RP-Department of Environmental Health

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Role of Attitude in Influencing Compliance with Tuberculosis Infection Prevention and Control Guidelines among Healthcare Workers
(AJPHR, 2023) Wangari, Janeffer Muthoni; Mwangi, Emmah; Arodi, Washington Auma
Tuberculosis is a major occupational hazard among healthcare workers, not just in Kenya but globally due to consistent and routine exposure. This is especially true among the nurses and laboratory workers among the professional cadre who are regarded as high-risk groups for both Latent Tuberculosis Infection (LTBI) as well as active TB, with the lowest risk noted among the administrative staff. The escalated occupational cases were associated with poor implementation of the full hierarchy of IPCs as outlined by the World Health Organization (WHO), especially administrative control. This study was a cross-sectional study that was conducted at Kenyatta National Hospital and Mbagathi District Hospital, Nairobi County. Objective: The study sought to find out the influence of the attitude of HCWs on TB IPC guidelines in Kenyatta National Hospital and Mbagathi District Hospital. Materials and methods: The study adopted a descriptive cross-sectional community study design. The study utilized qualitative and quantitative research methods in order to obtain the required information from respondents. Quantitative data collection was done by use of semi-structured, self-administered questionnaires while qualitative data was collected through Key Informant Interviews (KII) and standardized observation checklists among Health Care Workers (HCWs), specifically nurses and laboratory staff. Confidentiality of information collected was observed and consent was sought from the respondents before collecting any form of information from them. A total of 38 nurses and 4 laboratory staff from Mbagathi District Hospital and 332 nurses and 32 laboratory staff from Kenyatta National were randomly selected (n=406). The response rate was 98% with 398 participants having completely and accurately filled and returned the questionnaires. The tools that the researcher used included questionnaires, interview schedules, pens and pencils. Descriptive data was analyzed with the aid of the Statistical Package for Social Sciences (SPSS) version 22.0 with the help of the Microsoft Excel program to generate frequency tables, graphs, and pie charts. Inferential statistics were calculated using Chi-Square tests (p=0.005) done at a 95% confidence level to determine the linkage between the Variables. Results: The attitude level was reported at 72.1% (good) with most respondents indicating that they had a higher risk of acquiring the infection and although they knew about the disease, they expressed concern about being infected while in the line of duty. Further, perceptional survey audits are conducted as random spot checks periodically to ensure that the staff attitude improves. Conclusion: The study findings revealed that there is a dire need to develop and implement a robust occupational health management system that takes cognizance of development and adherence to sensitization framework; accurate and prompt surveillance and reporting of TB; supportive legal framework; committed leadership; financial investment and strict/stringent measures in place to ensure compliance to set guidelines.
Factors Associated With the Injuries Inflicted To Workers in Slaughterhouses and Meat Processing Plants in Nairobi, Kenya
(IJCRLS, 2018) Makori, C.M; Warutere, P.N; Nguhiu, P.N.
Background: Slaughterhouse facilities and meat processing plants are known to pose significant threats to worker’s safety and health due to the hazardous conditions involving animals, tools and dangerous machines used in the meat industry. Objective: To investigate the types of injuries and associated factors experienced by workers in slaughterhouses and meat processing plants in the study area since the extent of this has an impact on the safety of the employees. Methodology: A total of 347 respondents were included in this study out of an estimated population of 2206 workers in slaughterhouses and meat processing plants in the study area. Information was obtained using structured questionnaires, Key informant Interviews and focused group discussions. Result: The types of injuries inflicted to these workers included wounds/superficial injuries (57.3%), bone fracture(7.5%), concussion, internal injury, burn, scald or frost bite(4.0%), poisoning, infection and suffocation (4.0%) and other types (8. 0%). Demographic factors had a significant influence on injury rates and so was the category of a slaughterhouse and processing plant. The level of implementation of Occupational Health and Safety Act (OSHA, 2007) determined the injury rates in these facilities. Overall, workers in Nairobi experienced very high injury rates (21.9 per 100 full-time workers). Conclusion: Demographic factors had an influence on incidence of injuries and the category of slaughterhouses and processing plants which again was closely linked with the level of compliance to OSHA, 2007.
Compliance with Tuberculosis Infection, Prevention and Control Guidelines among Healthcare Workers in Kenyatta National Hospital and Mbagathi District Hospital
(Science and Education Publishing, 2023) Wangari, Janeffer Muthoni; Mwangi, Emmah; Arodi, Washington Auma
Background: Tuberculosis is a major occupational hazard among healthcare workers, not just in Kenya but globally due to consistent and routine exposure. This is especially true among the nurses and laboratory workers among the profession cadre who are regarded as high-risk groups for both latent Tuberculosis infection (LTBI) as well as active TB, with the lowest risk noted among the administrative staff. The escalated occupational tb cases were associated to poor implementation of full hierarchy of IPCs as outlined by the World Health Organization (WHO) especially the administrative control. This study was cross sectional study which was conducted in Kenyatta National Hospital and Mbagathi District Hospital, Nairobi County. Objective: The study sought to determine the influence of socio-demographic factors on compliance to TB IPC guidelines among HCWs in Kenyatta National Hospital and Mbagathi District Hospital. Materials and methods: The study adopted a descriptive cross-sectional community study design. The study utilized qualitative and quantitative research methods in order to obtain the required information from respondents. Quantitative data collection was done by use of semi-structured, selfadministered questionnaires while qualitative data was collected through key informant interview (KII) and standardized observation checklist among Health Care Workers (HCWs), specifically nurses and laboratory staff. Confidentiality of information collected was observed and consent was sought from the respondents before collecting any form of information from them. A total of 38 nurses and 4 laboratory staff from Mbagathi District Hospital and 332 nurses and 32 laboratory staff from Kenyatta National were randomly selected (n=406). The response rate was 98% with 398 participants having completely and accurately filled and returned the questionnaires. The tools that the researcher used included questionnaire, interview schedule, pens and pencils. Descriptive data was analyzed with the aid of the Statistical Package for Social Sciences (SPSS) version 22.0 with the help of Microsoft Excel programme to generate frequency tables, graphs and pie-charts. Inferential statistics was calculated using Chi-Square tests (p=0.005) done at 95% confidence level to determine the linkage between the Variables. Results: There was no statistically significant association between marital status and compliance to TB-IPC guidelines (P=0.067) with the divorced more likely to comply with TB-IPC standards (OR=3.6, CI: 0.504, 25.323). The study findings further revealed that majority 171 (59.6%) of participants had a fair attitude and comply to TB-IPC guidelines (P=0.034). 245(61.6%) have a work experience of less than 2 years, followed by 142(35.7%) having worked three to five years with 11(2.8%) having worked over 5 years. There was a statistical association between the number of years worked and compliance to TB-IPC guidelines. According to the study findings, participants with good attitude levels are more likely to comply with TB-IPC guidelines (OR=1.688, CI: 1.15, 2.555). Conclusion: There is a dire need to develop and implement a robust occupational health management system that takes cognizance of: development and adherence to sensitization framework; accurate and prompt surveillance and reporting of TB; supportive legal framework; committed leadership; financial investment and strict/stringent measures in place to ensure compliance to set guidelines.
Analysis of Aflatoxin Levels in Broiler Chicken Feed from Selected Farms in Nairobi City County, Kenya
(Springer Nature Switzerland, 2023) Chepkosgei, Kirinyet Ruth; Njogu, Warutere Peterson; Purity, Nguhiu; Ojola, Patroba C; Joel, Kirinyet
Aflatoxin levels in animal feed should be observed from the farm to the table to ensure the safety of the feed to animals and humans. The contamination of cereals and other agricultural supplies used in animal feed production could happen in the farm in the pre-harvest phase or in the post-harvest phase. The study sought to determine Aflatoxin levels in broiler feed from selected farms in Nairobi City County. A total of 42 feed samples were collected. Samples were analyzed using the LCMS/MS technique. Results from the study show that Aflatoxin levels in broiler starter were; B1(17.26±3.07 ppb), B2 (2.44±0.84 ppb), G1 (8.87±2.41 ppb), G2 (0.9±0.44 ppb) and Total AF (29.47±6.13 ppb). Aflatoxin levels in broiler finisher were B1 (17.17±3.09 ppb), B2 (2.68±1.18 ppb), G1 (9.25±2.7 ppb), G2 (1±0.45 ppb) and Total AF (30.1±6.88 ppb). Results from analysis of feed samples showed that AFB1 levels in both broiler starter and broiler finisher were above the KEBS limit but were below the EAC, EU and WHO/FAO limit. Total Aflatoxin levels were above the KEBS limit but below the EAC limit. There is need to enhance the capacity of feed surveillance and monitoring in the country through various laboratory analysis techniques among various agencies in the feed value chain to ensure feed safety
Visual Comfort and Discomfort in Public Boarding Secondary Schools in Nairobi City County, Kenya
(EAST AFRICAN NATURE & SCIENCE ORGANIZATION, 2023) Magero, Cynthia Vugudza; Nyamari, Jackim; Mutisya, Redempta
Indoor light quality is the intensity and amount of illumination of interior spaces. Technological developments have led to the utilisation of artificial natural light. Illumination is crucial in the visibility of tasks. Quality of light can influence the visual comfort and ocular health of the students. Although Kenya lacks lighting standards for schools, ISO and CIE provide international guidelines on optimal illumination for various facilities. This study was conducted on public boarding secondary schools in Nairobi City County to assess the visual comfort or discomfort of students in classrooms. The study utilised a cross-sectional descriptive study design. Four hundred twenty-three students were randomly sampled from 8 schools. Illumination levels were measured in 38 classrooms using a calibrated Benetech GM1010 light metre and compared to levels recommended by ISO and CIE. A self-administered semi-structured questionnaire was used to collect data on students’ visual comfort or discomfort. Data was analysed using SPSS version 23. Descriptive data were analysed using frequencies, while inferential data were analysed using chi-square. The study established that 15% of the respondents experience visual comfort during the day, 13.5% at night, and 12.7% both day and night. Fourteen classrooms achieved the recommended illumination level at 7:30, 20 at 13:00 hours, and 10 at 18:00 hours. Recorded levels ranged from 56.71 lux to 1289.93 lux. The study found a statistically significant association between visual comfort and factors such as existing eye problems, presence of blinds or curtains, number of windows, presence of whiteboards, classroom orientation and student sitting positions. The study recommends that public secondary schools need to ensure quality indoor illumination in their facilities to enhance the visual comfort of students in learning facilities in their facilities to enhance the visual comfort of students in learning facilities.
Compliance To Hand Hygiene Standards Amongst Health Care Providers In Selected Public Hospitals In Uasin Gishu County, Kenya
(International Journal of Scientific and Research Publications, 2021) Koech, Sharon Jerop; Nyamari, Jackim; Njogu, Eunice
Hand hygiene is a simple act of hand cleansing and the most effective measure of decreasing healthcare-associated infections among the health care workers. The infections not only lengthen the hospitalization period but also increase financial burden to individual, family and a country at large for example in Europe approximately €13–24 billion is spent annually. Hand hygiene compliance has remained unacceptably as low as 40% worldwide with the developing countries reporting a lower percentage. The broad objective of this study was to determine the level of compliance with hand hygiene standards amongst the health care providers in selected public hospitals in Uasin Gishu County. The study used the cross-sectional study design. The lower level health facilities were selected randomly while higher level health facilities were selected purposively. Sample size determination was done using Fisher’s (1999) formula and Cochran’s correction formula was used due to the population of health workers being below 10,000. A total of 301 sample size was arrived at and additional ten percent of the 301 sample size was included to accommodate for attrition hence having a total sample size of 331 respondents. The Simple random sampling technique was used to identify the 331 health care providers taking into consideration the use of probability proportionate to sample size technique in obtaining the number of health care providers from each health facility. The Data collection instruments included a self-administered questionnaire and observational checklist. Quantitative Data analysis was carried out by utilizing the Statistical Package for Social Sciences (SPSS) software version 20. The findings revealed a compliance rate of 49.8%. Pearson’s test of correlation revealed that the main determinants of compliance with hand hygiene standards were professional cadre (r=014; P=0.015), training (r=0.371; P=<0.01) level of education (r= 0.168; P=0.004), availability of clean running water (r=0.271; P=<0.01) and hand washing soap (r=0.168; P=0.003). The study recommends that the policy makers and health stakeholders need to come up with a policy that ensures that the health care workers adhere to hand hygiene standards and ensure adequate provision of hand hygiene facilities so as to enhance compliance with hand hygiene standards.
Evaluation of Benzene and Toluene Levels Released into the Breathing Zone of Spray Painters Working in Small Scale Informal Auto-Garage, in Embakasi, Nairobi, Kenya
(International Journal of Innovative Research and Advanced Studies, 2019) Mwatu, Agnes; Warutere, Peterson; Keraka, Margaret; Muhoho, Ngethe
Volatile Organic Compounds (VOCs) are both naturally occurring as well as man-made chemicals. They range from harmless, to highly mutagenic and carcinogenic types. Benzene and toluene are among the widely used VOCs as solvents and diluents in products such as paints and aerosols. Lack of exposure control to benzene and toluene in the informal auto garages may lead to spray painters’ risk of acquiring ill-health symptoms associated with benzene and toluene exposure. Depending on method of application and control measures applied during auto spray painting in small scale informal auto garages, uncontrolled and a high amount of benzene and toluene may be released into the ambient air and into the breathing zone of the spray painters. The aim of this study was therefore, to evaluate the levels of benzene and toluene compounds in the ambient air and especially the levels emitted in the breathing zone of the spray painters in small scale informal auto garages, through a cross-sectional method of study. The study population was composed of twenty nine (29) spray painters randomly selected from one hundred and ten (110) spray painters in the study area. The benzene and toluene compounds were collected by use of Gastec passive colour dosimeter tubes placed near the breathing zone of spray painters during spraying process. The average amounts of benzene and toluene were 73.46ppm and 61.22ppm respectively, against WHO’s recommended maximum of 0.5ppm for benzene and 50ppm for toluene. The amounts of benzene and toluene were significantly high, (P = 0.0001) and (P = 0.001) respectively. T-test was used to compare the means of various variables in the study. The study concluded that there was a high concentration of benzene and toluene released in the breathing zone of spray painters during spray painting exercise and, recommended the results to guide policy on benzene and toluene exposure control and awareness creation among the auto spray painters.
Birth Preparedness among Women in Tharaka Nithi County, Kenya
(AFRICAN Journal of Midwifery and Women’s Health, 2015) Gitonga, Eliphas; Keraka, Margaret; Mwaniki, Peter
Background/Aim: In 2005, the sub-county health management team identified a need for information to reduce the lack of skilled attendance at birth. This study assesses the determinants of birth preparedness among women who had given birth in the last 2 years in Tharaka Nithi County, Kenya. Methods: Stratified sampling was used to select 345 pregnant women for interview. Systematic sampling was used so that every 14th client attending a maternal/child health clinic in the sampled facilities was interviewed. A descriptive crosssectional survey design was used. A chi-squared test and logistic regression were used to analyse the data Results: Approximately 20% of the interviewed sample were prepared for birth on all six recommended aspects of birth preparedness. The most planned for aspect of birth was hospital birth expenses (74%), followed by place of birth (69%). The least prepared for aspect was transport to a health facility (35%). Conclusions: Higher level of education, higher income, salaried occupation and at least four antenatal care visits all increased the likelihood of being more prepared for birth. A history of stillbirth reduced the likelihood of birth preparedness. It is recommended that the Kenya Ministry of Health improve levels of birth preparedness through the provision of antenatal car
Assessment of Knowledge, Attitude and Perceptions of Village Residents on the Health Risks Posed by Kadhodeki Dumpsite in Nairobi, Kenya
(Scientific and Academic Printing (SAP), 2013) Njagi, J.M.; Ireri, A.M.; Njagi, E.N.M.; Akungah, Daniel Nyagetiria; Afullo, A.O.; Ngugi, M.P.; Mwanzo, I.; Karugu, N.I.
Studies show that the health risks posed by dumpsites are significant especially when the area used for dumping is easily accessible. Children, the immunocompromised, the mentally challenged individuals are specifically vulnerable to the physical, ecological and chemical dangers posed by wastes. This study sought to assess the knowledge, attitude and perceptions of the residents of Kadhodeki village on the health risks posed by the Kadhodeki dumpsite. Using households as units of sampling, a descriptive cross sectional survey was carried out in June 2012. Random data were collected using a face-to face researcher administered structured questionnaire where 323 participants were interviewed. Chi square was used to determine the association between the different variables. Findings indicate that residents posses a significantly low knowledge and a positive attitude (χ2 (1) = 224.03, p < 0.01; χ2 (1) = 8.697, p < 0.01).There were however no differences in risk perceptions. Participant’s age, duration one had lived in the village and their level of education, were proxy measures of knowledge, attitude and perception. Odds ratio analysis indicates that age and duration did not influence participant’s knowledge, attitude or perceptions. However, education accounted for a non significant 28% variation in respondents’ attitude towards the health risks of the dumpsite (OR= 1.282; CI 0.828- 1.997). Adequate education on the other hand significantly accounted for 67% variation in respondents’ health risk perception (OR= 1.671; CI 1.304-2.140). From the findings of this study, the ministry of Health is recommended to come up with health education programmes for the general population on the dangers of uncontrolled waste disposal sites.
Prevalence, Knowledge, Attitude and Practice of Speeding in Two Districts in Kenya: Thika and Naivasha.
(Elsevier Ltd, 2013) Nyamari, J. M.; Bachani, A. M.; Hung, Y. W.; Mogere, S.; Akungah, Daniel Nyagetiria; Stevens, K. A.; Hyder, A. A.
INTRODUCTION: In Kenya, RTIs had the second highest increase in disability-adjusted life years between 1990 and 2010, compared to other conditions. This study aims to determine the prevalence, knowledge, attitudes and practices for speeding in Thika and Naivasha districts in Kenya. METHODS: Direct observations of vehicle speed were conducted at various times during the day and different days of the week on six roads selected based on a multi-stage sampling method in two districts to determine the prevalence of speeding. Roadside KAP interviews were administered to drivers, at motorcycle bays, petrol stations, and rest areas. RESULTS: Eight rounds of speed observations and four rounds of KAP interviews were conducted between July 2010 and November 2012. Results from the speeding observational studies show an overall high proportion of vehicles speeding above posted limits in both districts, with an average of 46.8% in Thika and 40.2% in Naivasha. Trend analysis revealed a greater decline in this prevalence in Thika (OR: 0.804, 95% CI: 0.793-0.814) than in Naivasha (OR: 0.932, 95% CI: 0.919-0.945) over the study period. On average, 58.8% of speeding vehicles in Thika and 57.2% of speeding vehicles in Naivasha travelled at 10 km/h or higher above speed limit. While the majority of respondents agreed that speeding is a cause of road traffic crashes in both Thika (70.3%) and Naivasha (68.7%), knowledge of speed limits at the location of the interview was limited. Enforcement levels also remained low, but subsequent rounds of data collection showed improvement, especially in Thika. CONCLUSIONS: This study demonstrates an improvement in the prevalence of speeding in two districts of Kenya over 2010-2012. It also highlights the need for further action to be taken to address the problem, and represents new data on speeding in Kenya and Africa.
Knowledge, Attitude and Perceptions of Village Residents on the Health Risks Posed by Kadhodeki Dumpsite in Nairobi, Kenya.
(The Ethiopian Journal of Environmental Studies and Management ., 2013) Njagi, J.M.; Ireri, A.M.; Njagi, E.N.M.; Akungah, Daniel Nyagetiria; Afullo, A.O.; Ngugi, M.P.; Mwanzo, I.; Njagi, I.K.
This study sought to assess the knowledge, attitude and perceptions of the residents of Kadhodeki village on the health risks posed by the Kadhodeki dumpsite. Using households as units of sampling, a descriptive cross sectional survey was carried out in June 2012. Random data were collected using a face-to-face researcher administered structured questionnaire and 323 participants were interviewed. Chi square was used to determine the association between the different variables. Findings indicate that residents possess a significantly low knowledge and a positive attitude (χ2 (1) = 224.03, p < 0.01; χ2 (1) = 8.697, p < 0.01) towards the Kadhodeki dumpsite. They were however no differences in risk perceptions. Participant’s age, duration one had lived in the village and their level of education, were proxy measures of knowledge, attitude and perception. Odds ratio analysis indicates that age and duration did not influence participant’s knowledge, attitude or perceptions. Rudimentary however, education accounted for a non significant 28% variation in respondents’ attitude towards the health risks of the dumpsite (OR= 1.282; CI 0.828- 1.997). Also adequate education significantly accounted for 67% variation in respondents’ health risk perception (OR= 1.671; CI 1.304-2.140). This study would recommend that the ministry of Health come up with health education programmes for the general population on the dangers of uncontrolled waste disposal sites.

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