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Knowledge Attitudes and Practices Regarding Vitamin A Supplementation among Caregivers of Children Aged from Six to Fifty-Nine Months in Vihiga County, Kenya
No full textVitamin A is an essential micronutrient needed in small amounts for, among other uses, the normal functioning of the visual and immune systems. The deficiency of this vital nutrient, therefore, compromises a children's ability to fight diseases and increases their risk of getting sick. The World Health Organization recommends Vitamin A Supplementation (VAS) as a strategy to combat the effects of vitamin A deficiency, but unfortunately, the coverage is low (64% in priority countries and 59% in East and Southern Africa, as reported in UNICEF global nutrition database 2000-2021). The study area recorded low coverage at 26% in 2019 and 54.9% in the year 2020. This study employed a descriptive cross-sectional study design to determine the knowledge, attitude, and practices among caregivers of children 6-59 months regarding vitamin A supplementation in Vihiga County, Kenya, and the influencing factors. In total, 393 caregivers out of the sample size of 400 (98.3%) were recruited into the study. Binary logistic regression was used to determine associations between variables and a p-value <0.05 was considered significant. High VAS awareness was reported in this study, with 90.6% of caregivers having heard of VAS. The main sources of VAS information were health workers (74.3%) and Community Health volunteers (53.2%). Other sources were Radio & TV (6.9%), Social gatherings (7.1%). There was, however, low knowledge of the benefits of VAS (30%) and the problems associated with vitamin A deficiency (30.3%). Sadly, a quarter of caregivers (24.6%) did not know any VAS benefit. A significant proportion of caregivers (77.6% p=<0.001) had adequate knowledge of VAS, scoring more than half of the 10 knowledge questions. In addition, caregivers displayed a highly positive attitude towards VAS, scoring between 88.3% and 92.6% on attitude questions. There was low VAS uptake, with only 59.5% of children having taken the supplement during the semester preceding the survey, mainly sourced from health facilities (68.4%), outreach (15.8%), CHV (10.7%) and the ECDE centres (5.1%). For children who missed VAS in the semester of reference, 38% of caregivers indicated they had no reason for missing, 20% said there was no need since the child had completed immunization, while others just forgot (9%). The key drivers of VAS uptake were knowledge (p=<0.001), availability of services at health facilities (p=0.001) and services by community health volunteers) p=0.028). Although more than three-quarters (77.6%) of caregivers demonstrated good knowledge, it did not correspond to the VAS uptake recorded in this study, pointing to a knowledge-practice gap. The VAS knowledge was shallow in terms of specific areas like benefits. The caregivers, however, had very positive attitudes towards VAS. Further, this study concludes that better knowledge is an important ingredient for VAS uptake and recommends implementing programmes to improve caregiver knowledge and optimization of the various service delivery platforms to increase both knowledge and uptak
Impact of food hygiene and safety training on knowledge, attitude, and practices of food hygiene and safety practices among food handlers in boarding schools of Embu County, Kenya
No full textBackground: The reduction of foodborne illnesses depends on the adoption and evaluation of effective food handling procedures in the food service industry. The purpose of the study was to evaluate the impact of food hygiene and safety training on the knowledge, attitudes, and practices of food handlers in boarding schools in Embu County, Kenya.Methods:A longitudinal nonequivalent quasi-experimental survey design was utilized.A sample size of 198 study respondents was generated, Magnani formula was used. Multistage sampling was applied to select the study participants.STATA version 17 was employed for data analysis.Results:The knowledge score changed from 71% at baseline to 90% at the end line compared to the control arm which did not significantly change. Attitude score changed from 71% at baseline to 89% at endline compared to the control arm which did not significantly change (64% to 63%). This corresponds to a DID change of 19 percent increase in the attitudes scores (p<0.001). Lastly, practices score changed from 63% at baseline to 93% at endline. This corresponded to a 34 percentage point increase in the practice scores (p<0.001).Conclusions:Overall, Knowledge, attitude and practices were low at baseline than at the endline survey. Statistically, the study revealed that knowledge, attitude, and practices were associated with adherence to food safety and hygiene standards. The Government through the Ministries of health and education should consider training of food handlers on food safety and hygiene for improved knowledge, attitude, and practices
Access to and use of Tobacco Production Health Hazard Information Sources by Tobacco Farmers in Kuria West Sub – County, Migori County, Kenya
No full textTobacco production poses serious dangers to tobacco farmers especially in developing countries. Previous studies have shown that tobacco production activities continue to expose tobacco farmers to health risk. This study examines sources of health hazard information that tobacco farmers in Kuria West Sub- County of Migori County, Kenya access and use in an effort to protect themselves. The data was collected from a sample size of 100 tobacco farmers and 41 key informants. A representative sample was chosen from the four selected wards of Kuria West Sub-County. Software Packages for Social Sciences (SPSS) was used to analyse data. A major finding was that majority of tobacco farmers used various sources of information whose adequacy about potential risks associated with the crop farming remained a challenge. The paper concludes that, the sources of information that tobacco farmers relied on are unreliable and not trustworthy. The study recommends the establishmen
Evaluation of the awareness and utilization of oral rehydration salt and zinc in managing diarrhoea among under-five children in Oyo State, Nigeria.
No full textIntroduction: Despite the recommendation that a child having the symptoms of diarrhoea must be given Oral Rehydration Salt (ORS) and Paediatric Zinc Sulphate Dispersible Tablets (Zinc) within 24 hours of such notice, Nigeria ranks as one of the highest countries with the negative consequences of diarrhoea in sub-Saharan Africa (SSA). This study seeks to evaluate the awareness and utilization of ORS and zinc in managing diarrhoea among under-five children (U5C) in Oyo State, Nigeria.
Methods: Data was obtained from a cross-sectional survey (n=1154) as well as focus group discussions (FGD) among mothers/caregivers of U5C and key informant interviews in Oyo State. Descriptive, bivariate and multivariate logistic regression analyses were performed. The primary outcomes were awareness and utilization of ORS and zinc for managing a recent episode of diarrhoea. The level of significance was set at 5%. Data were analyzed with STATA 16.0 and Nvivo software.
Results: Nine of every ten caregivers were aware of the use of ORS/Zinc for managing diarrhoea cases. Prevalence of ever-use of ORS/Zinc for managing diarrhoea cases was 5.4% while the prevalence of having diarrhoea recently was 6.2%(71/1154). Of the 71 mothers whose U5C recently had diarrhoea, 41(57.7%) used ORS/zinc to manage a recent episode of diarrhoea. Adjusted odds of using ORS/Zinc to manage diarrhoea was 2.64 (aOR = 2.64; 95% Confidence Interval (CI): 1.18–10.27) times higher among children who are the first births (first-order) than those with fourth or higher birth order. The adjusted odds of using ORS/Zinc to manage diarrhoea was 9 times (aOR= 9.15; 95% CI: 1.99–34.47) higher among mothers aged 20 to 24 years and 3.82 times (aOR= 3.82; 95% CI: 1.02–14.27) higher among mothers aged 25 to 29 years than those aged 30 to 39 years. Having problems accessing healthcare services was also significant. Some of the FGD participants claimed they have used ORS/zinc before.
Conclusion: Despite the high level of awareness of the use of ORS and Zinc in managing diarrhoea, ever-utilization is low but recent use by three-fifths of the caregivers is fair. Maternal age, children birth order and proximity to healthcare facilities are the key influencers. There is a need for Oyo State Ministry of Health and other stakeholders to promote the use of ORS and Zinc in managing diarrhoea
An integrated lab-on-a-chip device for RNA extraction, amplification and CRISPR-Cas12a-assisteddetection for COVID-19 screening in resource-limited settings
Get PDFn response to the ongoing COVID-19 pandemic and disparities of vaccination coverage in low-and middle-incomecountries, it is vital to adopt a widespread testing and screening programme, combined with contact tracing, to monitor and effectively control the infection dispersion in areas where medical resources are limited.This work presents a lab-on-a-chip platform, namely“IFAST-CRISPR”, as an affordable, rapid and high-precision molecular diagnostic means for SARS-CoV-2 detection. The herein proposed “sample-to-answer”platform integratesRNA extraction, amplification and CRISPR-Cas-based detection with lateral flow readout in one device. The microscale dimensions of the device containing immiscible liquids, coupled with the use of silica paramagnetic beads and GuHCl, streamline sample preparation, including RNA concentration, extraction and purification, in15 min with minimal hands-on steps. By combining RT-LAMP with CRISPR-Cas12 assays targeting the nucleoprotein (N) gene, visual identification of ≥470 copies mL-1genomic SARS-CoV-2 sampleswas achieved in 45 min, with no cross-reactivity towards HCoV-OC43 nor H1N1. On-chip assays showed the ability to isolate and detect SARS-CoV-2 from 1,000 genome copies mL-1of replication-deficient viral particles in 1 h. This simple, affordable and integrated platform demonstrated a visual, faster, and yet specificity and sensitivity-comparable alternative to the costly gold-standard RT-PCR assay, requiring only a simple heating source. Further investigations on multiplexing and direct interfacing of the accessible Swan-brand cigarette filter for saliva sample collectioncould providea complete work flow for COVID-19 diagnostics from saliva samples suitable for low-resource settings.This study was funded by the Newton-Utafiti Fund Kenya Country Prize 2020
Active tuberculosis case finding on diabetic patients attending diabetic outpatient clinic at JM Kariuki county hospital, Nyandarua county Kenya
Get PDFNotwithstanding the concerted efforts to attain the objectives stipulated in tuberculosis
(TB) End Strategy by 2035, tuberculosis continues to be one of the principal healthcare
concerns globally. Tuberculosis- Diabetes comorbidity accelerates tuberculosis disease
and complicates treatment hence aggregating the possibility of poor tuberculosis
outcome. The principal objective of this study is to determine missed active tuberculosis
disease among diabetic patients enrolled in the outpatient diabetes management clinic at
JM Kariuki County Hospital, Nyandarua County. The study investigates the prevalence
of tuberculosis, estimates the positive yield of tuberculosis diagnosis by Gene Xpert, X ray and Fluorescent microscopy (FM) diagnostic methods, and explores the
socioeconomic factors of tuberculosis infection among patients with diabetes at JM
Kariuki County Hospital, Nyandarua. A sample size of 139 study participants was used
for the study. Data was collected through carrying out diagnostics tests which included:
Fluorescent TB smear microscopy, Gene-Xpert test, Chest X-ray, blood sugar test and
face to face interviews which was recorded in a structured interviewer checklist and the
clinical data uploaded in various ministry of health laboratory tools. SPSS version 22
was used to analyse the data. A high prevalence rate (2.66%) of missed tuberculosis
cases was recorded among diabetics. The results suggested Gene Xpert (with a positive
yield of 1.60%) as the test with the highest positivity yield in the diagnosis of
tuberculosis among diabetics at JM Kariuki County Hospital, Nyandarua. A notable
difference was noted in the prevalence of tuberculosis among different age groups of
participants (p = 0.001) suggesting strong statistical relationship between tuberculosis
infection and age, emphasizing the established association between tuberculosis and age
factor. A p-value of 0.613 suggested the existence of a weak association between the
gender of diabetic patients even though a significant statistical association was noted
between occupation and tuberculosis occurrence (p = 0.003). A significant statistical
association was noted to exist between smoking and alcoholism and tuberculosis
infection among diabetics (p = 0.001). The study proposes tuberculosis screening for all
new diabetes mellitus (DM) incidences when resources allow, and prioritized screening
using chest x-ray for diabetes mellitus patients and gene expert analysis for people who
have suggestive symptoms and patients aged 40 above, as well as those engaging in
behaviours such as habitual alcohol consumption and cigarette smoking. Additional
focus is recommended for tuberculosis infections in the lower lobes of the lungs, since
lower lung involvement is one of the common features of tuberculosis infection among
people with diabetes mellitus. Patients suffering from both diabetes mellitus and
tuberculosis face higher chances of presenting cavitation, smear-positivity during
diagnosis, and they may continue being culture positive 8 weeks after the onset of the
treatment plan. Additional diagnostic initiative that focuses on continuous monitoring of
serum drug concentration and ensuring that the tuberculosis therapy dosage is enough is
recommended to enable a sustained advancement of the patient towards tuberculosis
eradication. As such, the findings of this study emphasize the need to incorporate active
tuberculosis case finding in diabetes mellitus management in Nyandarua County, as a
milestone towards the enhancement of the national tuberculosis strategy
Potential pharmacologic interventions targeting TLR signaling in placental malaria
No full textIn P. falciparum malaria endemic regions, expectant women are at high risk of placental malaria due to P. falciparum sequestration in the placenta, which adversely affects pregnancy outcomes.
Placental malaria persists even when the peripheral parasite has been cleared from maternal circulation or is undetectable, and is detectable only by placental histological analysis.
There are no interventions for clearing P. falciparum from the placenta or reversing associated placental injury.
Poor placental malaria outcomes are attributed to maternal innate immune reactions to P. falciparum sequestration in the placenta. Studies show that fetal innate immune responses counter maternal responses, improving placental malaria outcomes.
Evidence suggests that pharmacologically targeting fetal–maternal innate immune interactions during placental malaria may improve pregnancy outcomes.
Complications from placental malaria cause poor pregnancy outcomes, including low birthweight, preterm delivery, and stillbirths. Many of these complications are driven by maternal innate proinflammatory responses to the sequestration of Plasmodium falciparum in the placenta. However, recent studies show that, in reaction to maternal innate immune responses that are detrimental to the fetus, the fetus mounts innate immune counter-responses that ameliorate pregnancy outcomes. Such fetal–maternal conflict in placental malaria has potential for pharmacologic modulation for better pregnancy outcomes. Here, we discuss placental malaria pathogenesis, its complications, and the role of innate immunity and fetal–maternal innate immune conflict in placental malaria. Finally, we discuss pharmacologic immunomodulatory strategies and agents with the potential to improve placental malaria outcomes
Utilization of post-natal care services among post-natal women in Ngara health centre, Starehe sub-County, Nairobi County
No full textPost natal period starts within 1 hour after delivery and up to six months after delivery.
Post Natal Care (PNC) has proven to decrease the infants and maternal morbidities and
also the mortalities; though the utilization has been low. In Kenya, it’s only around
51% of the mothers that receive these services from a skilled health care worker.
Minimal research of the factors that are linked with use of the post-natal services has
been done. The study identified the utilization of the PNC services in Ngara Health
Centre, Nairobi County. The study had 3 objectives as follows: Identifying the level of
utilization of postnatal care services, determining the health system factors influencing
utilization of postnatal care services, and identifying the client factors that influence
utilization of postnatal care services in Ngara Health Centre, Nairobi County were the
objectives of this research. The target population was mothers seeking maternal
neonatal child health from the MNCH clinics to include the immunization and family
planning rooms. The research utilized descriptive cross sectional study design. A semi structured questionnaire was used to gather information on knowledge, demographic
and institution related factors influencing postnatal care.155 mothers out of 212
responded which was 73% response rate. There was low utilization of post-natal care
which was 43%. The number of children the mother had, history of loss of a child,
duration taken to receive postnatal care services and reasons for seeking postnatal care
services (for checkup, or ill health of either mother or baby) On client factors, number
of children, loss of a child, nature of return date given and presence of complications
after delivery influenced post-natal care. conclusion; level of utilization was low, health
care providers should be time conscious when handling clients at the clinic to reduce
the overall turnaround time and to avoid missed opportunities and also emphasize the
need for checking maternal health status so that mothers would come for PNC services,
even if the baby does not have any health need or pending immunizations.
Recommendations; The government should ensure that by use of qualified and
experienced personnel that they educate the communities on the importance of PNC,
health care providers should be time conscious when handling clients at the clinic in
order to reduce the overall turnaround time, to avoid missed opportunities, health care
providers should emphasize the need for checking maternal health status so that
mothers would come for PNC services, even if the baby does not have any health need
or pending immunization
Synthesis, substitution kinetics, DNA/BSA binding and cytotoxicity of tridentate N^E^N (E = NH, O, S) pyrazolyl palladium(II) complexes
No full textThe pincer complexes, [Pd(L1)Cl]BF4 (PdL1), [Pd(L2)Cl]BF4 (PdL2), [Pd(L3)Cl]BF4 (PdL3), [Pd(L4)Cl]BF4 (PdL4) were prepared by reacting the corresponding ligands, 2,6-bis[(1H-pyrazol-1-yl)methyl]pyridine (L1), bis[2-(1H-pyrazol-1-yl)ethyl]amine (L2), bis[2-(1H-pyrazol-1-yl)ethyl]ether (L3), and bis[2-(1H-prazol-1-yl)ethyl]sulphide (L4) with [PdCl2(NCMe)]2 in the presence NaBF4. The solid‐state structures of complexes PdL1–PdL4 confirmed a tridentate coordination mode, with one chloro ligand completing the coordination sphere to afford square-planar complexes. Chemical behaviour of the complexes in solution confirms their stability in both aqueous and DMSO stock media. The electrochemical properties of the compounds showed irreversible two-electron reduction process. Kinetic reactivity of Pd complexes with the biological nucleophiles viz, thiourea (Tu), L-methionine (L-Met) and guanosine 5′-diphosphate disodium salt (5’-GMP) followed the order: PdL2 100 µM) when tested against the human cervical adenocarcinoma (HeLa) cell line and the transformed human lung fibroblast cell line (MRC-5 SV2)
Lessons learnt from community referral and follow up of sick young infants with Possible Severe Bacterial Infection in Turkana County, Kenya
No full textIntroduction Management of possible severe bacterial infections in young infants (0-59 days) requires timely identification of danger signs and prompt administration of efficacious antibiotic treatment. The Possible Severe Bacterial Infection guidelines underscore the importance of close follow up in an outpatient basis to ensure treatment adherence and early detection of illness-related complications. The purpose of this study was to strengthen the follow up and referral of sick young infants on day 4 and 8 by introducing community-led interventions that facilitated community health volunteers to identify sick young infants, conduct community reviews, link data with responsive facilities, and refer appropriately.
Methods Six health facilities were included a a longitudinal, descriptive, mixed methods approach weaved around an initial formative context assessment and three-monthly assessments. Quantitative data was extracted from facility registers to identify gaps in follow up and referral feasibility. Qualitative data was through focus group discussions with community health volunteers and key informant interviews with frontline providers.
Results Qualitative data provided insights into key barriers and facilitators of community follow up and referral. Barriers include community socio-cultural practices, competing tasks, dysfunctional community referral pathway, drivers of common infections, and unavailability of essential commodities. Key facilitators entail indication of competency in identification of danger signs in sick young infants, presence of older women, men, and community resource persons that can leveraged on in community engagement and sensitization, and mothers are the primary decision makers in care seeking. There was increased utilization of decision support tools and an increase in the number of sick young infants managed in dispensaries. The COVID-19 pandemic however negatively impacted community follow up and referral of sick young infants.The project that generated data used in this study was made possible by the support of the United Nations Children's Fund (UNICEF) under the terms of the contract number 43291592