyond to inform prevention interventions in accordance with national and global action plans.Item Prevalence of Tuberculosis and Tuman Immunodeficiency Virus Co-infections and Risk Factors among Prisoners in Shimo-la-Tewa Maximum-Security Prison, Mombasa County, Kenya(Kenyatta University, 2024-10-30) Mwatenga, Suleiman AthumanTuberculosis (TB) is one of the leading causes of death due to ‘communicable disease in the world. Despite the WHO recommended TB control strategies to curb the spread, TB burden in prisons is disproportionately higher compared to general population. However, the epidemiological data on TB in prisons from many resource-constrained countries, particularly Kenya, is limited. This study aimed to determine the epidemiology of TB and Human immunodeficiency virus (HIV) co-infections among prisoners (=18 years) presenting with symptoms suggestive of TB at Shimo La Tewa prison health Centre in Mombasa County, Kenya. A descriptive cross-sectional study design was adopted and followed a consecutive sampling technique, excluding patients on current TB treatment or on follow up after completing treatment course in the past 3 months, and those declining to grant study consent. A pretested structured questionnaire was used to collect demographic and clinical characteristics of the participants. Sputum samples (early spot and morning samples) on two consecutive days were collected in clean and sterile 50-ml falcon tubes and kept 2-8°C for analysis within 10 days. Fresh early morning urine samples were collected in a wide-mouth falcon container and held at 2-8°C up to 3 days. Capillary whole blood (20-50 pl) was collected for HIV testing using pipettes after pre- < testing counselling by a qualified nurse. Sputum samples were screened for TB using . fi Xpert MTB/RIF assay and fluorescence microscopy (FM), and urine samples using T Lateral flow urine lipoarabinomannan assay (LF-LAM). HIV virus was screened using Alere DetermineTM and confirmed using HIV-1/2 Ag/Ab First Response® rapid HIV tests, respectively. Data was organized in MS Excel and analyzed using Strata version 17. Analysis on association was done using bivariate and multivariate regression with the statistical significance level at P < 0.05 (95% Confidence Interval). Ethical approval was granted by the Kenyatta University Ethical Review Committee, and all participant provided informed written consent, with an assurance of privacy through anonymity and data coding. TB prevalence among the study participants varied based on the diagnostic technique, highest at 11.5% (18/157) by LF-LAM. HIV prevalence was 19.1% (30/157), while the HIV/TB co-infection rate was 11.5% (18/157), with the highest burden among those aged 30 - 44 years (18/30) and underweight (26/30). The predictive ability of TB LF-LAM for TB diagnosis in comparison to Xpert MTB/RIF assay was 100% sensitivity and 98.6% specificity, with a positive predictive value (PPV) and negative predictive value (NPV) of 88.9% and 100% respectively. Education level, smoking, and use of illegal drugs were independent factors associated with positive TB findings. Participants that had acquired formal education had a 85% less likelihood of having positive TB results in comparison with those haying no formal education, aOR =0.15, 95%CI: 0.04 — 0.50, P=0.002. Respondents with smoking history were four times likely to have positive TB results compared to those who had no such history (aOR = 4.03, 95% CI: 1.17 — 13.96, P =0.028). Those with history of illegal drugs abuse had five times likelihood of having positive TB results compared to those who were not using any illegal drugs (aOR =4.82, 95%CI: 1.02- 22.7, P =0.047). This study recommends a systematic and continuous TB and HIV surveillance. This will inform infection prevention interventions, use of urine LF-LAM as a simple and inexpensive tool for TB in routine active TB case tracing, and TB control programs. The program design will focus on public health education and behavior change, among smokers and illegal drugs users in Shimo La Tewa Maximum Security Prison and beyond.Item Multidrug-Resistant Gram-Negative Bacterial Infections, Risk Factors, and Outcome among Patients Admitted to Intensive Care Unit at Nairobi West Hospital, Kenya(Kenyatta University, 2024-04) Maina, Jane WairimuEmergence and global spread of Gram-negative bacteria (GNB) exhibiting carbapenem-resistance pose a critical public health concern since infections with these bacteria are difficult to treat, and results in increased morbidity and mortality among patients admitted in the intensive care unit (ICU). However, current epidemiological data on the circulating carbapenem-resistant pathogens to inform infection prevention and control programs in accordance with Global Action Plan on antimicrobial resistance (AMR) is limited in most Sub-Saharan African countries. This research intended to determine the spectrum of the multidrug-resistant Gram-negative bacterial infections, risk factors for acquisition and outcome among ICU-admitted patients at Nairobi West Hospital, Kenya. A descriptive cross-sectional study design was adopted and 162 patients purposively recruited based on clinical presentation suggestive of bacterial infection, as judged by the on-duty clinician. Participants with positive GNB culture were followed for 30 days to determine the ICU admission outcome (death or discharge). Patients' socio-demographic data, medical history and clinical data were gathered using case report forms and a well-structured questionnaire. Urine, pus swabs, tracheal aspirates, ascetic tap, sputum, stool, throat swab, and blood samples were collected based on the patient’s clinical presentation and transported to the hospital microbiology laboratory for processing following standard bacteriology methods. Isolation of bacteria was done on selected media, while identification and antibiotic susceptibility was done using BD PHOENIX M50 (BD, USA). Analysis of AST was based on CLSI standards (2022). Overall, 55.6% (90/162) GNB prevalence was observed. Thirteen GNB pathogens were isolated, with Escherichia coli (33.3%) being the most prevalent isolate followed by Klebsiella pneumoniae (31%), Pseudomonas aeruginosa 14.4 % and Acinetobacter baumannii (5.6%). The most predominant infection was urinary tract infections (UTI) (35/90, 39%) commonly caused by E. coli (18/35, 51%). Carbapenem resistance was highest among non-fermenting GNB (60% to 100%), including P. aeruginosa and A. baumannii, whereas among Enterobacteriaceae the dominating pathogen was Klebsiella pneumoniae (46% to 54%) followed by Escherichia coli (10% to 27%). Multidrug-resistance (MDR) was observed among 92 % of the isolates, with E. coli (27/30, 90%) being the most frequent, then K. pneumoniae (25/28, 89.3%), and P. aeruginosa (13/13, 100%). The only non-MDR bacterial pathogen isolated was Salmonella typhi. Those at increased risk of GNB infection were patients: referred from other hospitals (cOR = 2.23, p = 0.025), had prior usage of antibiotics (aOR = 4.23, p =0.001), using feeding tubes (aOR = 3.04, p = 0.013), suffered respiratory tract infections (RTI) (aOR = 5.3, p= 0.005), and with cardiovascular conditions (CVD) (aOR = 5.7, p = 0.024). Patients at increased risk of death during ICU admission were those with respiratory tract infections (aOR = 13.6, p = 0.015) and those referred from other healthcare facilities (cOR = 2.26, p = 0.039). This study findings underscores the importance of culture-based diagnosis and antibiotic susceptibility testing for rationale antibiotic prescription among ICU admitted patients, strict implementation of comprehensive infection control measures, routine screening of MDR carriage among the high-risk individuals, and continuous AMR surveillance as per Global action plan, in the current study setting and beyondItem Biochemical Markers Analysis for Sars-Cov-2 Infected Patients in Kakamega County, Kenya(Kenyatta University, 2024-07) Njue, Gatavi LilianAims and objectives: Severe Acute respiratory syndrome corona virus 2(SARS-CoV-2) is a type of coronavirus that first emerged in Wuhan, China late 2019. Once this virus infects any person, it causes Coronavirus disease 2019 (COVID-19) capable of causing death. Since then, hundreds of thousands of deaths have been reported as a result of COVID-19 globally. It is critical to detect the people with the potential of becoming very sick with COVID-19 early enough in order to save their lives by testing blood for certain chemicals known as biomarkers. This study aimed to determine biochemical markers in SARS-COV-2 infected patients in Kakamega County, Kenya. The Selected biochemical markers LFT, RFT, electrolytes, blood glucose level C-reactive protein (CRP), lactate dehydrogenase (LDH), were also evaluated for correlation with disease severity. Materials and methods: A cross-sectional study was conducted on 350 patients with COVID 19 attending Kakamega County general teaching and Referral Hospital. Ethical approval was sought from Kenyatta University Ethical and research committee and permission was obtained from Kakamega county general teaching and referral hospital administration. Socio-demographic, clinical characteristics of covid-19 among admitted patients in Kakamega Country Referral hospital was collected using a questionnaire. Five (5ml) of venous blood was collected and analyzed using standard hematological parameters profile, assessment of liver, renal and cardiac functions tests and evaluation of High-sensitivity C-Reactive protein. Results: A total of 350 patients were enrolled in the study. Majority of the participants were male (52.9%, 185/350) while 165(47.1%) were female. Out of the 350 patients recruited, 296 (84.6%) were Covid-19 positive while 44 (15.1%) were negative. This indicated a high prevalence of 84.6% of Covid-19 among patents who attended the facility during the study period. Data presentation was done using tables and figures and analyzed using formula of Le and Boen, Chi square and Correlation tests. Conclusions: Out of the 350 patients recruited, 296 (84.6%) were Covid-19 positive while 44 (15.1%) were negative. This indicated a high prevalence of 84.6% of Covid-19 among patents who attended the facility during the study period. Biochemical markers of the liver (ALT, AST), Total bilirubin, blood protein were elevated among Covid-19 positive patients, while albumin was low among Covid-19 negative patients.Item Determinants of Access to Comprehensive Care Centre Services among Hiv/Aids Patients in Mandera County, Kenya(Kenyatta University, 2024-09) Ibrahim, Abdi MaalimHuman immunodeficiency virus (HIV) is a major public health problem in many parts of the world. Kenya has the fourth-largest HIV epidemic in the world. Mandera County is part of north eastern province of Kenya. The county has poor infrastructure and inaccessible health facilities. Only 30% of the residents live around a health facility. The County has low HIV testing prevalence with residents associating HIV with immorality and highly stigmatized. Retention to ART care is 68% against the national target of 90%. The County has only 10 CCC distributed within 7 sub-counties serving a population of 867,457. The main objective of the study was to determine the determinants related to access of CCC services among HIV/AIDS patients in Mandera County. The study was cross-sectional which involved interviewing patients in Mandera County using a structured questionnaire. It was carried out between August and October 2021 and participants were recruited from five CCC in Mandera East sub county. The interviewees were picked randomly from CCC patients visiting the hospital and those defaulted. The data was entered in a data collection form and analyzed using SPSS version 20 under strict ethical considerations to ensure patients’ confidentiality were safeguarded. Descriptive statistics included frequencies and percentages while inferential statistics included cross tabulations and chi square tests for associations testing of the independent against dependent variables. The chi-square was tested at p≤0.05 significance level. Results revealed that most of the respondents 38.7% aged between 35-39 years out of 336 respondents, 60.4% were male, 44.1% were married, 33.9% had secondary level of education, 75.9% had informal occupation and 84.8% were from Mandera East Sub-County. There was a significant relationship between age group P<.001, level of education P<.001, occupation P<.001, residence P=0.048, source of income P<.001, employment status P<.001, nature of employment P<.001, category of earning P<.001, means of transport to the facility P<.001, healthcare workers’ attitude P=0.023, provision of incentives P=0.002, compliance to instructions P<.001, perceived stigma from healthcare workers P=0.01 and access to CCC services in Mandera County. It is concluded that there is significant relationship between determinants and access to CCC services therefore it recommended that the determinants affecting access that can be modified and corrected by the healthcare workers at the facility level like stigma, attitude and provision of incentives to be corrected in order to increase access to CCC services in Mandera County. The County to formulate policies in conjunction with the national government and implementing partners on the ground to address and formulate targeted interventions.Item Biochemical Markers Analysis for Sars-Cov-2 Infected Patients in Kakamega County, Kenya(Kenyatta University, 2024-07) Njue, Gatavi LilianAims and objectives: Severe Acute respiratory syndrome corona virus 2(SARS-CoV-2) is a type of coronavirus that first emerged in Wuhan, China late 2019. Once this virus infects any person, it causes Coronavirus disease 2019 (COVID-19) capable of causing death. Since then, hundreds of thousands of deaths have been reported as a result of COVID-19 globally. It is critical to detect the people with the potential of becoming very sick with COVID-19 early enough in order to save their lives by testing blood for certain chemicals known as biomarkers. This study aimed to determine biochemical markers in SARS-COV-2 infected patients in Kakamega County, Kenya. The Selected biochemical markers LFT, RFT, electrolytes, blood glucose level C-reactive protein (CRP), lactate dehydrogenase (LDH), were also evaluated for correlation with disease severity. Materials and methods: A cross-sectional study was conducted on 350 patients with COVID 19 attending Kakamega County general teaching and Referral Hospital. Ethical approval was sought from Kenyatta University Ethical and research committee and permission was obtained from Kakamega county general teaching and referral hospital administration. Socio-demographic, clinical characteristics of covid-19 among admitted patients in Kakamega Country Referral hospital was collected using a questionnaire. Five (5ml) of venous blood was collected and analyzed using standard hematological parameters profile, assessment of liver, renal and cardiac functions tests and evaluation of High-sensitivity C-Reactive protein. Results: A total of 350 patients were enrolled in the study. Majority of the participants were male (52.9%, 185/350) while 165(47.1%) were female. Out of the 350 patients recruited, 296 (84.6%) were Covid-19 positive while 44 (15.1%) were negative. This indicated a high prevalence of 84.6% of Covid-19 among patents who attended the facility during the study period. Data presentation was done using tables and figures and analyzed using formula of Le and Boen, Chi square and Correlation tests. Conclusions: Out of the 350 patients recruited, 296 (84.6%) were Covid-19 positive while 44 (15.1%) were negative. This indicated a high prevalence of 84.6% of Covid-19 among patents who attended the facility during the study period. Biochemical markers of the liver (ALT, AST), Total bilirubin, blood protein were elevated among Covid-19 positive patients, while albumin was low among Covid-19 negative patients.Item Diversity and Endosymbionts of Tick Borne Pathogens at Human-Wild Life Livestock Interfaces in Coastal National Reserves, Kenya(Kenyatta University, 2024-04) Godani, Salim KoboTicks are vectors that can harbor pathogens like viruses, protozoa, and bacteria that can cause zoonotic diseases in humans. Human gets infected through tick bites where the pathogens are passed into the human blood. The lack of surveillance information about tick-borne pathogens and diseases has made it impossible to assess its impact on human and livestock. This study determined the diversity and endosymbionts of tick borne pathogens at human-wild life livestock interfaces in coastal national reserves, Kenya. Ticks were collected from both near Tsavo National Reserve in Taita Taveta County and Shimba hills national gane reserves in Kwale County using sterile forceps from restrained cattle and detected morphologically with the aid of morphological keys. Representative of the morphologicaly identified ticks were molecularly identified. Identity as well as characterization of pathogens carried by ticksand endosymbionts was done by Anaplasma, Ehrlichia, and Rickettsia specific RT-PCR product sequencing and HRM analysis.The sum of 317 (281 adult ticks and 36 nymphs) was sampled near Tsavo National Reserve, which includes seven species. Amblyomma was the most sampled genus withAmblyomma gemma being the most sampled species (n=135, 42.6%). Another Amblyomma species sampled was Amblyomma Variegatum (n= 40, 12.62%). Greatest species diversity was identified in Rhipicephalus genus with four species identified that includes; Rhipicephalus appendiculatus (n=44, 13.9%), Rhipicephalus Averts (n=1, 0.31%), Rhipicephalus Decoloratus (n=5, 1.6%), Rhipicephalus Pulchellus (n= 91, 28.7%). A single species of Hyalomma sp. was sampled. From near Shimba Hill game reserve (SHNR), a total of 240 adult ticks were sampled comprises of eight species. Amblyomma was the most sampled genus and againAmblyomma gemma was the most sampled species (n=156, 65 %). Other Amblyomma species sampled includes; Amblyomma Lepidum (n= 5, 2.1 %), Amblyomma Variegatum (n= 15, 6.3 %). Greatest species diversity was also identified in Rhipicephalus genus with four species identified that includes; Rhipicephalus appendiculatus (n=18, 7.5 %), Rhipicephalus Averts (n=6, 2.5 %), Rhipicephalus Decoloratus (n=4, 1.7 %), Rhipicephalus Pulchellus (n= 34, 14.2 %). The least sampled species was a single species of Hyalomma Scupense (n=2, 0.83 %). At near Tsavo National Reserve (TNR), a total of three pools of Rhipicephaline appendiculatus were positive for Theileria parva, two pools of Rhipicephaline evertsi for Anaplasma platys, and one pool of Amblyomma variegatum nymphs for Rickettsia africae. From near Shimba Hill game reserve (SHNR), , Rickettsia africae pathogen was detected in two pools of Am. variegatum and one pool of Am. Gemma. Rickettsia sp. and Anaplasma sp. were detected in Am. Gemma and Rh. evertsi respective. R. aeschlimannii was isolated in a pool of Am. Gemma.Coxiella spp.endosymbionts were detected in Rhipicephalus ticks in both study area. Robust vector surveillance and biological control programs against ticks should be emphasized in both Tsavo and Shimba Hills National Reserves. Biological control mechanisms for tick endosymbionts should be encouraged for employment as a tick control methods due to their ability to limit vector competency.Item Determination of Diagnostic Predictors of Prostate Cancer among Patients Attending Garissa County Referral Hospital, Kenya(Kenyatta University, 2024-01) Mukaa, Januaris MwanthiProstate malignancy refers to a type of cancer that occurs on glandular cells of the prostate gland. It can also occur in other tissues when the cancer cells break away and travel through the blood vessels and lymphoid tissues. The latter is referred to metastatic Prostate Cancer. The disease is prevalent among old men with average age of 60 years. Prostate cancer needs early diagnosis to enable prevention of high mortality and morbidity associated with the disease. Early initiation of treatment is associated with reduced morbidity and mortality hence a need for easily accessible and reliable detection method. Prostatic specific antigen test is nonspecific hence delaying intervention while Confirmatory test (histopathology) is invasive and expensive. The study was aimed at investigating other predictors of prostate cancer in urine that can be an alternative to PSA or be interpreted together with PSA to offer an alternative confirmatory diagnosis instead of histopathology. Such predictors include sarcosine and zinc. Using a cross-sectional study design, all suspected cases of prostate cancer that were found during the study period based on clinical assessment were chosen. In plastic tubes, a volume of roughly 10 milliliters of midstream urine was collected. After centrifuging the urine and collecting the supernatant, zinc and sarcosine levels were measured. The levels of the urinary sarcosine and zinc was compared between study units who developed positive confirmatory test and those whose results are negative for confirmatory test. The collected numerical data was entered into a Microsoft Excel spreadsheet and then imported into the statistical package for social science (SPSS), where it was displayed as the mean, standard error of mean, and +/-standard deviation. The independent t test and analysis of variance (ANOVA) were used to compare the means and standard deviations across different age groups. Predictability of the analytes for the prostate cancer was determined using chi-square. Level of significance was set at 95% i.e., <0.05% for all comparisons. Prostate cancer patients' mean zinc concentration (0.98µmol/ml) was significantly lower than that of control participants (6.20µmol/ml; p<0.001). The age groups of prostate cancer patients showed that the zinc concentration used in the calorimeter to diagnose prostate cancer did not significantly differ. (p = 0.85). However, among control participants, there was no discernible variation in zinc concentration (p=0.11). Additionally, an ELISA test revealed that the sarcosine concentration (4.30±0.11 nmol/ml) in participants with prostate cancer was significantly higher than the control group's (0.47±0.06 nmol/ml) concentration (p<0.001). Using ELISA, there was no discernible difference in the age groups of the prostate cancer patients' sarcosine concentration (p=0.57). Sarcosine concentrations did not differ significantly between the age groups of the control subjects (p=0.17). The ELISA and calorimetric diagnosis results for sarcosine and zinc showed a significant difference between reality and the values for sensitivity, specificity, and predictability (p<0.001). The sensitivity of prostate cancer diagnosis using sarcosine ELISA and zinc calorimetric was 93.9% respectively while the specificity for both zinc and sarcosine was 100%. Both zinc and sarcosine recorded a positive predictive value of 100% and a negative predictive value of 93.5%. County governments need to allocate funds for diagnostic facilities to ease the burden of diagnosis. Future researchers should investigate other metabolites to supplement zinc and sarcosine in the diagnosis of prostate cancer.Item Development, Stability Testing, and Performance of Xpert MTB/RIF Proficiency Testing Material in National Tuberculosis Reference Laboratory, Nairobi City County, Kenya(Kenyatta University, 2024-01) Nganga, Margaret WairimuSystematic and ongoing proficiency testing (PT) program is a fundamental element of external quality assurance in diagnosis of TB using Xpert MTB/RIF assay. In many resource-limited setting, particularly in Kenya, PT is poorly covered and largely inconsistent following inadequate supply of dried tube specimens (DTS). This has serious negative implications on patients‘ management and TB control programs. The aim of this study was to develop, assess stability and performance of local DTS panels for Xpert MTB/RIF assay PT in Kenya. This study was conducted at the National Tuberculosis Reference Laboratory (NTRL) and DTS piloting was done in Xpert MTB/RIF sites in Nairobi City County. An experimental study design was adopted to develop and assess stability DTS panels, and a cross sectional study design was adopted to pilot panels. The piloting sites were purposively selected to include all the twenty (20) TB diagnostic laboratories that were using Xpert machine in Nairobi City County, from August 2019 to December 2019.Bacterial strains stored in a -80oC freezer at the NTRL were retrieved and processed following standard bacteriological procedures. The strains were sub-cultured in liquid culture media (MGIT), growth detected by the BACTEC® MGIT 960® system, and their purity confirmed. Bacterial cultures were then heat-inactivated and pre-tested using Xpert MTB/RIF assay before preparing DTS. To assess the effect of drying on the stability of DTS panels, DTS panels were left uncapped inside a biosafety cabinet for 7, 10, and 14 days, and immediately subjected to Xpert MTB/RIF assay. In assessing the stability of the DTS panels at various temperatures as anticipated in TB diagnostic laboratories that use Xpert machine across the Kenya, 36 DTS panels from 7, 10, and 14 days drying periods were held at 18oC, 20oC, 24oC, 33oC, and 40oC for 12 weeks, and subjected to Xpert MTB/RIF weekly. For piloting, a set of 5DTS panels, 5 disposable sterile dispensing pipettes, processing instructions, and PT results evaluation form were delivered to the targeted piloting sites in a sealable transparent bag for testing by the Xpert MTB/RIF personnel who printed the results, entered them into the reporting form, and a scanned image send to the principal investigator for analysis. Data were analyzed using STATA v17 and variables were summed up in medians, interquartile range, means, and standard deviation (SD). Each of the five pilot DTS panels was assigned an accuracy score of 20 points, and individual laboratory scores as follows; incorrect determination of either MTB detection (0 points), unsuccessful result (error, invalid, or no results) (5 points), RIF-indeterminate result (10 points), and correct determination of both MTB detection and RIF resistance (20 points). Total scores for each laboratory were computed, with 100% being considered Excellent, ≥80% Satisfactory, and <80% Unsatisfactory. The DTS panels‘ probe A Ct values were within the expected mean range (16-23) and SD limit (≤3), with100% concordance between those dried for 7, 10 or 14 days and the pretest results. Except for DTS panels held at -80oC, the probe A mean Ct values of panels dried for 7 and 14 days increased with increasing temperature (from -20oC to 40oC) during the 12 weeks‘ study period (p= <0.001), with the greatest mean Ct value increment was at 40ᵒC.Ninety-five per cent (18/20) of piloted laboratories reported the expected, with 10% (2/20) of sites giving discordant results, false MTB detection (5%, 1/20) and error (code 5007) (5%, 1/20). 90% (18/20) of the piloted sites had satisfactory, 80% had excellent, and 10% (2/20) had unsatisfactory results. This study recommends adoption of 7-day DTS drying period, -80oC and 40oC storage up to 2 weeks, and up scaling DTS production for proficItem Relationship between Impaired Electrolytes, Glycated Hemoglobin and Poor Adherence to Antidiabetics among Patients Attending Samburu County Referral Hospital, Kenya(Kenyatta University, 2024-06) Lengeiya, Francis LengasuType 2 Diabetes mellitus is a persistent metabolic disorder that can have devastating effects on patients, resulting in numerous healthcare challenges in terms of its management and the associated cost burden. Adherence to antidiabetics has been consistently sub-optimal in previous studies and remains a significant clinical issue in the management of diabetes. Patients having uncontrolled blood glucose levels often exhibit electrolyte imbalance which greatly influences their treatment. Glycated hemoglobin test, assessing average blood glucose levels over a period of roughly three months, is widely regarded as the gold standard for diagnosing diabetes. The aim of this research was to study the relationship between electrolytes and glycated hemoglobin among diabetic patients with poor adherence to antidiabetics. The study was carried out at Samburu County Referral Hospital, employing a descriptive cross-sectional study design and convenience sampling technique involving adult diabetic patients aged 18 years and above who attended the diabetic clinic. Seventy-two patients, (48.6% females, 51.4% males) who were on antidiabetics for at least three months and demonstrated poor adherence, participated in the study. Adherence levels were assessed using the Morisky Medication Adherence Scale-8. Those with adherence scores <6 was categorized as having low adherence and further assessed using a questionnaire to identify factors contributing to poor adherence to antidiabetics. Blood samples were collected to measure glycated hemoglobin levels and serum electrolytes levels, including potassium, sodium, calcium, magnesium, phosphorus, and chloride. Serum electrolytes were analyzed using the Selectra Prom biochemistry analyzer while glycated hemoglobin levels were measured using the standard F200 HbA1c analyzer. The relationship between electrolytes and glycated hemoglobin was visualized using scatter plots, and correlation coefficients were determined using the Karl Pearson correlation method. Several factors contributing to poor adherence were identified, with lack of money to buy drugs being the most frequently reported factor (69%) among study participants. A significant correlation was observed between glycated hemoglobin and calcium (r=-0.2398 P ≤0.05) as well as sodium (r=-0.31369 P≤0.05). However, no significant correlation (P≥0.05) was observed between phosphorus, magnesium, chloride and potassium r=, -0.04, -0.07,0.05 and -0.01 respectively, with HbA1c levels. This study revealed that calcium and sodium electrolytes imbalances were significantly present in diabetic patients with poor adherence to antidiabetics. Therefore, routine monitoring of serum electrolytes levels among diabetic patients is paramount. The results highlight the importance of comprehensive diabetes management strategies that address both glycemic control and electrolyte status. The findings from this study can inform policy makers on ways to enhance management of Type 2 Diabetes mellitus as well as inform into causes of non-compliance with antidiabetic medications.Item Molecular Diversity of Hepatitis B Virus in HIV Infected Patients at Mbagathi District Hospital, Nairobi City County.(Kenyatta University, 2024-06) Khaemba, Samuel BarasaWith increasing access to antiretroviral therapy (ART) across Sub-Saharan Africa, HIV-infected individuals live longer and are frequently co-infected with HBV due to similar transmission routes. Persons with Hepatitis B Virus and HIV dual-infection advance more swiftly to end-stage hepatic disease. With 8-15% genomic divergence by DNA sequence, HBV is currently classified into 10 genetic variants, from A to J with numerous subtypes. HBV genotypes have been clarified as influencing the clinical outcome of the chronic disease in hosts. Considering paucity of data on HBV genotypes among HBV/HIV co-infected individuals in Kenya and the significance of HBV variants in antiretroviral therapy response, a cross-sectional study on the molecular diversity of Hepatitis B virus genotypes and the risk factors among HIV infected patients in Kenya was undertaken. The systematic random sampling was used to recruit 180 HIV seropositive male and female individuals attending routine CD4+ T-lymphocyte and viral load laboratory monitoring. A structured questionnaire was administered to capture socio-epidemiological data while an ELISA for qualitative testing of HBsAg in human serum was used and HBV DNA was extracted from 9 HBsAg seropositive samples and HBV genotypes established in 5 nucleic acids by nested-PCR of pre-S gene, direct sequencing and phylogenetic tree clustering. The HBV prevalence was found to be 5.0% serologically and 2.8% by PCR. Drug injection, heavy alcohol consumption, low use of protection during sexual intercourse and increased frequency of sexually transmitted infections were found to be direct risk factors for increased HBV infection. This study reveals that HBV genotype A1 (60%) and D (D6 and D7) were the most prevalent and they showed very low genetic diversity. In addition, these strains indicated very close phylogenetic relationship to those isolated from Sudan, S. Africa, Botswana and Tunisia. The five isolate genotypes were found to have susceptible mutations in S gene for Lamivudine, Adefovir, Entecavir and Tenofovir. In conclusion, the HBV/A1 was predominant variant and this imply the possibility of increased incidence of the HBV genotype A1 in Kenya and indeed across the region due to increased migration and regional interaction of human populationsItem Reproducibility and Stability of Stabilization Agents for Cd4 Cells Storage in HIV Positive Samples at Kilifi County Referral Hospital, Kenya(Kenyatta University, 2023-03) Nella, Raphael Kalama; Margaret Muturi; Scholastica MathengeAbstractItem Lipid Profiles Cardiovascular Disease AND Dyslipidemia in HIV Positive Patients in Machakos level 5 hospital Machakos, Kenya(Kenyatta University, 2023-10) Syengo, Sarah M; Scholastica G Mathenge and Nelson C MenzaHuman Immunodeficiency Virus infection is a worldwide pandemic that has been controlled and managed through the use of highly active antiretroviral therapy drugs. However, long-term use of antiretrovirals is linked with dyslipidemia and cardiovascular disease, which are major issues for public health. In developing countries such as Kenya, there is a gap in knowledge regarding the prevalence of dyslipidemia and risk of cardiovascular disease among persons on antiretroviral medication who have the Human Immunodeficiency Virus. Thus, this study determined the lipid profiles, the prevalence of dyslipidemia, the likelihood of acquiring cardiovascular disease, and the risk factors associated with dyslipidemia and cardiovascular disease in people who are positive for the Human Immunodeficiency Virus on antiretrovirals. The research was undertaken at Machakos Level V Hospital, Machakos County, Kenya for four months. The study applied a cross- sectional design. Systematic sampling was used to choose 406 study participants living with the Human Immunodeficiency Virus on antiretrovirals. Blood samples were obtained from each participant, and the serum obtained was used for the lipid profile test. The results were then used to determine the prevalence of dyslipidemia for the study participants. The study also applied the Framingham Risk Score in assessing cardiovascular disease risk in the next ten years. The Framingham Risk Score was based on seven coronary risk aspects: high-density lipoprotein, total cholesterol, age, sex, systolic blood pressure, time on antiretrovirals, and cigarette smoking. The risk factors were collected through structured questionnaires. Data on the lipid profiles, Framingham risk score, and prevalence of dyslipidemia and cardiovascular risk alongside assessed risk factors were presented using tables. A bivariable analysis was conducted to identify significant exposure variables linked to dyslipidemia and cardiovascular disease. Multivariate analysis was conducted, including exposure variables with p < 0.2. The findings showed that the total cholesterol to high-density lipoprotein cholesterol ratio was significantly linked with antiretroviral regimens p<0.05. Those using protease inhibitors were 4 times more expected to have a high ratio than those using non-nucleoside reverse transcriptase inhibitors (OR = 4.19), 95% CI: 1.03 - 17.02, p<0.05. Based on the Framingham Risk Score, 289(71.2%) had low cardiovascular disease risk, 75(18.5%) had moderate risk, 40(9.8%) had moderately high risk while 2(0.5%) had high risk. The results established that age, low high-density lipoprotein, cigarette smoking, and high systolic pressure were significantly linked with a high Framingham Risk Score (p<0.001). Gender and duration on Highly Active Antiretroviral Therapy were also significantly linked with a high Framingham Risk Score (p=0.001). High total cholesterol values were not significantly linked with a high Framingham Risk Score (p=0.313). The general occurrence of dyslipidemia in the study was 74.1%, with 301 participants having dyslipidemia. The findings showed that age was significantly linked with dyslipidemia (p = 0.005). High systolic pressure was significantly linked with dyslipidemia (p=0.049). Hypertension was significantly linked with dyslipidemia (p<0.001). Gender, age, high systolic pressure, history of hypertension, cigarette smoking, and cardiovascular disease family history were significantly linked with the risk of developing cardiovascular disease (p<0.001). Diastolic pressure was not statistically significant (p = 0.861). People living with the Human Immunodeficiency Virus on antiretrovirals are still at a high risk of developing dyslipidemia and cardiovascular disease. The study offered information that will inform the policymakers on better approaches to employ in addressing the health outcomes for people living with the Human Immunodeficiency Virus under treatment with antiretrovirals while addressing the cardiovascular diseases that may be confounding by the use of antiretrovirals.Item Multidrug-Resistant Acinetobacter Baumannii among Patients Admitted to Intensive Care Unit at Moi Teaching and Referral Hospital, Uasin Gishu County, Kenya(Kenyatta University, 2023-11) Kipsang, Fred; Abednego Musyoki; Nelson MenzaAbstractItem Spectrum, Antimicrobial Susceptibility Profiles, and Molecular Characteristics of Bacterial Pathogens from Severely Ill Covid-19 Patients in Kenyatta National Hospital, Kenya(Kenyatta University, 2023-06) Mutua, Jeniffer Munyiva; Abednego Musyoki; John Mwaniki njeruBacterial infections are among the leading causes of morbidity and mortality among patients with viral respiratory infections. Because distinguishing between viral and bacterial pneumonia based on clinical presentation can be challenging and bacterial pathogens’ epidemiology varies geographically, Coronavirus Disease 2019 patients are prescribed antibiotics frequently, even without laboratory-based evidence of bacterial infection. This has a serious negative implication on antimicrobial resistance situation that is expected to worsen, causing a staggering number of 10 million fatalities and economic setback of 100 billion USD by 2050. Information on bacterial infections among Coronavirus Disease 2019 patients in many developing nations, including Kenya, is limited. This study aimed to determine the spectrum, antimicrobial susceptibility profiles and molecular characteristics of pathogenic bacteria among patients with COVID-19 at Kenyatta National Hospital, Kenya. The research utilized an analytical cross-sectional study design and a total of 120 participants purposively recruited among laboratory-confirmed severely ill Coronavirus Disease 2019 patients who gave informed consent through a legally authorized representative. Socio-demographic, clinical and outcome data were gathered using case report forms and structured sample collection forms. Nasopharyngeal and oropharyngeal swabs, tracheal aspirates and blood samples were collected, transported to KNH microbiology laboratory, and analyzed following the standard bacteriological methods. Bacterial isolation was done on selected culture media, whereas isolates identification and susceptibility testing were done using MALDI-TOF (VITEK ® MS) and VITEK® 2 COMPACT system, respectively. The AST data was interpreted based on 2021 CLSI standards. The screening for ESBLproduction was conducted using the Double-Disc Synergy Tests, which was subsequently confirmed through Phenotypic Confirmatory Disc Diffusion Test. ESBL-resistant genes were PCR-detected from all ESBL-producers at the Centre for Microbiology Research, KEMRI. An overall prevalence of 44.2% (53/120) bacterial infections was found among the study participants, with a 31.7% (38/120) mortality rate. Isolates of Gram-negative bacteria (GNB) exhibited greater prevalence, (73.1%, 49/67). Majority (69.6%, 32/46) of multidrug resistant (MDR) bacteria were GNB. K. pneumoniae (45.5%, 15/33) was the dominant ESBL producer and most of MDRGNB harboring the TEM (83%, n=10/12) and SHV resistance gene (100%, n=7/7) were resistant to beta lactamase inhibitors including amoxicillin/clavulanate but susceptible to piperacillin/tazobactam (60%, n=6/10). Male patients were more likely to have bacterial infections (aOR = 2.61, 1.2 – 5.65), including those caused by ESBL producing bacteria (aOR=0.21, 0.06 - 0.68). Individuals with pre-existing comorbidities were found to have a five-fold increased likelihood of harboring ESBLproducing bacteria (cOR=5.46, 1.37 - 21.67). Patients: aged 25 to 44 years (aOR = 0.13, 0.02 – 0.6), hospitalized in the IDU ward (aOR=3.27, 1.08– 6.89), vaccinated for Coronavirus Disease 2019 (aOR = 0.2, 0.05 – 0.83) and hospitalized for short duration (0 -5 days) (aOR=14.28, 3.25 - 62.76) had a positive hospitalization outcome. These results highlight a significant burden of bacterial infections among Coronavirus Disease 2019 patients, with males at higher risk. Those: not vaccinated, admitted to CCU, aged over 60 years, and with pre-existing comorbidities had poor outcome. There is urgent need for systematic and continuous AMR surveillance at KNH and beyond to inform prevention interventions in accordance with national and global action plans.Item Lipid Profiles, Cardiovascular Disease Risk and Dyslipidemia in HIV-Positive Patients on HAART at Machakos Level Five Hospital, Machakos County, Kenya(Kenyatta University, 2023-10) Syengo, Sarah Malinda; Scholastica G. Mathenge; Nelson C. MenzaHuman Immunodeficiency Virus infection is a worldwide pandemic that has been controlled and managed through the use of highly active antiretroviral therapy drugs. However, long-term use of antiretrovirals is linked with dyslipidemia and cardiovascular disease, which are major issues for public health. In developing countries such as Kenya, there is a gap in knowledge regarding the prevalence of dyslipidemia and risk of cardiovascular disease among persons on antiretroviral medication who have the Human Immunodeficiency Virus. Thus, this study determined the lipid profiles, the prevalence of dyslipidemia, the likelihood of acquiring cardiovascular disease, and the risk factors associated with dyslipidemia and cardiovascular disease in people who are positive for the Human Immunodeficiency Virus on antiretrovirals. The research was undertaken at Machakos Level V Hospital, Machakos County, Kenya for four months. The study applied a cross-sectional design. Systematic sampling was used to choose 406 study participants living with the Human Immunodeficiency Virus on antiretrovirals. Blood samples were obtained from each participant, and the serum obtained was used for the lipid profile test. The results were then used to determine the prevalence of dyslipidemia for the study participants. The study also applied the Framingham Risk Score in assessing cardiovascular disease risk in the next ten years. The Framingham Risk Score was based on seven coronary risk aspects: high-density lipoprotein, total cholesterol, age, sex, systolic blood pressure, time on antiretrovirals, and cigarette smoking. The risk factors were collected through structured questionnaires. Data on the lipid profiles, Framingham risk score, and prevalence of dyslipidemia and cardiovascular risk alongside assessed risk factors were presented using tables. A bivariable analysis was conducted to identify significant exposure variables linked to dyslipidemia and cardiovascular disease. Multivariate analysis was conducted, including exposure variables with p = ≤ 0.2. The findings showed that the total cholesterol to high-density lipoprotein cholesterol ratio was significantly linked with antiretroviral regimens p<0.05. Those using protease inhibitors were 4 times more expected to have a high ratio than those using non-nucleoside reverse transcriptase inhibitors (OR = 4.19), 95%CI: 1.03 - 17.02, p<0.05. Based on the Framingham Risk Score, 289(71.2%) had low cardiovascular disease risk, 75(18.5%) had moderate risk, 40(9.8%) had moderately high risk while 2(0.5%) had high risk. The results established that age, low high-density lipoprotein, cigarette smoking, and high systolic pressure were significantly linked with a high Framingham Risk Score (p<0.001). Gender and duration on Highly Active Antiretroviral Therapy were also significantly linked with a high Framingham Risk Score (p= 0.001). High total cholesterol values were not significantly linked with a high Framingham Risk Score (p= 0.313). The general occurrence of dyslipidemia in the study was 74.1%, with 301 participants having dyslipidemia. The findings showed that age was significantly linked with dyslipidemia (p = 0.005). High systolic pressure was significantly linked with dyslipidemia (p =0.049). Hypertension was significantly linked with dyslipidemia (p<0.001). Gender, age, high systolic pressure, history of hypertension, cigarette smoking, and cardiovascular disease family history were significantly linked with the risk of developing cardiovascular disease (p = <0.001). Diastolic pressure was not statistically significant (p = 0.861). People living with the Human Immunodeficiency Virus on antiretrovirals are still at a high risk of developing dyslipidemia and cardiovascular disease. The study offered information that will inform the policymakers on better approaches to employ in addressing the health outcomes for people living with the Human Immunodeficiency Virus under treatment with antiretrovirals while addressing the cardiovascular diseases that may be confounding by the use of antiretrovirals.