Mount Kenya University Institutional Repository
Not a member yet
5772 research outputs found
Sort by
Institutionalizing the Management of Sick Young Infants:Kenya’s Experience in Revising National Guidelines onIntegrated Management of Newborn and Childhood Illnesses
Get PDFIntroduction:In 2015, the World Health Organization (WHO)developed guidelines for the management of sick young infants(SYIs) with possible serious bacterial infection (PSBI) where refer-ral is not feasible. The Ponya Mtoto project was designed as animplementation research project to demonstrate how to adopt theWHO PSBI guidelines in the Kenyan context.Ponya Mtoto Project Description:Between October 2017 andJune 2021, Ponya Mtoto was implemented in 4 Kenyan countieswith higher infant and newborn mortality rates than the nationalmean. A total of 48 health facilities stratified by level of serviceswere selected as study sites.Implementation Approach:The following activities were done toinstitutionalize the management of SYIs with PSBI where referralis not feasible in Kenya’s health system: (1) participating in acocreation workshop and development of a theory of change;(2) revising the national integrated management of newbornand childhood illnesses guidelines to incorporate the manage-ment of PSBI where referral is not feasible; (3) improving avail-ability of essential commodities; (4) strengthening providerconfidence in the management of SYIs; (5) strengthening aware-ness about PSBI services for SYIs at the community level; and (6)harmonizing the national integrated management of newbornand childhood illnesses guidelines to address discrepancies in thecontent on the management of PSBI. In addition, the project fo-cused on strengthening quality of care for SYIs and using imple-mentation research to track progress in achieving project targetsand outcomes.Conclusion:Using an implementation research approach to intro-duce new WHO guidelines on PSBI where referral is not feasibleinto Kenya’s health care service was critical to fostering engage-ment of a diverse range of stakeholders, monitoring provider skillsand confidence-building, strengthening provision of key commodi-ties for managing SYIs with PSBI, and sustaining community-facilitylinkagesFunding for this project was made possible by the generoussupport of the American people through the United States Agency forInternational Development (USAID) under the terms of AID-OAA-A-17-0003
Assessing factors associated with FSM practices among residents living in Baidoa, Somalia
No full textBackground: Excreta is a normal part of life, but if it is not appropriately controlled, it can lead to waterborne
diseases, most low- and middle-income countries lack adequate FS treatment and management service coverage. The
study's main goal was to assess fecal sludge management practices and associated factors among communities in
Baidoa, Somalia.
Methods: The study adopted a cross-sectional study design. The collected data was analyzed using Statistical
Software for Social Sciences (SPSS) version 21. Descriptive statistics and chi-square were used. Qualitative data was
thematically analyzed.
Results: The study identified that 66% of the Baidoa FS produced is not well managed. Regarding community
perceptions, about 75.80% of the study participants don’t understand poor sanitation while 30.1% don’t know the
relationship between poor sanitation and health risk. Results showed a significant association between education level
and access to latrines, (2 (4, n=385) = 50.672, p<0.001). The findings revealed a statistically significant association
between residential status and access to FSM services (2 (23, n=385) = 148.82, p<0.001). HH monthly income is
significant in access to FSM services (2 (64, n=385) = 113.180, p<0.001); and limited capacity of Baidoa
municipality.
Conclusions: There are gaps in FSM management and residents are at risk of health hazards/disease outbreaks. The
key recommendation is the development of strategic sanitation service delivery planning in view of FSM service
chain and formulation of regulations to govern FSM service provision by different actors to safeguard the health
safety of living, learning, and working environment
Rapid profiling of Plasmodium parasites from genome sequences to assist malaria control
No full textMalaria continues to be a major threat to global public health. Whole genome sequencing (WGS) of the underlying Plasmodium parasites has provided insights into the genomic epidemiology of malaria. Genome sequencing is rapidly gaining traction as a diagnostic and surveillance tool for clinical settings, where the profiling of co-infections, identification of imported malaria parasites, and detection of drug resistance are crucial for infection control and disease elimination. To support this informatically, we have developed the Malaria-Profiler tool, which rapidly (within minutes) predicts Plasmodium species, geographical source, and resistance to antimalarial drugs directly from WGS data.
Results
The online and command line versions of Malaria-Profiler detect ~ 250 markers from genome sequences covering Plasmodium speciation, likely geographical source, and resistance to chloroquine, sulfadoxine-pyrimethamine (SP), and other anti-malarial drugs for P. falciparum, but also providing mutations for orthologous resistance genes in other species. The predictive performance of the mutation library was assessed using 9321 clinical isolates with WGS and geographical data, with most being single-species infections (P. falciparum 7152/7462, P. vivax 1502/1661, P. knowlesi 143/151, P. malariae 18/18, P. ovale ssp. 5/5), but co-infections were identified (456/9321; 4.8%). The accuracy of the predicted geographical profiles was high to both continental (96.1%) and regional levels (94.6%). For P. falciparum, markers were identified for resistance to chloroquine (49.2%; regional range: 24.5% to 100%), sulfadoxine (83.3%; 35.4– 90.5%), pyrimethamine (85.4%; 80.0–100%) and combined SP (77.4%). Markers associated with the partial resistance of artemisinin were found in WGS from isolates sourced from Southeast Asia (30.6%).This work was funded by a UKRI MRC Artificial Intelligence for Biomedical and Health Research grant (Ref. MR/X005895/1), a Wellcome iTPA Translational Accelerator Award (214227/Z/18/Z), and a UKRI EPSRC award in Artificial Intelligence innovation to accelerate health research (EP/Y018842/1). SC and TGC are funded by the UKRI MRC (MRC IAA2129, MR/R026297/1, and MR/X005895/1) grants. JG and TGC were funded by a Royal Society FLAIR Collaborative grant (FCG\R1\211029). JGD was supported by fellowships from FAPESP (2019/12068–5 and 2022/02771–3)
Infectious and environmental placental insults: from underlying biological pathways to diagnostics and treatments
No full textBecause the placenta is bathed in maternal blood, it is exposed to infectious agents and chemicals that may be present in the mother’s circulation. Such exposures, which do not necessarily equate with transmission to the fetus, may primarily cause placental injury, thereby impairing placental function. Recent research has improved our understanding of the mechanisms by which some infectious agents are transmitted to the fetus, as well as the mechanisms underlying their impact on fetal outcomes. However, less is known about the impact of placental infection on placental structure and function, or the mechanisms underlying infection-driven placental pathogenesis. Moreover, recent studies indicate that noninfectious environmental agents accumulate in the placenta, but their impacts on placental function and fetal outcomes are unknown. Critically, diagnosing placental insults during pregnancy is very difficult and currently, this is possible only through postpartum placental examination. Here, with emphasis on humans, we discuss what is known about the impact of infectious and chemical agents on placental physiology and function, particularly in the absence of maternal–fetal transmission, and highlight knowledge gaps with potential implications for diagnosis and intervention against placental pathologies
Barriers to Voluntary Medical Male Circumcision Uptake to Prevent HIV Transmission: A Qualitative Study among Married Men
No full textBackground: Voluntary medical male circumcision (VMMC) is a relatively new intervention that has been found to reduce sexual transmission of HIV among heterosexual partners by 60% when properly practiced. However, the poor acceptance of VMMC makes it difficult to accomplish the objectives of health policy to boost uptake. The purpose of this study was to explore the barriers to VMMC Uptake among married men in Kitgum municipality.
Methods: The qualitative descriptive design was employed in this study. The purposive sampling method was used to recruit 30 married men who lived within any of the three divisions of the municipality and had been married for at least one year. Data collection was done using an in-depth interview method. Inductive content analysis was used to generate the themes and categories.
Results: The study findings revealed that fear, financial uncertainty, involvement of female health workers, cultural beliefs, religious belief, sexual dissatisfaction and advanced age were barriers to voluntary medical male circumcision uptake among the married men in Kitgum municipality.
Conclusion: In Kitgum municipality, VMMC Uptake is still low, but the majority of the males had sufficient knowledge about it. We found the low uptake was primarily attributed to anxiety, involvement of female health workers, financial instability, sexual unhappiness, and advanced age. There is a need for proper re-packaging of the health education messages during mobilisations to address the anticipated side effects and to clearly state the reasons for the VMMC program. There is a need for proper re-packaging of the health education messages during mobilisations to address the communication gaps and to clearly state the reasons for VMMC program. Adequate psychological preparation of the men to expect any sex of staffs working in these clinics
HIV Treatment and Care of Adolescents: Perspectives of Adolescents on Community-Based Models in Northern Uganda
No full textBackground: Differentiated service delivery models for people living with HIV continue to be scaled up to expand access to HIV services and treatment continuity. However, there is a gap in information on adolescents’ perspectives on community-based models. We aimed to explore the perspectives of adolescents living with HIV on community-based models in northern Uganda.
Materials and Methods: Between February and March 2022, we conducted a descriptive qualitative study at two health centres IV in Northern Uganda. Data was collected using an interview guide. The study had 25 purposively selected adolescents enrolled in community-based models for HIV care and treatment. The interviews were audio-recorded, transcribed verbatim, and translated. We analyzed data using a thematic approach.
Results: A total of 25 in-depth interviews with HIV-positive adolescents were conducted. More than half (52.0%) of the participants were females, 84.0% were not married, and 44.0% had no formal education. The mean age of the respondents was 15.6 (± 1.9) years. The major themes were: community-based models currently accessed by adolescents, benefits, and challenges of the models. Although there are other community-based models (community pharmacies, home ART deliveries) our exploration only discovered two models used by these adolescents to access care, namely, Community Drug Distribution Point (CDDP) and Community Client-Led ART Delivery Groups (CCLADs). The benefits included reduced transportation costs, convenient service access, ART adherence, peer support, a comfortable environment and less stress. However, our results indicate that these models had some challenges, including lack of confidentiality and privacy, perceived stigma, and a lack of face-to-face interaction.
Conclusion: Our findings show that CDDP and CCLADs are the two CBMs used by adolescents in Lira District to access treatment and care. Adolescents benefited from these models through reduced transport costs, the convenience of accessing HIV care and treatment, and social support. The challenges associated with these models are lack of confidentiality and privacy, perceived stigma, and a lack of face-to-face interaction. The Ministry of Health should work with other implementing partners to strengthen the implementation of these models to improve HIV/AIDS service delivery for adolescents
Determinants of Covid-19 Vaccine Uptake Among Adults in Mwala Sub County, Machakos County, Kenya
No full textCOVID-19 has had immense negative effects on different populations both economically and socially. Since the pandemic started in 2019, it has caused numerous deaths and lowered quality of life among various victims and survivors. In efforts to contain the pandemic, virologists and vaccine manufacturers have worked and invented different COVID-19 vaccine variants with diverse but remarkably good levels of efficacy against the disease. Despite the Kenyan government’s efforts to make the vaccines available to the eligible population, vaccine hesitancy and refusal has brought about poor uptake hence slowing down the vaccination process. In this regard, the broad objective was to investigate the determinants of COVID-19 vaccine uptake among adults. The specific objectives were to identify the individual, administrative, social, and demographic factors that influence COVID-19 vaccine uptake among adults in Mwala Sub-county. It engaged the adult population residing in Mwala sub-county, Machakos County, Kenya as the study participants only. Analytical cross-sectional study design was used to achieve these objectives. Ethical clearance was issued by Mount Kenya University Ethical Review Committee and NACOSTI before data collection. The study targeted residents of Mwala Sub-county aged above 18 years of age. Data collection was carried out by means of structured questionnaires administered to 384 respondents and key informant interview guides that engaged six informants. The questionnaire respondents were sampled using systematic random sampling method from individuals visiting the six vaccination centres in the Sub-county. The process adhered to ethical considerations of informed consent, confidentiality, and anonymity. Data analysis was done with the aid of the SPSS software version 26. Descriptive analysis was conducted to describe the socio-demographic findings of the study as well as COVID-19 vaccine uptake of the respondents. Uptake of the first dose was 46.60% while fully vaccinated individuals were 11.70% of the total number of respondents. The association between some variables was identified through Chi-square test of association at significance level p=0.05. There were statistically significant associations between the outcome variable (COVID-19 vaccine uptake) and demographic predictors of age (χ2=15.524, df=3, P=0.001), sex (χ2=5.250, df=1, P=0.022), education level (χ2=107.556, df=3, P<0.001), and marital status (χ2=35.328, df=3, P<0.001). Additionally, social factors such as dependence on unreliable sources of information (χ2=32.904, df=3, P<0.001), collective responsibility of getting vaccinated to protect others (χ2=292.931, df=3, P<0.001), and religious teachings (χ2=11.763, df=1, p=0.001) also exhibited significant associations. Among predictors of low vaccine uptake was individual factors of susceptibility perception (χ2=189.471, df=1, p<0.001), severity perception (χ2=234.515, df=3, P<0.001), safety concerns (χ2=277.624, df=3, P<0.001), and perception that the vaccine benefits did not outdo associated side effects (χ2=277.624, df=3, P<0.001). Administrative factors of vaccine stock-outs (OR = 0.86, 95% CI 0.82 – 0.90) and long queues (OR=0.87, CI 95% 0.83–0.90) were not significantly related to the outcome variable. The study concludes that the vaccine uptake in Mwala is generally low. To overcome the low vaccine uptake, the government should incorporate COVID-19 vaccination into the existing routine vaccination schedule and address conspiracy theories revolving around the vaccine in various social media sites during health education and awareness vaccination campaigns
Prevalence and predictors of work-related musculoskeletal disorders among healthcare professionals in Sub-Saharan African region: systematic review and meta-analysis protocol
Get PDFBackground: The Global Burden of Diseases 2017 found that musculoskeletal disorders (MSDs) are the second most prevalent cause of years lost to injury, although years of life lost are decreasing in low-income countries, especially in Sub-Saharan Africa. The objective will be to describe the regional prevalence of WMSD for different anatomical body areas and their risk factors in different health professions in the sub-Saharan African region.
Method: We will search databases such as Scopus, PubMed, Science Direct, AJOL, and Google Scholar for publications published between January 2002 and December 2022. The primary outcome will be the prevalence of work-related musculoskeletal disorders among health professionals, and risk factors related to WRMSDs will be the secondary outcome. Three reviewers will screen all abstract data, full-text articles, and all citations independently. The Newcastle-Ottawa scale (NOS) will be used to assess the quality of eligible publications. Subgroup analysis will be conducted to explore the potential heterogeneity (e.g., age, sample size, gender, and occupational activities). Publication bias and heterogeneity will be assessed and reported using the appropriate tools.
Discussion: This systematic review and meta-analysis will provide a synthesis of the literature on work-related musculoskeletal disorders and their predictors among health professionals in the Sub-Saharan Africa region. The consensus of data from this review will provide a regional view to help occupational health-related policymakers, healthcare professionals, and program managers in developing countries gain a better understanding of the prevalence, causes, and trends to build better evidence-based occupational musculoskeletal health and disorders prevention programs among various health professionals
Risk Factors Associated with Hypertension among Adults 18-65 Years in Kirinyaga County, Kenya
No full textHypertension is one of the non-communicable diseases linked with heart disease and accounts for about 64% of stroke cases globally. BP is becoming the leading global public health problem with over 10M death every year. Despite growing evidence that high blood pressure is on the rise, information about its risks factors on patients seeking medical care in Kenyan hospitals is limited. This research investigated the risk factors associated with high blood pressure among adults aged 18-65 in Kirinyaga County, Kenya.
Analytical cross-sectional study, using quantitative and qualitative methods of data collections, a multistage sampling procedure sampled 380 study participants chi square and logistic regression made deductions about the study population. In qualitative data, deductive approach used research questions as a guide for data analysis. Gender chi-square χ2 (2, N=345=128.640, P=.000), respondent age χ2(5, N=345=158.021, P=.000), education level χ2 (3, N=345=77.677, P=.000), marital status χ2(4, N=345=69.413, P=.000), state of being pregnancy χ2(1, N=345=224.599, P=.000), currently smoking cigarette χ2(1, N=50=28.890, P=.000), currently taking alcohol χ2(1, N=273=16.548, P=.000), engaging in physical activities χ2(3, N=345=58.183, P=.000), and weight status χ2(2, N=184=40.044, P=.000) were statistically significantly associated with the development of hypertension. Routine screening and advocacy by the health worker should be done for early detection, timely treatment, follow up and prevent complications related to hypertension
Effectiveness of Health Education on Prevention of Antibiotic Misuse and Self-Medication Among HIV-Positive Adults in Bauchi State Nigeria
Get PDFMisusing antibiotics and self-medications constitute one of the major public health
challenges across the globe. Resistance to common antibiotics often necessitates shift
towards more expensive and scarcely available higher generations antibiotics. People
living with HIV/AIDS are likely to experience multiple health challenges irrespective of
their use of anti ret rovi ral drugs. The objective of this study was to determine the prevalence
of antibiotics misuse and self-medication and the effect of Health Education (HE) on the
prevention of antibiotics misuse and the behavior of self-antibiotics prescribed
treatments for common bacterial infections among HIV positive adults residing in
Bauchi State Nigeria. The study was quasi-experimental design. A total of 85
participants were selected in the intervention and control groups respectively. H e a l t h
education intervention was conducted among experimental group.
Data was collected using structured questionnaire at baseline and three months post-
intervention and analyzed using SPSS and R software. The magnitude of antibiotics
misuse and self-medication among intervention and control groups at baseline were
67.1% and 64.7% respectively. However, following health education, the
magnitude in the intervention and control groups was 24.3% and 67.5% (P<0.005)
respectively. Occupation was significantly associated with having good knowledge of
antibiotics misuse and self-medication, while years spent on ARVs were significantly
associated with having good attitude towards antibiotics misuse and self-medication,
so also tribe and the CD4 count status on perceived control beliefs. On adjusting for
confounding effect using logistic regression analysis, the predictors of knowledge
were marital status of married (AOR=2.01, 95%CI=1.67−3.99), occupational status of
employed (AOR =4.00, 95%CI = 1.17−10.27), education (AOR=1.95,
95%CI=1.45−4.18) and duration of ARV therapy (AOR=2.12, 95%CI=1.77−7.88).
Also, marital status of married (AOR=3.11, 95% CI=1.23–4.56), educational status of
secondary school and beyond (AOR=3.99, 95%CI=2.76–9.54), and duration of ARV
therapy (AOR=3.00, 95%CI=2.11–6.44) were significant predictors of poor attitude
towards antibiotics misuse and self-medication among intervention group who received
health education. Health education was found to have significant effect in reducing
prevalence of antibiotics misuse and self-medication among HIV positive adults.
Integration of health education into routine HIV care will be useful in reducing
antibiotics misuse and self-medication. Further research is required on the long-term
effects of health education on reducing antibiotics misuse and self-medication among
HIV positive adult.
Key Words: Self-Medication, Antibiotics, HIV, Health Educatio