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HIV-related stigma experiences and coping strategies among pregnant women in rural Uganda: A qualitative descriptive study
No full textBackground
HIV-related stigma is a global problem among HIV clients with far-reaching effects including increased rates of mother-to-child transmission of HIV. However, HIV-related stigma experiences and coping strategies have received little attention, especially among pregnant women in rural settings. We explored the HIV-related stigma experiences and coping strategies among pregnant women in rural northern Uganda.
Methods
This was a qualitative descriptive study conducted among HIV-positive pregnant women seeking care at Aboke Health Center IV, Kole district, northern Uganda. We conducted 12 in-depth interviews using a semi-structured interview guide. Data were analyzed using the inductive thematic approach of Braun and Clarke.
Results
The age range of the 12 participants was 17 to 35 years while the average duration with HIV since diagnosis was five years. The majority of the participants were subsistence farmers who had attained a primary level of education. Social rejection and public ridicule were identified as HIV-related stigma experiences while ignoring, social support, and prayers were identified as HIV-related coping strategies among the study participants.
Conclusion
Enacted HIV-related stigma is common among pregnant women in rural northern Uganda. Healthcare providers should work closely with HIV-positive women and other stakeholders to identify and strengthen HIV-related stigma coping strategies among pregnant women in rural settings
Maternal Factors Associated With Preterm Births at Thika Level 5, Kiambu County, Kenya.
No full textA preterm birth is defined as those that occur before 37 weeks of gestation, common symptoms of babies born prematurely include immature lungs, difficulty regulating body temperature, poor feeding and slow weight gain. Premature babies ay need intense nursery care, medication and sometimes surgery. Preterm birth is one of the leading causes of neonatal mortality it contributes to 60-80 per cent of all neonatal deaths. The causes of preterm birth are unknown in over 50% of spontaneous preterm labor, and mechanisms of preterm labor remain poorly understood .Child birth outcomes have become the focus of achieving MDG 4 that aims to reduce child mortality and reduce the less than 5 mortality rate by two thirds. The main objective of the study was to determine the factors associated with birth outcomes among post-natal mothers at Thika Level V Hospital, Kiambu County. The specific objectives aligned with the main objective included: to investigate the maternal socio demographic factors associated with preterm births at Thika Level V Hospital; to assess the health seeking behaviours associated with preterm births at Thika Level V Hospital; to establish the maternal health obstetric factors associated with preterm births at Thika Level V Hospital.This was a descriptive cross-sectional study. Quantitative approach was used in collection of data using structured interviewer administered questionnaire. Simple random sampling technique was used to sample the participants; and analysis performed using STATA. Chi square test of independence was used to determine significance of the variables; it revealed that the iron and folic acid supplementation (IFAS) in pregnancy (p=0.035) and number of antenatal visits (p=0.001) were the significant factors associated with preterm births. Bivariate logistic regression was used to determine the factors independently associated with preterm births. This confirmed the outcome of the prior findings; Antenatal visits odds ratio p=.459, OR=.1.359 (95% CI; .385, .1.537). And the odds of IFAS supplements are p=.103, OR= 1.694(95% CI: .899, .3.192). IFAS supplements and antenatal visits are significant factors associated with preterm births
Determinants of blood donation among selected tertiary college students in Homa Bay County Kenya
No full textBackground:Globally blood donation rate is low. 31.5 donations per 1000 people in high income countries and 5.0 donations per 1000 people in low-incomecountries. Donors aged 16-25years are ideal target for recruitment efforts. The study aimed to assessdeterminantsof blood donation amongstudents of selected tertiary institutions of Homa Bay County Kenya.Methods:Cross-sectional study using both quantitative andqualitative methods was used to collect data from 424 study participants, three focused group discussions and three key informants between April 2021 and July 2021.Data collection tools included structured questionnaire and interview guide. Data analysed using statistical package for social sciences version 21.0, Pearson’s correlation calculated for reliability. Percentage agreement calculated with values>75%being acceptable. Chi square (χ2) test and logistic regression were used to determine association and strength, while qualitative data coded thematically.Results:Most respondents were male 132(67%)and 93(47%)of respondents were of 19-21years age group. Majority were blood donors 198(54.50%). Reliability result was significant, r (39)=(0.82), p=(0.000) with simple percentage agreement of 78%. The study revealed that sex OR-0.493 p=0.013 and rare blood type, A-(OR) 8.597 p=0.009, and O+ (OR) 2.189 p=0.012 of the students were significant factors associated with blood donationConclusions:Sex and blood type were significant socio-demographic characteristics associated with blood donatio
Knowledge, tools, utilisation and sources of brucellosis surveillance data among animal health workers in Nairobi County, Kenya
No full textBrucellosis is a neglected zoonosis considered as reemerging in several countries
including Kenya. Globally Brucellosis affects over 500.000 humans and several
thousands of livestock annually. Live animals and animal products are the key sources
of human infection, which has been on the increase in urban populations. This is
associated mainly with increasing raw milk trade and consumption in urban settings.
The purpose of the study was to evaluate knowledge, tools, utilization and sources of
brucellosis surveillance data among animal health workers in Nairobi County, Kenya.
The specific objectives of the study were to determine data sources for brucellosis
surveillance among animal health workers in Nairobi County, to assess tools available
for brucellosis surveillance among animal health workers in Nairobi County, to
determine levels of knowledge on brucellosis surveillance data management among
animal health workers in Nairobi County and to establish utilization of brucellosis
surveillance data among animal health workers in Nairobi County. This research was
being guided by Health Belief Model, Knowledge Attitude Practice Theory and
Epidemiological Triad Model. The study used applied cross-sectional study design to
determine data sources knowledge, tools, utilization and sources of brucellosis
surveillance data among animal health workers in Nairobi County, Kenya. Study area
will be the administrative County of Nairobi. The approach used quantitative and
qualitative study approach. Data was collected by the use of structured questionnaire,
key informant interview and focus group discussions. Data was systematically entered
and analyzed using SPPS software for analysis. The target population in this research
was comprised of animal health workers in Nairobi County in Kenya. The study used a
census survey procedure that included all the 101 animal health care workers in the
County. Data was cleaned, entered, and analyzed using SPSS versus 20 packages. A
bivariate logistic regression was used to determine factors associated with Brucellosis
surveillance data management knowledge and practice. Quantitative data was presented
in form of graphs, tables and pie charts. In addition, information collected from key
informants interviews and focused group discussions was analyzed in terms of themes
and sub -themes using quotes from the findings, data sources and data collection
mechanism had significance effect on brucellosis surveillance data management
practice among animal health workers in Nairobi County. Availability of tools, level of
knowledge practice and data utilization has a significant effect on brucellosis
surveillance data management practice among animal health workers in Nairobi
County. The study recommended that animal health workers should be trained
equipped supported with logistics and regularly supervised. The results of this study
will be shared to both the veterinary and public health authorities and relevant
stakeholders and it was expected to contribute towards an improved health information
systems and an integrated human-animal brucellosis control strategy in urban settings of Kenya
Community Healthcare Worker’s Social Demographic Factors and Roles Influencing Uptake of Maternal Health Services in Musanze District, Northern Province, Rwanda
No full textCommunity health workers integrate individuals of their communities to provide preventive, habitual, and emergency maternity healthcare requirements. The aim of this study was to assess Community Health Workers social demographic factors and roles influencing uptake of Maternal Health services in Musanze District, Northern Province, Rwanda. Methods:The study design used was analytical cross-sectional study design utilizing both quantitative and qualitative methods. In this study, a simple random sample approach was employed to choose 208 CHWs and 16 CHW’s supervisors were interviewed for qualitative data (KII). The statistical tool for social sciences (SPSS) Version 26, was utilized to examine the data. Bivariate analysis with Chi-square test of independence was used to check the relationship between the dependent and independent variables. Ordinal logistic regression was used as the most suitable inferential statistic because the predictor variables and the dependent were ordinal variables.Qualitative data were analyzed by INVIVO version 10. Community health workers 208 participated in the study and all were female.Results: This study found that the uptake of maternal health services was regarded as very high. Among those services, deliveries at the Health Facility were at 73.6%, Antenatal care at 65.9
Ethnic conflicts influencing socio-economic development of border communities, a case of Abagusii and Kipsigis in Borabu and Bomet central sub-counties, Kenya
No full textEthnic conflicts are a global menace, with the highest frequency in newly
democratic African countries. They are marked with deficiency in communication, or
lack of peaceful coexistence that hampers interaction between members of different
ethnic groups. The recurrence of ethnic conflicts along the border in the study location
has been a common phenomenon, it was therefore, imperative that this study sought to
assess the ethnic conflicts influencing socio-economic development of border
communities between the Kipsigis and Abagusii of Bomet Central Sub-County and
Borabu Sub-County respectively. The specific objectives of the study were to: analyze
the ethnic conflicts of multiparty democracy influencing socio-economic development
of the Abagusii and Kipsigis along the border, examine the ethnic conflict of
administrative-political resource sharing influencing socio economic development of
Abagusii and Kipsigis along the border and evaluate the challenges in ethnic conflicts
mitigation influencing socio-economic development of the Abagusii and Kipsigis along
the border. The study was informed by the Theory of Ethnic Conflict and Identity
theory. The researcher used correlation research design adopting both qualitative and
quantitative methodologies. The study was carried in Borabu and Bomet Central Sub Counties with a target population of 243,610 people from the two Sub-Counties. A
sample population of 384 respondents determined by Mugenda and Mugenda formula
was used in the study involving; youth group leaders, elders, administrators and clergy.
Data collection instruments included questionnaires, interview guides, observation and
document review. The qualitative data collected from the field was coded and edited in
conformity with specific research objectives of the study while quantitative data was
analyzed thematically. The analyzed data was presented using descriptive statistics in
form of figures, tables and charts. The study adhered to ethical standards which
included anonymity of participants and insuring that they gave their consent before
participating. The findings of the study revealed that multiparty democracy influenced
ethnic conflicts through ethnic and regional choice, multiparty elections and multiparty
disagreements. Ethnic violence was influenced through politically instigated resource
sharing among border communities. Administrative way of sharing resources like land
interfered with land uses leading to communal discords. This influenced negatively the
socio-economic development along the border. The study also found that lack of
compensation of the aggrieved parties in the ethnic conflicts and perceived bias in the
administration of justice and resource sharing were the major setbacks in the
management of ethnic conflicts along the border. The study concluded that, besides
communities perceiving resource sharing being underlining causes of conflicts,
multiparty democracy in Kenya has a place too in influencing ethnic conflicts
especially among border communities. The study recommends that sensitization of
communities on multiparty democracy and good governance through elected leaders.
Furthermore, perceived bias in resource sharing along the border should be addressed
through development of partnerships between institutions, local leaders and
communities. Finally, the study recommended that ensuring sustained peace and ensure
socio-economic development along the border requires a bottom-up peace building
initiative where warring communities fully participate in decision making on peace
progress and socio-economic development
Potential application of the haematology analyser XN-31 prototype for field malaria surveillance in Kenya
No full textSimple and accurate diagnosis is a key component of malaria control programmes. Microscopy is the current gold standard, however it requires extensive training and the results largely rely on the skill of the microscopists. Malaria rapid diagnostic tests (RDT) can be performed with minimal training and offer timely diagnosis, but results are not quantitative. Moreover, some Plasmodium falciparum parasites have evolved and can no longer be detected by existing RDT. Developed by the Sysmex Corporation, the XN-31 prototype (XN-31p) is an automated haematology analyser capable of detecting Plasmodium-infected erythrocytes and providing species differentiation and stage specific parasite counts in venous blood samples without any preparation in approximately one minute. However, factors such as stable electricity supply in a temperature-controlled room, cost of the instrument and its initial set-up, and need for proprietary reagents limit the utility of the XN-31p across rural settings. To overcome some of these limitations, a hub and spoke diagnosis model was designed, in which peripheral health facilities were linked to a central hospital where detection of Plasmodium infections by the XN-31p would take place. To explore the feasibility of this concept, the applicability of capillary blood samples with the XN-31p was evaluated with respect to the effect of sample storage time and temperature on the stability of results.
Methods
Paired capillary and venous blood samples were collected from 169 malaria-suspected outpatients in Homa Bay County Referral Hospital, Kenya. Malaria infections were diagnosed with the XN-31p, microscopy, RDT, and PCR. Capillary blood samples were remeasured on the XN-31p after 24 h of storage at either room (15–25 °C) or chilled temperatures (2–8 °C).Open access funding provided by Karolinska Institute. AK received support
from JSPS KAKENHI (Grant No. JP18KK0248 & JP19H01080), JICA/AMED joint
research project (SATREPS) (Grant no. 20JM0110020H0002), and Sysmex Cor-
poration. WK received support from JSPS KAKENHI (Grant No. JP18K15139
Meta-Analysis of Human Antibodies Against Plasmodium falciparum Variable Surface and Merozoite Stage Antigens
No full textConcerted efforts to fight malaria have caused significant reductions in global malaria cases and mortality. Sustaining this will be critical to avoid rebound and outbreaks of seasonal malaria. Identifying predictive attributes that define clinical malaria will be key to guide development of second-generation tools to fight malaria. Broadly reactive antibodies against variable surface antigens that are expressed on the surface of infected erythrocytes and merozoites stage antigens are targets of naturally acquired immunity and prime candidates for anti-malaria therapeutics and vaccines. However, predicting the relationship between the antigen-specific antibodies and protection from clinical malaria remains unresolved. Here, we used new datasets and multiple approaches combined with re-analysis of our previous data to assess the multi-dimensional and complex relationship between antibody responses and clinical malaria outcomes. We observed 22 antigens (17 PfEMP1 domains, 3 RIFIN family members, merozoite surface protein 3 (PF3D7_1035400), and merozoites-associated armadillo repeats protein (PF3D7_1035900) that were selected across three different clinical malaria definitions (1,000/2,500/5,000 parasites/µl plus fever). In addition, Principal Components Analysis (PCA) indicated that the first three components (Dim1, Dim2 and Dim3 with eigenvalues of 306, 48, and 29, respectively) accounted for 66.1% of the total variations seen. Specifically, the Dim1, Dim2 and Dim3 explained 52.8%, 8.2% and 5% of variability, respectively. We further observed a significant relationship between the first component scores and age with antibodies to PfEMP1 domains being the key contributing variables. This is consistent with a recent proposal suggesting that there is an ordered acquisition of antibodies targeting PfEMP1 proteins. Thus, although limited, and further work on the significance of the selected antigens will be required, these approaches may provide insights for identification of drivers of naturally acquired protective immunity as well as guide development of additional tools for malaria elimination and eradication.This work was funded in part by JSPS KAKENHI (grant numbers JP20H03481, JP21H02724, JP21KK0138) and in part by Strategic Promotion of International Cooperation to Accelerate Innovation in Africa by MEXT, Japan. BK is an EDCTP Fellow under EDCTP2 programme supported by the European Union grant number TMA2020CDF-3203. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
Towards identification and development of alternative vaccines against pregnancy-associated malaria based on naturally acquired immunity
No full textPregnant women are particularly susceptible to Plasmodium falciparum malaria, leading to substantial maternal and infant morbidity and mortality. While highly effective malaria vaccines are considered an essential component towards malaria elimination, strides towards development of vaccines for pregnant women have been minimal. The leading malaria vaccine, RTS,S/AS01, has modest efficacy in children suggesting that it needs to be strengthened and optimized if it is to be beneficial for pregnant women. Clinical trials against pregnancy-associated malaria (PAM) focused on the classical VAR2CSA antigen are ongoing. However, additional antigens have not been identified to supplement these initiatives despite the new evidence that VAR2CSA is not the only molecule involved in pregnancy-associated naturally acquired immunity. This is mainly due to a lack of understanding of the immune complexities in pregnancy coupled with difficulties associated with expression of malaria recombinant proteins, low antigen immunogenicity in humans, and the anticipated complications in conducting and implementing a vaccine to protect pregnant women. With the accelerated evolution of molecular technologies catapulted by the global pandemic, identification of novel alternative vaccine antigens is timely and feasible. In this review, we discuss approaches towards novel antigen discovery to support PAM vaccine studies.BK is an EDCTP Fellow under EDCTP2 programme supported by the European Union grant number TMA2020CDF-3203-EndPAMAL. JG is supported by the African Academy of Sciences and the Royal Society FLAIR grant number FLR\R1\201314. The funding sources had no role in study design, collection, analysis, interpretation of data, and publication
A survey on knowledge, attitude, and practice about antibiotic prescribing and resistance among medical practitioners in Kenya
No full textAntibiotic resistance is a growing global health threat worldwide and especially in developing countries. Irrational antibiotic prescription as well as lack of the requisite knowledge and awareness of proper antibiotic use are major drivers of antibiotic resistance. In Kenya, although the Ministry of Health has developed antibiotic use guidelines, these guidelines are not widely followed. Antibiotic prescription is, therefore, hugely at the discretion of the clinician. It is thus necessary to understand the knowledge, attitude, and practices (KAP) of antibiotic prescription among medical practitioners in the country. This study aimed to evaluate the knowledge, attitude, and practices (KAP) among antibiotic prescribers in three counties (Kiambu, Nakuru, and Bungoma) in Keny