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Item Prevalence and Risk Factors Associated with Visceral Leishmaniasis in West Pokot County, Kenya(Kenyatta University, 2023-06) Khalif, AbdullahiRala-azar is a vector-borne parasitic disease caused by Leishmania species and transmitted by sand fly to human. Epidemiologically, kala-azar remains disease of global public health importance with over hundred thousand reported cases annually and a growing endemicity of approximately hundred nations located mostly in the third-world. In Kenya, the disease is prevalent in the arid and semi-arid climatic zones that constitute approximately eighty percent of the country land mass. Current study aimed to establish the current disease prevalence in the area, as well as environmental, social economic and social cultural risk factors associated with visceral leishmaniasis in Pokot north constituency of West Pokot County, Kenya. A descriptive cross- sectional study design was utilized in carrying out the study. The study area was purposively selected considering the high number of cases registered in the hospital as well as disease endemicity. Cluster sampling of locations and villages and systematic sampling of households was undertaken. Semi-structured household questionnaire, observation checklist, key informant interviews and focus group discussions was used in gathering information from the field. Microsoft word template and Microsoft excel sheet was used in data entry. Statistical Package for the Social Science (SPSS) version 22 as well as Microsoft excel software was utilised in Quantitative data analysis while NVivo software was used in qualitative data analysis. Self reported household prevalence of visceral leishmaniasis in Pokot north sub-County was 21.48%. Significant risk factors in association with disease were social demographic factors like lack of formal education (X?=16.218, df 3, p<0.05), large household size (X?=9.435, df=4, p<0.05), herding and peasant farming occupation (X>=76.341, df=5, p<0.05); Environmental factors: presences of seasonal water channels and rock piles (X?=30.706, df=1, p<0.05), and presence of acacia tree in and around the compound was significantly associated with high risk of infection (X?<21.40, df=1, p<0.05); Social economic factors: lower household monthly income (X?=10.973, df=4, p<0.05), residing in mud house type (X*=8.353, df=3, p<0.05), and dog ownership (X?=15.209, df=1, p<0.05); Social cultural factors: practice of traditional night dances (X?=4.718, df=1, p<0.05) as well as practicing nomadic tradition of moving houses to new temporary compounds (X?=20.919, df=1, p<0.05). The prevalence of kala-azar remains high and environmental, social economic, as well as social cultural characteristics are important predictors of risk of infection. The study recommends community economic empowerment to reduce level of vulnerability and social mobilization targeting behaviour modification to achieve better disease prevention and control outcome.Item Pre-Eclampsia and Eclampsia Outcomes and Their Determinants among Women Who Deliver In Nakuru Level Five Hospital, Nakuru County, Kenya(Kenyatta University, 2023-05) Mugucia, SamuelIrccizl:.\mpsln and cclampsia (PET/E) are a major cause maternal, fetal and neonatal 1}101‘})|§11ly and n.\nrlnlily globally. Many studies place hypertensive disorders which include F 'E"l /E as the lAhII'LI leading cause of maternal mortality in the world. Roughly 6,300 women dle‘cach year in Kenya duc to pregnancy related causes. (WHO, 2016). PET/E are also the major f:‘llology for premature births resulting in perinatal mortality and morbidity. A_pp_rox1_nmlcly 96 stillbirths and 92 neonatal deaths occur every day in Kenya. There is dlmmuln_/c data on Nakuru level 5 hospital (NL5H) and indeed Nakuru County as a whole on PET/E related mortality and morbidity due to lack of rescarch in the area. The goal of this study is to provide data that can be utilized to upgrade and ameliorate maternal and neonatal health outcomes for pregnant women. An analytical cross sectional study was conducted to find out the incidence, awareness level and outcomes of PET/E in the postnatal wards at NLSH. Structured questionnaires and key informant interview guides were used. One hundred and thirteen women were interviewed on their first postnatal day. The data collection tools’ contents were organized systematically examined for accomplishment, redacted for faults and omissions, and then they were encoded. The data was subsequently arranged based on the research questions and objectives. Data was analyzed using SPSS version 23. Chi-square and correlation was used to test for association and logistic regression for inferential statistics. Data displayed in the form of frequency tables, and pie charts, and then elaborations followed to clarify the context. The results showed that the incidence of preeclampsia and eclampsia among women delivering at NLS5H was 6.9%. A majority of the respondents (43.4%) had low level of awareness. The most common complications to the mothers were premature labour (36%), postpartum haemorrhage (23%) and antepartum haemorrhage (7%). The most common complications of the newborn were prematurity (37%), low birth weight (25%) and birth asphyxia (23%). Symptomatic presentation i.e. hypertension, proteinuria and oedema showed statistically significant relationship with complication to both mother and the baby using person’s chisquare. Those with more severe form of the symptoms were more likely to develop complications as per binary logistic regression analysis. For instance severe hypertension (odds ratio=7.7), proteinuria +++ (odds ratio=6.2) and presence of oedema (odds ratio=5.4) were more likely to develop complications than those with mild symptoms. To the neonate, it also showed that those with more severe proteinuria (proteinuria +++) (odds ratio=4.5) were more likely to develop complications. In addition, those with presence of oedema (odds ratio=3.5) were also more likely to develop complications. It was concluded that the incidence of preeclampsia and eclampsia among mothers who deliver at NLSH is within the national and international averages. The study also concluded that, knowledge levels on symptoms of PET/E are low. Furthermore it was identified that premature labour, postpartum haemorrhage and antepartum haemorrhage as the most common complication of PET/E to the mothers. In addition prematurity, low birth weight and birth asphyxia, neonatal jaundice and neonatal death were also identified as the most common neonatal complications. It was also confirmed that symptomatic presentation was associated with complication of PET/E. Those with severe symptoms were more likely to develop complications to both the mother and neonate. The study recommends early identification, management, referral, closely monitoring and follow up pregnant women with preeclampsia throughout the pregnancy continuumItem Pre-Eclampsia and Eclampsia Outcomes and Their Determinants among Women who Deliver in Nakuru Level Five Hospital, Nakuru County, Kenya(Kenyatta University, 2023-05) Mugucia, SamuelIrccizl:.\mpsln and cclampsia (PET/E) are a major cause maternal, fetal and neonatal 1}101‘})|§11ly and n.\nrlnlily globally. Many studies place hypertensive disorders which include F 'E"l /E as the lAhII'LI leading cause of maternal mortality in the world. Roughly 6,300 women dle‘cach year in Kenya duc to pregnancy related causes. (WHO, 2016). PET/E are also the major f:‘llology for premature births resulting in perinatal mortality and morbidity. A_pp_rox1_nmlcly 96 stillbirths and 92 neonatal deaths occur every day in Kenya. There is dlmmuln_/c data on Nakuru level 5 hospital (NL5H) and indeed Nakuru County as a whole on PET/E related mortality and morbidity due to lack of rescarch in the area. The goal of this study is to provide data that can be utilized to upgrade and ameliorate maternal and neonatal health outcomes for pregnant women. An analytical cross sectional study was conducted to find out the incidence, awareness level and outcomes of PET/E in the postnatal wards at NLSH. Structured questionnaires and key informant interview guides were used. One hundred and thirteen women were interviewed on their first postnatal day. The data collection tools’ contents were organized systematically examined for accomplishment, redacted for faults and omissions, and then they were encoded. The data was subsequently arranged based on the research questions and objectives. Data was analyzed using SPSS version 23. Chi-square and correlation was used to test for association and logistic regression for inferential statistics. Data displayed in the form of frequency tables, and pie charts, and then elaborations followed to clarify the context. The results showed that the incidence of preeclampsia and eclampsia among women delivering at NLS5H was 6.9%. A majority of the respondents (43.4%) had low level of awareness. The most common complications to the mothers were premature labour (36%), postpartum haemorrhage (23%) and antepartum haemorrhage (7%). The most common complications of the newborn were prematurity (37%), low birth weight (25%) and birth asphyxia (23%). Symptomatic presentation i.e. hypertension, proteinuria and oedema showed statistically significant relationship with complication to both mother and the baby using person’s chisquare. Those with more severe form of the symptoms were more likely to develop complications as per binary logistic regression analysis. For instance severe hypertension (odds ratio=7.7), proteinuria +++ (odds ratio=6.2) and presence of oedema (odds ratio=5.4) were more likely to develop complications than those with mild symptoms. To the neonate, it also showed that those with more severe proteinuria (proteinuria +++) (odds ratio=4.5) were more likely to develop complications. In addition, those with presence of oedema (odds ratio=3.5) were also more likely to develop complications. It was concluded that the incidence of preeclampsia and eclampsia among mothers who deliver at NLSH is within the national and international averages. The study also concluded that, knowledge levels on symptoms of PET/E are low. Furthermore it was identified that premature labour, postpartum haemorrhage and antepartum haemorrhage as the most common complication of PET/E to the mothers. In addition prematurity, low birth weight and birth asphyxia, neonatal jaundice and neonatal death were also identified as the most common neonatal complications. It was also confirmed that symptomatic presentation was associated with complication of PET/E. Those with severe symptoms were more likely to develop complications to both the mother and neonate. The study recommends early identification, management, referral, closely monitoring and follow up pregnant women with preeclampsia throughout the pregnancy continuum.Item Quality of Life for Family Caregivers to Cancer Patients in Kenyatta National Hospital Nairobi City County, Kenya(Kenyatta University, 2022-08-02) Mwangi, Samuel N.AbstractItem Prevalence of Helicobacter Pylori and Associated Risk Factors among Community Members in Makueni County, Kenya.(Kenyatta University, 2023-01) Muma, Benedict M.AbstractItem Utilization of antinatal care services and skilled birth attendants among mothers in Belet Weyn District, Hiran Region of Somalia(Kenyatta University, 2017-05) Abdikadir, Sheikh Mohamed DahirItem Patients Perspectives on Seclusion and Restraint Experience at Mathari National Teaching and Referral Hospital Nairobi City County, Kenya(Kenyatta University, 2024-11) Mwangi, Mary WanjiruMental health research across the world has elicited various perspectives regarding the experiences of seclusion and restraint of mentally unwell, aggressive patients. In spite of the need of understanding some of the determinants of seclusion and restraint of mentally ill patients, there has been limited publications particularly in the Kenyan context addressing the experiences of seclusion and restraint on social demographic characteristics of a mentally ill patient, patient and Institutional factors leading to seclusion and restraint as well as exploring the experiences of the mentally ill patients undergoing seclusion and restraint at Mathari National Teaching and Referral Hospital. The present study therefore aimed to explore patient’s experience on seclusion and restraint at Mathari National Teaching and Referral Hospital as well as describing the patient and institutional factors leading to their seclusion and restraints. Phenomenological research approach was carried out and Qualitative data was gathered using interview guide. The study targeted all the patients who had been nursed in seclusion and restraint during admission to Mathari National Teaching and Referral Hospital Nairobi City, Kenya, and those who consented to the study and were mentally stable. The study used purposive sampling method to select participants whereby the sample consisted of 10 participants who were interviewed until saturation of data was reached. Audio recorder was used to record the patients as they narrated their experiences. Data was collected for a period of about two months. The data was transcribed verbatim, Coding was done and codes which were similar were grouped into same categories. Similar categories were grouped into themes. Data was analyzed through iterative approach. It was revealed that seclusion procedure at Mathari National Teaching and Referral Hospital was not patient friendly as they were forced to it and not provided with the basic needs apart from medication. The interviewees also described two main themes relating to experiences of patients undergoing seclusion and restraint at Mathari National Teaching and Referral Hospital including desirable views of seclusion and restraints and undesirable views on seclusion and restraints experiences. The desirable view on seclusion experiences included that seclusion and restraint provided relief and a less stimulating environment in which they felt safe and secure. Patients were grateful for the constant support and supervision of health care providers. However, the undesirable experiences as mentioned by the respondents was that during seclusion and restraint they experienced abandonment, mistreatment and neglect. The study concludes that seclusion and restraint is a crucial but contentious treatment which should only be used as a last resort, and steps should be taken to guarantee that patients’ dignity is preserved as guided by the Mental Health Act 2016. The study recommends that Mathari National Teaching and Referral Hospital to have the seclusion sessions customized to each patient’s unique cognitive ability and mental condition.Item Psychological Morbidity among Post-Partum Adolescent Mothers Attending Pumwani Maternity Hospital, Nairobi City County, Kenya(Kenyatta University, 2024-11) Ireri, Grace KarambuIn the recent past, adolescent pregnancy has been on the rise. Estimations indicate that, globally, teenage girls who give birth annually are roughly sixteen million. In countries with few resources, it becomes challenging. Mental health has found a greater concern related to reproductive and sexual health; however, depression-related information in Kenya is limited. This means that more studies on psychological morbidity among teenage mothers are an important area of inquiry. A number of studies from developed countries show a rise in teenage pregnancy and the health consequences to both the teenage mother and the baby, such as anemia, preterm labour, obstructed labour, retardation in intrauterine growth, increased post-partum hemorrhage risk, eclampsia, cephalic pelvic disproportion, sepsis, neonatal death, genital fistula, and the risk of death which contribute to psychological morbidity. The study aimed at assessing predictors of psychological morbidity among post-partum teenage mothers at Pumwani maternity hospital. Descriptive correlation design was the study design whereby 74 postnatal mothers aged between 10 and 19 years who had been admitted in the postnatal wards at Pumwani maternity hospital were recruited through a convenient sampling method. The study used interviewer-administered and self-administered questionnaires in collecting data from those who could read and understand and those who could not read and understand, respectively. SPSS Version 25 was used in verification, coding, and analysis of data. Findings showed that, 51.3% (n =38) were aged between 16 and 18 years, 56.8% (n =42) were single, 60.8% (n =45) had secondary level education with only 12.2% (n =9) had accomplished their education in their respective levels. Out of 74 post-partum adolescent mothers in maternity at Pumwani Hospital, 86.5% (n =64) had psychological morbidity 95%CI:76.6% - 93.3%. The multivariable analysis established that aged less than 18 years (AOR = 11.41, 95%CI:3.08 – 26.23, p =0.004), those who were single (AOR =3.33, 95%CI:1.51 – 21.87, p=0.031) were more likely to have postpartum depression while those who had received care as they wanted were 94% less likely to have depression compared to those who did not receive the care they wanted, (AOR =0.06, 95%CI:0.01 – 0.67, p=0.022. The prevalence of psychological morbidity is high with age (<18years) and completing highest level of education being significant determinants. Thus, hhealthcare providers should regularly screen new mothers for depression to help control the burden of psychological morbidity.Item Immunization Coverage among Children Aged Between 12-23 Months in West Pokot County, Kenya(Kenyatta University, 2024-08) Kirongo, David KiharaImmunization coverage and healthcare utilization among children aged 12-23 months significantly impact public health outcomes. However, in West Pokot County, Kenya, these indicators remain suboptimal, posing challenges to achieving optimal child health. The main aim of this research was to assess the vaccination rates among children in West Pokot County, Kenya, between the ages of 12 and 23 months. The objectives of the study were to (i) calculate the immunization coverage among children aged 12-23 months in West Pokot County, Kenya; (ii) analyze the factors influencing immunization coverage among the same demographic; and (iii) assess the effects of healthcare utilization on immunization coverage among children aged 12-23 months in West Pokot County, Kenya. A cross sectional study design was employed, involving a sample of 393 children aged 12-23 months and their caregivers in West Pokot County, Kenya. Data was collected through structured interviews, questionnaire and focus group discussion. Descriptive and inferential statistical analyses were conducted to examine the relationships between various factors and immunization coverage, as well as healthcare utilization. The study revealed that West Pokot County, 62.4% of mothers or guardians partially vaccinated their children, while 36.6% completely immunized them, and only 1.1% did not vaccinate their children at all. This indicates that only a third of children in the county have received all recommended vaccinations, revealing a significant gap in achieving desired coverage. The study identified parental age as a key determinant, with older caregivers more likely to completely vaccinate their children. Furthermore, a negative correlation was found between the number of children in a household and vaccination coverage. Teachers and farmers were more likely to have their children completely vaccinated compared to those in other occupations, highlighting the impact of parental occupation on vaccination rates. Additionally, respondents who paid for vaccination services were more likely to fully immunize their children. Healthcare utilization significantly influenced vaccination coverage, as respondents who visited a healthcare facility during the previous year were more likely to completely immunize their children. Hence the study concludes that findings underscore the importance of addressing sociodemographic factors, such as parental age, occupation, and financial capability, to enhance vaccination coverage among children aged 12-23 months in West Pokot County. Encouraging regular healthcare visits and promoting healthcare-seeking behavior among parents and caregivers are crucial for improving vaccination rates. This study recommended Conduct regular immunization coverage surveys with local health facilities and community health workers for informed decision making. Analyze factors influencing immunization coverage and develop targeted interventions. Assess healthcare utilization patterns among mothers and guardians and implement measures to enhance healthcare service deliveryItem Antibiotic Prescribing Practices of Clinical Officers for Patients with Upper Respiratory Tract Infection at Kiambu County, Kenya(Kenyatta University, 2024-11) Murigi, Kevin WambuaAccording to the World Health Organization (WHO), over 50% of all medicines are prescribed, dispensed or sold inadvertently, and more than half of all patients take them incorrectly. Antibiotics are the most routinely prescribed medications. Antibiotics are incorrectly prescribed for viral illnesses and broad-spectrum antibiotics are being used in place of narrow-spectrum antibiotics. Antibiotic resistance has emerged because of incorrect antimicrobial treatment and misuse of antibiotics. Findings from studies have shown an association between prescriber factors, patient factors, institutional factors and antibiotic prescribing. There is scarce data in Kenya about antibiotic prescribing practices, factors affecting antibiotic prescribing, how it varies between different healthcare workers and the mechanism by which interventions are effective. The goal of this study was to figure out antibiotic use among patients with upper respiratory tract infections in Kiambu County. The study design was a cross-sectional hospital-based study. The study area was one public level 5 hospital, five public level 4 hospitals and 14 public health centers within Kiambu County. Data was collected in the form of a modified WHO prescribing indicators checklist and using questionnaires. The WHO prescribing indicators checklist on rational use of medicine was used to collect data from 600 patient encounters. The questionnaire was used to collect data from 36 clinicians working in the outpatients. The data from the checklist included the total number of medications prescribed per encounter, the number of encounters with antibiotics, the proportion of generic antibiotics prescribed, the proportion of antibiotics prescribed from the Kenya Essential Medicines List (KEML), the antibiotic prescribed, its dose, frequency, duration and indication. The data from the questionnaire included prescriber age, gender, level of education, work experience, laboratory availability, availability of antibiotics and availability of guidelines. An Open Data Kit (ODK) was used to collect the WHO data collection checklist. Data was imported into a Microsoft Excel sheet from the ODK server then exported to a Statistical Package for Social Science (SPSS) version 22.0 for further cleaning and analysis. Descriptive statistics of frequencies and percentages were used to summarize categorical variables, and median (interquartile range) was used in case of continuous variables. Logistic regression was employed to find the association between antibiotic prescribing and the prescribing factors. Odds ratio with 95% confidence interval was reported in the logistic regression analysis. All analysis were considered significant when p < 0.05. Antibiotics were prescribed in 78% of patient encounters, 96.8% of encounters with an antibiotic had a generic antibiotic, and 96.6% of antibiotics prescribed were from the KEML. Over 91% of antibiotics prescribed were the right dose, 98.3% were the right frequency, 75.2% were the right duration, only 23.8% was the right indication. Availability of antibiotics p=0.026 and availability of hospital guidelines p=0.012 were significantly associated with rational antibiotic prescribing. Patient fever significantly affected rational antibiotic prescribing (OR 4.7, 95% CI 2.49, 8.89, p=<0.001), patient age and gender did not significantly affect antibiotic prescribing. Prescriber gender, p=0.63, age, p=0.92, education level, p=0.99 and work experience, p=0.22 did not significantly affect antibiotic prescribing.Item Assessment of predictors of birth preparedness among women in laikipia county, kenya(Kenyatta University, 2023-04) Wanjohi, Joseph MwangiMaternal death is defined as “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes”. It’s the second leading cause of death among women after HIV/AIDS. WHO estimates that about 94% of all maternal deaths worldwide occur in developing countries. One way of reducing the occurrence of maternal mortality is through promoting the practice of birth preparedness among pregnant women. Birth preparedness is the process of strategizing for normal spontaneous vaginal delivery and anticipating the action plan in an obstetric emergency. It helps prevent the occurrence of the delays associated with maternal morbidity and mortality, namely; delay in deciding to seek care, delay in reaching care, and delay in receiving adequate care. This study assessed the predictors of birth preparedness among women in Laikipia county, Kenya. It was a cross-sectional analytical study conducted in Laikipia East sub-county, Laikipia county, Kenya. The sample size for the study was 259 women who had delivered in the last one year at the time of the study, in Laikipia East sub-county and residing in the study area. Facilities were selected through simple random sampling, whereas participants were selected through systematic sampling at a sampling interval of 4. Quantitative and qualitative data were collected using structured questionnaires and key informant interviews from mothers and maternal and child healthcare providers respectively. Quantitative data was entered into Statistical Package for Social Sciences (SPSS) version 25. Both descriptive and inferential analysis were computed, and results presented in form of tables and graphs. Thematic analysis was applied for qualitative data and presented in themes. Level of birth preparedness was measured using six essential components including the identified facility of delivery, skilled birth attendant, birth companion, finances, transport arrangement and home caretaker. The level of birth preparedness was found to be low at 23.2%. Inferential analysis was done at 95% level of confidence and Pearson’s Chi square and Fisher’s Exact Test were used to measure association. The socio-demographic factors that had significant statistical association with birth preparedness included education, occupation and income (P<0.05). Pregnancy related factors that were significantly associated with birth preparedness included history of miscarriage or still birth, number of ANC visits and trimester of first ANC visit (P<0.05). The only health system related factor that had significant statistical association with birth preparedness was the level of facility visited for ANC (P<0.05). Statistical significant independent variables were further tested using logistic regression to show the strength and direction of association. Tertiary education was associated with high odds of practicing birth preparedness (AOR=8.469), formal employment increased odds of birth preparedness (AOR=4.898), income above Kshs 39,000 was associated with high birth preparedness (AOR=4.834), having history of miscarriage or still birth increased odds of birth preparedness (AOR=3.740), and first trimester for first ANC (AOR=2.638). In conclusion, education, occupation, income, history of miscarriage or still birth and trimester of first ANC were the predictors of birth preparedness. The researcher recommended strengthening of policies aimed at increasing birth preparedness and education on its importance to be scaled up. Increase income generating programs to empower women economically and enable them to plan for their births. Further studies also recommended to evaluate the utilization and impact of birth preparedness plansItem Maternal Compliance with Recommended Dietary Diversity in Prevention of Malnutrition among Children Aged 6-23 Months in Kwale County, Kenya(Kenyatta University, 2024) Chepkirui, FrancescaDietary Diversity (DD) is a crucial element of Infant and Young Child Nutrition (IYCN). WHO and UNICEF recommends feeding of diverse diets to children aged 6- 23 months as a public health measure in curbing malnutrition. In feeding of young children, caregivers (mostly mothers) play a central role. Mothers make vital decision pertaining breastfeeding and complementary feeding. Kenyan government has input lots of resources in fighting malnutrition however, children aged 6 to 23 months still have below-average levels of mother adherence with recommended dietary diversity with only 37% countrywide meeting the minimum dietary diversity. This study was conducted in Kwale County, where persistent chronic malnutrition has been noted. The main aim was to assess level of maternal compliance with recommended DD among children aged 6-23 months. Study’s objectives included: determining mothers’ socio demographic and economic characteristics, mother’s nutritional knowledge and other factors associated with compliance or non-compliance with recommended DD. The study utilized a mixed methods study approach, randomly selecting 244 mother-child pairings with children between the ages of 6 and 23 months. In order to gather information on the socio-demographics, financial status, and nutrition education of mothers, a pre-tested, moderately structured questionnaires were employed. A qualitative 24-Hour recall and DD questionnaires were also administered. Complementary information was collected through five subsequent Focus Group Discussions (FGDs). All respondents (244) were females aged 17- 68 years with a mean of 29.3 ±9.6 years. By educational levels, 29.5% of the respondents did not have any formal education, 10.2% had lower primary education (class 1 – 4), 53.3% had upper primary education (class 5- 8), and 5.3% had secondary education while only 1.2% had post-secondary education. Most (54.1%) of the respondents were housewives. A computed wealth index classified 20.5% in the first quintile (poorest) and 21.3% in the wealthiest quintile (5th quintile). Nutritional knowledge levels of the caregivers were generally very low with more than half (57.4%) of the mothers scoring zero (0) and only 3.3% having a high score of more than 9 out of 12 of the questions asked. Children’s DD scores ranged from 1 to 6 with a mean of 2.63 ± 0.9. Only 5.5 % of the children met the minimum dietary diversity (MDD) of 5 food groups or more in a day. A bivariate regression analysis to determine factors associated with children’s dietary diversity scores showed significant positive with caregiver’s educational level (r=0.186, P<.000, α=.01), household wealth index (r=0.163, P<.011, α=.05) but not with the caregiver’s nutritional knowledge (r=0.024, P>.05) and attitude score (r=0.098, P>.05). In conclusion, diets fed to children in the study area was poor in diversity. The socioeconomic situation of the household and low maternal education level was statistically significantly associated with this. Low maternal nutrition awareness and discrepancies in attitudes about providing children with a variety of foods exist. Other factors contributing to low DD were: poverty, environmental conditions, low educational levels and unfavorable cultural practices. The study therefore recommends a multisectoral approach in identification of interventions to address the identified issues.Item Male Involvement in Partner’s Cervical Cancer Screening Services in Makueni County, Kenya(Kenyatta University, 2024-05) Wambua, Ruth TaabuIntroduction: Malignant cervical cancer affects the lowest portion of the uterus. Globally, it is the fourth cause of cancer deaths, and in Kenya, it is ranked as the second cause of cancer-related deaths among females. Men are crucial in minimizing cervical cancer burden. However, there is limited information on the determinants of their involvement in cervical cancer screening in Makueni County, Kenya. The research aimed to establish determinants of the level of male involvement in their partner’s cervical cancer screening. The study’s significance was in identifying barriers and facilitators to male involvement in their partner’s cervical cancer screening so that stakeholders might intervene. Methodology: A descriptive cross-sectional study obtained data quantitatively and qualitatively. The study was done in Mbooni Sub-County Level 4 hospitals. Study participants were married men aged 18-64 years. The hospitals were selected through purposive sampling, and respondents through a simple random sampling. The Key Informants were selected through a total sampling technique. Study variables were knowledge, socio-cultural, economic, and hospital-related factors. Respondents’ data was collected through open and closed-ended questionnaires and face-to-face interviews with key informants. Qualitative data were analyzed using descriptive statistics such as measures of frequency, central tendency, and dispersion. Inferences were drawn from Chi squares, Fisher’s Exact, Likelihood ratio, and logistic regression. Qualitative data was analyzed through codes and themes. Results: Men’s involvement in their partner’s cervical cancer screening was low (82%). All knowledge factors were associated with the level of involvement (p=<0.05). Socio-economic factors such as education (p=0.000) and employment (p=0.04) were significantly associated with the level of male involvement in their partner’s cervical cancer screening. Socio-cultural factors such as beliefs, practices, norms, myths, and misconceptions were linked to the level of involvement (p=<0.005). Hospital-related factors such as service availability, presence of signages, and cost were significantly associated with the level of male involvement in their partner’s cervical cancer screening (p<0.005). The logistic regression model done on significant variables was statistically significant, X2 (22, N =262) = 91.043, p = 0.00. The model explained 48.9 % of the variance in men’s involvement (Nagelkerke R2) and correctly classified 82.8 % of cases. From the logistic regression, the significant predictors of high men involvement were knowledge of risk factors for cervical cancer (OR = 3,274, 95% CI [1.073, 9.991],p=0.037), knowledge on whether cervical cancer can be prevented (OR = 3.414, 95% CI [1.043, 11.177],p=0.042), the knowledge that duration for cervical cancer screening is below 10 minutes(OR = 3.718, 95% CI [1.160, 11.920],p=0.027), an understanding that men have a role in cervical cancer screening(OR = 4.550, 95% CI [1.307, 15.844],p=0.017), and the notion that cervical cancer occurs in those who abort (OR = 4.121, 95% CI [1.015, 16.728],p=0.048). Conclusion: Male involvement in cervical cancer screening was low. There is a need to intensify health education for all men to improve their knowledge and dispel myths and misconceptions about cervical cancer and its screening. All facilities should ensure continuous availability of free services and create awareness of the availability of such services.Item Utilization of Sexually Transmitted Infection Health Care Services among Men Who Have Sex with Men in Nairobi City County, Kenya(Kenyatta University, 2024-01) Nyasani, Delvin KwambokaMen who engage in same-sex relationships face a higher risk of contracting sexually transmitted infections (STIs). This heightened risk is attributed to engaging in unprotected receptive anal sex and reluctance to disclose their sexual orientation and associated behaviours to healthcare workers (HCWs). This lack of disclosure complicates clinical decision-making for HCWs, hindering their ability to offer appropriate STI treatment and prevention services. To enhance MSM utilization of STI healthcare services, open communication about their high-risk practices with HCWs is essential. In turn, they can learn risk reduction measures and access STI prevention and treatment options. However, on the contrary, MSM doesn't do this due to various reasons. This study aimed to explore how MSM in Nairobi City County utilize the STI health services, focusing on MSM hotspots within the County. The research employed a cross-sectional study design incorporating both quantitative and qualitative data collection methods. A systematic sampling approach involved 404 respondents, and in-depth interviews were conducted with five key informants selected through a purposive sampling of public health facilities and MSM health provider sites. Descriptive, bivariate, and multivariate analysis was used to analyse quantitative data from the study survey using SPSS version 25 while qualitative data from key informants was analysed thematically using Nvivo version 11. Demographically, the majority of the participants were Kenyans, youth, single, and Christians. Their level of education ranged from primary to post-secondary, more than half were employed and their income ranged from Kshs <5000 to >15,000. A significant relationship was found between participants history of having ever contracted STIs (p=0.000, aOR=6.58, 95%CI 3.38-12.82). Knowledge assessment of participants revealed that 49.4% scored below 50.0%. However, participant’s knowledge score was not correlated with utilization of STI health care services. Seventy- four percent of the participants had sought sexual healthcare services within the past 12 months, with 99.0% self-reporting HIV testing. Over half (54.9%; 223) had accessed services from NGO programs and privacy they offered was correlated with utilization of STI health care services (p=0.042, aOR=1.86, 95% CI 1.02-3.37). In-depth key informant interviews highlighted health and legal system factors as the major facilitators, while health system factors, MSM individual factors, referral challenges, and political system were identified as barriers to utilizing sexual healthcare services. In conclusion, the study found low STI knowledge among participants and they sought STI healthcare services when they were infected. This is an indication that there is a need for the participants to be educated about STIs and have routine check-ups. Stigma and discrimination are the root cause of challenges faced by MSM. This emphasizes the importance of training and sensitization for all HCWs. Also, the community needs to be sensitized to avoid instances where MSM hesitate or delay to seek STI healthcare services.Item Food Handling and Safety Practices Influencing Bacteriological Contamination in Food Establishments in Nairobi City County, Kenya(Kenyatta University, 2024-02) Kinyua, Peter MuriithiFood borne illnesses are major health burden leading to high morbidity and mortality. It is a growing public health concerns worldwide resulting from food and water contaminated by pathogenic microorganism, toxins or chemical hazards. It is estimated that 10 to 20% of food borne illness are contracted from food establishments. The purpose of the current study was to determine food handling and safety practices that contributes to ready to eat foods and water contamination in food establishments in Embakasi South Sub County Nairobi County. The study design was descriptive analytical design. The study employed multi stage sampling techniques. Embakasi South Sub County was purposively selected. Probability proportionate sampling technique was used to select food establishments in each ward. The food establishments were stratified into four categories including restaurants, food kiosks, hotels and cafeteria. Simple random sampling was used to select food handlers for interview within food establishments selected. The study randomly collected 274 samples of ready to eat foods and water using sterile food bags and water bottles respectively. The samples were transported to the laboratory in cool boxes packed with ice packs and analyzed within 6 hours after collection. Microbiological analysis of food and water were borrowed from WHO and bacteriological analytical manual of foods to identify and isolate coliforms, Staphylococcus aureus, Vibrio cholera, Escherichia coli and Salmonella spp. A sample size of 230 food handlers from 137 selected food establishments were interviewed using structured questionnaire and observational checklist made. Data was coded then entered into Microsoft excel database and later analyzed by SPSS version 20’ and presented using tables, graphs while association of variable was assessed using chi-square and binary regression model. It was found that ready to eat foods and water sold and consumed in selected food establishments were contaminated with food borne microorganisms. Escherichia coli isolated in 137 food samples were at 24.1%, Vibrio cholera at 23.4%,Staphylococcus aureus at 32.8%, and Salmonella spp at 4.4%. Total coliforms detectedin 137 samples of water were at 43.8% where out of which 32.8% were of Escherichiacoli. Among food handling practices, touching foods after handling money, fondling of body parts without handwashing, and lack of pretreatment of drinking water were significantly associated with foods and water contamination (P-value<0.05). Compliance level to food safety and other health requirements were low among food handlers and in food establishments, where 72.6% of food premises were not licensed,77.5% of food handlers lacked medical certificates, 66.4% of establishments lacked toilets. The study therefore recommends regular checking of the microbial quality of ready to eat foods and water sold at food establishments, health education drives on sources of contamination to the owners and managers of food eateries establishments, regular inspection and supervision by health officers to ensure compliance to the food safety laws and other public health requirements in the food establishments.Item Prevalence of Sexually Transmitted Infections among HIV Pre-Exposure Prophylaxis Users in Selected Health Facilities in Nairobi City County, Kenya(Kenyatta University, 2024-02) Kadianga, Emmanuel KibalaSexually transmitted infections remain a significant public health problem mainly in low-income countries including Kenya. Currently, approximately half a billion new cases occur worldwide annually, and more than one million STIs are acquired per day. Of the estimated total of 357 million incident cases of the curable STIs world-wide, 131 million are from Chlamydia trachomatis, 78 million are from Neisseria gonorrhea, 5.6 million are from syphilis and 143 million are from Trichomonas vaginalis. In May 2017, the Kenya Ministry of Health, through the National AIDS and STI Control Program rolled out pre-exposure prophylaxis nationally to individuals at high risk of HIV acquisition. However, the roll out of HIV-PrEP by NASCOP has not been assessed to establish the prevalence and behavioural risk factors of STIs among those on HIV-PrEP. Additionally, attitudes toward HIV-PrEP, STIs related level of knowledge and health seeking behaviour for STIs among HIV-PrEP users in Nairobi have not been investigated. The main aim of this study therefore was to address the above gaps by assessing the prevalence of STIs among HIV PrEP users in Nairobi City County. This study employed an analytical cross-sectional research design. The study targeted 3,330 HIV-PrEP users in Nairobi with a focus on five main health facilities in Nairobi City County namely; Mbagathi District Hospital, Mama Lucy Level Five Referral Hospital, Lang‘ata Health Centre, STC MOH-Casino Heath Centre (Comprehensive Care Centre) and Sex Workers Outreach Program Kenya. Simple random sampling technique was adopted to obtain a sample size of 357 respondents. The study used primary data which was collected using structured questionnaire and secondary data (lab results). Descriptive and inferential statistics were analyzed using Statistical Packages for Social Sciences version 26.0. Chi square test and logistic regression was used to derive relationships between variables; results were considered statistically significant with p value ≤0.05. The results were presented on tables and charts. The study findings revealed that 45.8% of the PrEP users visiting health facilities in Nairobi City County had at least one curable STI. The prevalence of STIs among this groups was; 13.4% for Gonorrhea, 9.7% for Chlamydia, 7.4% for Syphilis, 6.0% for Trichomoniasis, 5.1% for Herpes (Genital herpes), 3.7% for HIV and 0.5% for Genital warts. The study also found that most of the HIV-PrEP users visiting health facilities in Nairobi City County were well informed and knowledgeable about STIs occurrence and the benefits of HIV-PrEP. The findings furthermore revealed a significant association between level of related knowledge on STIs and the prevalence of STIs among HIV-PrEP users in the County, ( 2 =62.280, p=0.033). The study further established that HIV-PrEP users in Nairobi City County were engaging in risky sexual behaviours as most of them were involved in the following behavioural risk activities: condomless sexual intercourse, greater number of sex partners, etc... This was further confirmed by having STIs diagnosis. It was shown that there existed a statistically significant association between behavioural risk factors of STIs and the prevalence of STIs among HIV-PrEP users in Nairobi City County ( 2 =31.170, p=0.005<0.05). The study concludes that the adoption of HIV-PrEP is likely to influence sexual behaviour causing a greater risk-taking tendency. The study thus recommends that there is need for the County facilities offering HIV-PrEP services to implement a continuous comprehensive routine screening tests for STIs for prompt identification and treatment of asymptomatic cases, to create awareness about STIs for risky behaviour change, in order to lower the prevalence of STIs among HIV-PrEP users.Item Prevalence and Risk Factors for Hypertension among Rural and Urban Population of Kisii County, Kenya(Kenyatta University, 2023-03) Ondieki, Alex Ontiri; Harun Kimani; Titus KahigaAbstractItem Relationship between Umbilical Cord Practices and Neonatal Cord Outcomes among Newborns at Nakuru Level Five County and Referral Hospital, Kenya(Kenyatta University, 2023-05) Kithaka, Judy Wainoi; Stephen MachariaAbstractItem Disclosure of HIV Sero-Status and Uptake of PMTCT Services by Pregnant and Breastfeeding Women in Bujumbura-Mairie Province, Burundi(Kenyatta University, 2023-05) Ndayikeza, EvelyneAbstractItem Determinants of Malaria Routine Data Reporting among Health Workers in Selected Health Facilities in Trans-Nzoia County, Kenya(Kenyatta University, 2023-04) Lagat, Nicholas Kiptoo; John Paul Oyore; Julius KorirAbstract