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May Measurement Month 2017: the results of blood pressure screening of 14 845 individuals in Kenya-Sub-Saharan Africa
No full textElevated blood pressure (BP) is a growing burden worldwide leading to over 10 million deaths each year. Sub-Saharan Africa has the highest age-adjusted prevalence of hypertension. In Kenya, 24.5% of adults have elevated BP with lack of awareness being the main barrier to achieving satisfactory control rates. May Measurement Month (MMM17) is a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes worldwide. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2017. Screening was coordinated by the Kenya Cardiac Society in 17 sites across the country. Blood pressure measurements, the definition of hypertension and statistical analysis followed the standard MMM protocol. A total of 14 847 individuals were screened. After multiple imputation, 3647 (24.6%) had hypertension. Of individuals not receiving any antihypertensive medication, 2019 (15.3%) were hypertensive. Of individuals receiving antihypertensive medication, 740 (45.5%) had uncontrolled BP. Being diabetic and having a body mass index (BMI) ≥25 kg/m2 were associated with higher BP. Lack of awareness and poor control in those identified is a major challenge in Kenya. The MMM project demonstrated that mass screening for elevated BP is feasible, even in settings with limited resources. The presence of hypertension in a quarter of Kenyan adults with poor awareness and control rates demonstrates the need for programmes to raise awareness in the community
The Relationship Between Salivary Interleukin-1β Levels And Periodontal Health Status
No full textIntroduction: The periodontium consists of the gingiva, periodontal ligaments, cementum and
alveolar bone. Together the four components function as a unit and are the supportive structures
of the teeth, maintaining their function and stability.1 Periodontal diseases are inflammatory
conditions that affect these supportive structures.
Background: Inflammatory Periodontal diseases are the most common oral diseases in human
kind and as such it’s a serious public health issue and the second major cause of tooth loss.2
Presently the diagnosis of inflammatory periodontal diseases relies on the analysis of a range of
clinical parameters. These traditional methods of diagnosis only manage to describe past events
such as attachment loss and thus are not able to detect current disease activity. Consequently,
there is interest in developing new diagnostic markers which provide additional clinical
information over and above those obtained by clinical examination. The use of saliva as a tool
for diagnosis due to the fact that majority of biomarkers found in blood or in urine are also found
in saliva samples which is easier and more safe to collect. The identification of molecular
biomarkers of inflammatory periodontal disease found in saliva can objectively provide a rapid
and accurate tool that can diagnose and monitor disease activity and would go a long way in the
management of periodontal conditions.3
Objectives: The aim of the study was to investigate salivary IL-1β biomarker and how it relates
to the periodontal health status of the participants.
Materials and Methods: This was a descriptive cross-sectional study. The study population was
patients attending the University of Nairobi Dental Hospital (UONDH) for treatment of various
oral facial conditions. They were interviewed using a structured questionnaire on Bio-data,
socio-demographic characteristics, lifestyle habits and oral health status. The clinical
examination comprised of periodontal evaluation based on the basic periodontal examination
(BPE). Plaque and gingivitis were determined using Turesky modification of Quigley Hein, 1970
Index and Loe and Silness 1963 index respectively. Collection of whole saliva for analysis of
salivary IL1-β levels was done through the spit method.4Whole saliva samples were used and the
levels of interleukin1β were quantified using ELISA.
Data analysis and presentation: Data collected was coded and analyzed using SPSS software,
descriptive statistics, Independent T tests and ANOVA, Pearson’s correlation and linear
regression were used to investigate the relationship between salivary-interleukin 1β and
periodontal health status.
Results: 71 participants were recruited into the study. The age range of the participants was
between 18-81 years. Out of the 71, 48 (67%) were females and 23(32.4%) were males. 39
(54.9%) of participants had gingivitis, 20(28.2%) had mild to moderate periodontitis and 12
(16.9%) had severe periodontitis.................................................................................................................................................................................................................................................................................................................................................................................................a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Keny
Organization Policies And Performance Of Mobile Telecommunication Companies In Kenya
No full textThe Mobile Telephony Industry has created many employment opportunities. In order to create a sustainable and profitable business, it’s important to have proper organizational policies; firms with clear policies perform better than those companies that lack. Increasing intensity of competition in Kenya’s mobile telecommunication industry has negatively affected financial performance of mobile companies with most of them incurring huge losses in the recent past (CAK, 2019). From the study done there’s limited empirical proof on the association existing between organizational policies and performance, therefore the research gap this study sought to fill by answering the following research questions, is there a relationship between organizational policies and performance of mobile telecommunication companies in Kenya? This study was anchored on three theories which includes, competitive advantage theory, stakeholder theory and resource-based view theory. The study is important to the management of mobile telecommunication companies, as it guides them in understanding how strategic organizational policies are of importance in organizational performance. The study findings benefits policy makers as they get to understand how strategic organizational policies affects performance of mobile telecommunications companies. Researchers and academicians can use the study as a reference for future related studies. The study adopted a descriptive cross-sectional survey. This study focused on four major telecommunication firms operating in Kenya. The study focused on 178 managerial staffs of four mobile telecommunication companies firms based at the head office. The study sampled 50% of the population chosen through stratified random sampling. Stratification was based on mobile telecommunication company. This study used a questionnaire as data collection tool. Quantitative data collected was analysed by the use of descriptive statistics using SPSS (Version 23). Content analysis was used to test data that is qualitative in nature or aspect of the data collected from the open ended questions. Multiple regressions were done to establish the relationship between organizational policies and performance of mobile telecommunication companies in Kenya. Data was presented using tables, and pie charts to make them reader friendly. The study established that organization policies directly influences organizational performance suggesting that a unit increase in organizational policies will result in an increase in organizational performance. The study recommends management of the telecommunication companies to ensure that their policies are well-structured and suitable in order to ensure that the organization functions effectively and improves its performance. Mobile telecommunication companies should be concerned with operational policies especially policies focused on decision structures and team synergy and ensure they are flexible and adjusts accordingly depending on the current conditions. The study also recommends the companies to focus more on productivity policies to ensure there is speedy decision making; this ensures that professionals and management is protected from adhocracy details that negatively affect their creativity and performance. The study further recommends the companies to focus more on quality-management policies as strategies that can guide the company in attaining sustainable competitive advantage
Effect Of Corporate Governance Structures On The Shareholders Value Of State Corporations Listed At The Nairobi Securities Exchange
No full textCorporate governance structures are systems of internal controls and practices that enable the management of entities to become profitable units. These structures encompass the framework that describes the rights, duties and tasks of each group including the senior management team, shareholders and board of directors. Corporate governance structures are usually adopted to improve cost effectiveness, enhance productivity and profitability and minimize the conflict between shareholders and management teams. This study attempted to ascertain the influence of CG structures on the shareholder value of state corporations listed at the NSE. The study was for the ten year period between 2009 and 2019. The descriptive research design was used to sample the population of nine state corporations that are listed at the NSE. The study utilized secondary data from various sources including financial statements and annual reports as well as abridged reports of the listed corporations from the NSE. Data analysis was conducted to derive the mean, the maximum and minimum values. The F-test statistic was calculated at significance level of 5% using the regression analysis. Based on the findings, the F statistic was significant at 3.614. Board meetings was found to have a p-value of 0.030 which was insignificant, board size had a p-value 0.498 which was insignificant and firm size had a p-value of 0.358 which was insignificant. Leverage had a p-value of 0.33 which is higher than 0.05 thus the relationship was insignificant. The study determined that CG structures have a positive influence on the shareholder value of listed state corporations. Therefore, the study recommends that board sizes be determined based on the specific requirements of a given firm and the underlying conditions affecting corporations. Also, the board of directors should plan for and attend a significant amount of board meetings per given financial year to improve planning, implementation and monitoring of strategic objective
Quality of Life of Patients Treated for Oral and Oropharyngeal Squamous Cell Carcinoma at Kenyatta National Hospital and University of Nairobi Dental Hospital
No full textBackground: The number of patients treated for oral cancer continues to rise. Most of these patients have to live with debilitating complications which adversely affect their quality of life (QOL). Rarely do clinicians assess and record quality of life of these patients routinely. Evaluation and documentation of this subjective feedback will help provide a baseline against which evidence-based effectiveness of a treatment intervention can be measured.
Broad objective: To determine the quality of life of patients treated for oral and oropharyngeal carcinoma at Kenyatta National Hospital (KNH) and University of Nairobi Dental Hospital (UDH)
Materials and Method: This study was a descriptive prospective study conducted at Kenyatta National Hospital and University of Nairobi Dental hospital from August 2018 to August 2019 involving patients diagnosed with oral and oropharyngeal squamous cell carcinoma. University of Washington Quality of Life Questionnaire version 4 was used. QOL assessment was scheduled before starting treatment and 3 months after treatment. Scores for each question in every patient were tabulated and the means for all relevant variables were calculated mainly for comparison purposes
Results: Seventy-one patients were recruited in this study and most of them were presenting for treatment at advanced stage of cancer (98.6%). 37 were found suitable to participate in the second interview upon completing 3 months after treatment. 20 patients died within the course of this study and out of these 20 patients 6 had been interviewed 3 months after treatment. Nine patients were lost to follow up and the remaining eleven patients had not completed the required 3 months after treatment mainly due to treatment delays. The overall QOL mean score for the 71 patients before treatment was 61 points. The overall QOL mean score of the 37 patients who had been reviewed 3 months after treatment slightly improved from 68 points before treatment to 72 points after treatment although this change was not statistically significant (p value = 0.1645). There was significant improvement in emotional functions such as pain, mood and anxiety
following treatment. Patients presenting with base of the tongue lesions had the worst QOL scores (54 points) before treatment compared to others
Conclusion: There was overall slight improvement in QOL following treatment mainly due to better emotional functioning following treatment but this change was not statistically significant. Majority of the patients were presenting at advanced stage of cancer which translated to lower QOL as disease stage advanced. Patients treated at very advanced disease stage were more likely to get post-op complications and early mortalitya
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Keny
Assessment of Anthropogenic Activities and Their Impact on Ngong Hills Forest, Kajiado County: a Remote Sensing Approach
No full textMonitoring of the forest ecosystem is mandatory in detecting any changes in the ecosystem. Human beings are dependent on forests for various livelihood needs and thus the development and conservation of forests around the world is vital. Forests offer a variety of benefits including ecological, social as well as economic benefits thus more reason to protect this ecosystem. Forest cover change detection gives an opportunity to track the productivity, health and the forest cover as well over the years so as to enable proper management, promote conservation and enhance functionality. Optical and radar remote sensors make it possible to monitor changes by the use of various analytical techniques which include visual interpretations.
The study reviewed on how remote sensing can be applied to detect change in forest ecosystem and to assess the rate of change of Ngong Hills Forest. This project is focused on determining whether anthropogenic activities are the major cause of the change in Ngong Hills Forest. Data from satellite images was analysed from 1984 to 2019 to identify the changes that occurred on the ecosystem. By achieving this, it will thus be possible for management agencies to enforce conservation because of the presence of reliable data. Landsat and Rapid-Eye images were used to inform on change detection and in this case, rapid eye data was found to be better than Landsat data in informing on change detection because of its high resolution thus high precision and better results. The changes depicted by the remotely sensed data were mapped for ease of analysis and visualization.
The research depicted a massive decrease in the forest cover despite the afforestation efforts by the KFS in the 1990’s. The forest has been depreciating massively from 1995 depicting greater deforestation rates between 2010 and 2019. This depreciation has been acknowledged by the KFS as it is said to be occurring due to the anthropogenic activities mainly settlement and logging.
The means of detecting change by use of remote sensing is thus able to identify the exact areas that change has occurred and thus providing insight to the Kenya Forest Service and other ecosystem protection bodies on the most affected areas and the extent of change. Once the study area is mapped, it is possible to calculate the areas that have decreased in vegetation quantity, areas where increase has occurred as well as the areas that have remained unchanged
The Role of Maternal Fetal Movement Assessment on Antepartum Fetal Testing and Perinatal Outcomes Among Selected High-risk Pregnancies at the Kenyatta National Hospital, 2014-2018 (a Five-year Retrospective Cohort Study)
No full textA high-risk pregnancy is that in which the life of the gravid woman or her fetus is threatened. Factorsassociated with high-risk pregnancy include; pre-existing medical conditions, pregnancy-related complications and inherent fetal health problems. Some of the commonest high-risk conditions include hypertensive disorders of pregnancy (HDPs), diabetes mellitus (DM) and post-term pregnancies whichaffect approximately8-10%, 16.2% and 5-10%of pregnancies in that order.Fetal surveillance tests such as maternal fetal movement assessment, fetal heart sound auscultation, cardiotocography (CTG) and ultrasound biophysical profile (BPP)and doppler velocimetry identify at-risk fetuses and therefore predict or prevent adverse perinatal outcomes.
Maternal fetal movement assessment (FMA)is a valuable test because it’s easy to perform andinexpensive. Although FMA may not predictperinatal outcomes for all pregnancies, irrespective of the riskstatus, its role in high-risk pregnancies especially in low resource setting has not been fully described. In this study, we evaluated the antepartum fetal testing profile, early perinatal outcomes and the role of maternalfetal movement assessment in predicting adverse pregnancy outcomes specifically amongHDP,DM and post term pregnancies.
Objectives: To describe the antepartum fetal testing profile and perinatal outcomes and evaluate the role of maternal fetal movement assessment among selected high-risk pregnancies at Kenyatta National Hospital.
Methodology
Study Design: Records based retrospective cohort study
Sampling: Simple random sampling
Data collection: Standardpre-coded and pretested data abstraction tools were employed to collect relevant data.
Statistical analysis: Continuous data variables were analysed as mean and standard deviation from the mean and t-test used to evaluate for association. For categorical variables, frequencies were obtained and compared using chi-square test. Relative risks werecalculated. A p-value of less than 0.05 was considered statistically significant.
Results: Between January 2014and December 2018 we examined records of 1372 women and 392(28.6%) werefound to be eligible. Thesecomprised 196(14.3%) records of women who reported normal fetal movements and 196 records of womenwho perceived reduced fetal movements. The mean age of the patients was 29.6 (standard deviation=6.2) years. A total of 140(35.7%) had hypertension, 67(17.1%) had diabetes mellitus, 132((33.7%) had post-term pregnancies and 53 women (13.5%) had more than one of these three conditions.
The most prevalent antepartum fetal test wasBPP (51.5%), followed by CTG (46.7%),umbilical artery resistive index (44.9%) and middle cerebral artery (MCA) resistive index (16.1%) in that order. The prevalence of fetal testing was significantly higher in the reduced fetal movement (RFM) group%) compared to normal fetal movement (NFM) group (CTG 60.2% vs 33.2%, BPP 67.3% vs 35.7%, umbilical artery RI 58.7%vs 31.1%, MCA RI 22.4 vs 9.7%), p < 0.05.
There were 55(14%) adverse perinataloutcomes, specifically,stillbirths,poor APGAR scores and early neonatal death. Theprevalence of these outcomes was higher in those who .....a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Keny
Cytogenetic and Molecular Profiling of Acute Myeloid Leukemia Patients Presenting to the Adult Hemato-oncology Unit of Kenyatta National Hospital
No full textBackground-Acute myeloid leukemia is an infrequent disease yet it is associated with high morbidity and mortality. It harbors a unique configuration of cytogenetic abnormalities and molecular mutations that can be detected using microscopic methods and molecular sequencing respectively. These genetic tests are core elements of diagnosis and prognostication in high-income countries. They are routinely incorporated in clinical decision making, allowing for the individualization of therapy. However, these tests are largely inaccessible to most patients in Kenya and therefore no data has been reported on this group of patients.
Objective-To determine the chromosomal abnormalities and molecular mutations of patients diagnosed with acute myeloid leukemia presenting to the adult hemato-oncology unit of Kenyatta National Hospital.
Design: A cross-sectional descriptive study.
Setting: Adult hemato-oncology unit, Kenyatta National Hospital.
Subjects: Patients with a morphological diagnosis of acute myeloid leukemia
Sampling: Consecutive sampling
Methodology- The study participants that met the inclusion criteria and consented/assented to participate were enrolled to a sample size of ten. Peripheral blood samples were collected for conventional metaphase G-banding technique and next generation sequencing methods. A study proforma was used to record the patient’s social demographics, clinical and laboratory data.
Study Period: The study was done over a period of three months beginning July- September 2019
Analysis-No descriptive analysis was done due to the small sample size. Descriptive statistics are presented in tables.
Results: Ten patients underwent cytogenetic analysis and next generation sequencing using the Ampliseq for Illumina myeloid panel. Cytogenetic studies yielded no results. There were 29 mutations detected across 13 commonly mutated genes. At least one mutation was detected
for all the patients. Three patients with TP53 mutations were classifiable under the ELN adverse prognostic group.
Conclusions: The study demonstrated that patients with AML in KNH do have deleterious mutations that impart a unique genomic spectrum for each and every patient and contribute to the heterogeneity of disease outcomes among the patients. Lack of cytogenetic analysis and subsequently the results precludes us from drawing definite conclusions on the prognostic effect of these mutations.a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Keny
Effect Of Corporate Governance On The Dividend Payout Of Manufacturing Firms Listed At The Nairobi Securities Exchange
No full textThe outcome hypothesis gives a suggestion that dividend payout is an output of governance quality. In organizations with poor administration, managers who are self-seekers have the ability of retaining a lot of the cash within the organization, thus there is a high probability of them using that cash for their own personal profits at the peril of the shareholders. Contrary, the argument made by substitution hypothesis is that organizations with poor administration make higher payments of dividends to substitute for the weak administration by the managers. This research set to determine how corporate governance influences dividend payout of manufacturing and allied firms that are listed at the NSE. All 9 firms in this category formed population of this work. Independent variables in this research were corporate governance operationalized as the size of the board members, independence of the team and number of board committees. Control variables were profitability as given by return on equity, firm size given by natural log of total assets, liquidity represented by current ratio and debt financing given by the ratio of total debt to total assets in a year. The response variable was dividend payout given by the ratio of DPS to EPS. A five year period, January 2014 to December 2018, was studied through gathering of secondary data. Descriptive research design method was employed while multiple linear regressions model was applied in analysis of the association between the variables. The data was analyzed by use of SPSS version 22. An R-Square value of 0.925 was produced from the study results which meant that a large percentage, 92.5%, of dividend payout of manufacturing and allied firms that are listed at the NSE are attributable to the seven predictor variables as 7.5% of disparity of dividend payout was related to variables that were not part of this study. Findings of ANOVA highlight how F was important at the 5% level, showing p=0.000. Therefore, this case showed that the model was appropriate in explaining the correlations between the differing variables. In addition, it was revealed that board independence and firm size showed a positive and statistically substantial influence on dividend payout while debt financing had a negative and statistically significant influence on dividend payout. Board size, board committees, profitability and liquidity produced insignificant values for this research work. This research recommends that policy makers should develop policies aimed at making boards more independent, because this has a statistically substantial influence on dividend payout among manufacturing and allied firms listed at the NSE
Influence Of Strategic Alliances On Performance Of Kenya Women Microfinance Bank Limited
No full textStrategic alliances are an important element for the success of any business in the 21st
century, which is characterized by a highly competitive environment. It has been
projected that the rate of failure of the strategic partnerships could be 70% high,
probably due to the fact that they did not satisfy the objectives of their holding firms
nor delivered on strategic and operational benefits which they desired to produce. The
rates of terminating an alliance have been reported as above 50 per cent. In many
instances like termination of such relations has led to destruction of the value of
shareholders for firms participating in those alliances. Although many studies have
been done on strategic alliances in financial sector few have narrowed down to a
microfinance institution. This study therefore sought to fill this research gap by
establishing the influence of strategic alliance on performance of Kenya Women
Micro Finance Bank Limited. The study was guided by Resource Based Theory,
Capability Based View, Resource Dependency Theory and Strategic Alliance
Dynamism Model. A case study design that entailed detailed investigation of
individuals from the organization was adopted by use of interview guide. The study
targeted seven senior managers in the following departments: Finance, Insurance,
Information Technology, Legal & Regulatory, Product Development, Credit and
Digital Lending. The researcher personally conducted the interviews. Content analysis
was applied for analyzing the data. This study concluded that strategic alliances at
KWFT are driven by competition, value adding, technology, profitability, joint sales
and improved distribution channels. The study concluded Kenya Women
MicroFinance Bank Limited used key performance indicators (KPIs) such as loan
portfolio growth, profitability, market share and clientele growth. The study revealed
that KWFT has continued to register positive growth which can be related to effective
and efficient strategic alliances. The study therefore recommended that the structure
of the alliance between KWFT and its partners need to be defined in a way that
enables mutual balance between competition and co-operation. Senior management
should be involved in strategic operations while ensuring clear and common vision to
avoid conflict of interest. There should also be clear guidelines which govern the
alliance in order to ensure transparency while promoting mutual trust