24 research outputs found
Factors affecting the uptake of Exclusive Breastfeeding (EBF) in Kisumu East District, Kenya
No full textExclusive breastfeeding (EBF) the best means of infant nutrition. This is because it offers great benefits to maternal and child health in general, including prevention of vertical transmission of HIV/ AIDS. This study sought to identify the factors associated with the uptake of EBF among mothers with children aged 0-<6 months. Overall, the uptake of EBF was higher than is seen in other countries in Africa and across the globe. Binary logistic regression identified having male children and ownership of certain assets as positive predictors of EBF uptake. Absence of a chronic disease and knowledge of cultural and traditional practices surrounding EBF were shown to be negatively associated with uptake of EBF. Keywords: breastfeeding, child health, maternal healt
Lifestyle Factors Influencing Falls among Older People in Central Kenya
No full textAn estimated one-third of the older people worldwide sustain falls every year, which contributes to over 20% of injuries in this age group. In the central region of (Mount) Kenya, despite increasing awareness about this condition, the magnitude as well as the socio-demographic and lifestyle factors leading to falls in the older people are not well known. The main objective of this study was to investigate the prevalence of falls, their outcomes, and the factors influencing their occurrence among older persons aged 65 years and above living in Gatanga Sub-County, Murang’a County, central Kenya. An analytical cross-sectional study design was used. Using systematic random sampling, 403 out of 9247 study participants were identified and interviewed at home. Using a structured interview form, data was collected on socio-demographic, socio-economic, lifestyle, and medical factors, as well as on fall or non-fall status from September 2016 to August 2017. Proportions were used to evaluate the occurrence of falls, lifestyle factors and medical conditions. Pearson’s Chi square and logistic regression were used to evaluate associations between lifestyle and medical exposures and falls outcomes. With 41%, the prevalence of falls amongst the older people in this region is high.
The farming lifestyle involving animal husbandry and medical illnesses are significantly associated with falls. To reduce the occurrence of falls, we need to integrate relevant preventive measures that reduce the risk of falls in communities of the older people in Central Kenya
Factors associated with falls among elderly persons living in Gatanga Sub-county, Murang'a County: A descriptive cross-sectional study v1
No full textFalls are the leading cause of morbidity and mortality among the elderly people with a third of them falling annually thus contributing to majority of injuries in this age group. Preventing falls can significantly reduce the burden of illness from falls. In Kenya, the incidence, prevalence and risk factors of falls in elderly aged 65 years and above are not known. The main objective of this study was to determine the prevalence and factors associated with falls among elderly persons living in Gatanga Sub-county, Murang’a County, Kenya. A descriptive cross-sectional study design was used. Using systematic random sampling, 424 out of 9146 study participants residing in their homes were identified. Using structured interview forms data was collected on socio-demographic, socio-economic, lifestyle and medical factors, and fall or non-fall status from September 2016 to August 2017. Statistical analysis was done with STATA 13.0 to establish the distribution and characteristics of falls. Factors that were associated with the falls in the multivariate analysis were blindness (OR=27.6, CI=7.9-96.9), diabetes (OR=7.7, CI=2.4-34.5), engaging in crop farming (7.3, CI=4-13.6), female gender (OR=6.8, CI= 3.4 -13.3), syncope (OR=6.4, CI=1.5-27.6), wounds (OR=5.5, CI=2.0-14.9), frailty for non-disabled index (OR=4.5, CI= 2.8 -7.3), difficulty in carrying out usual activities (OR=3.9, CI=1.8-8.4), dependency on relatives/well-wishers for hospital bills payment (OR= 3.3, CI=1.7–6.6), current medications use (OR=3.1, CI=1.7-5.8), engaging in animal husbandry (OR=3.0, CI=1.6-5.4), hearing impairment (OR=2.9, CI=1.5-5.8), use of assistive walking devices (OR=2.8, CI=2.0-4.0), neck pains (OR=2.4, CI=1.3-4.7), lower back pains (OR=2.3, CI=1.1-5.0), headache (OR=2.2, CI=1.0-4.6) and memory loss (OR=2.1, CI=1.1-4), The study found that falls are a significant problem of the elderly in this region. There is need to come up with policies recognizing falls as a problem of the elderly and initiate preventive public health intervention measures aimed at mitigating the problem. </p
Timing and Determinants of Tuberculosis Treatment Interruption in Nairobi County, Kenya
No full textTuberculosis (TB) treatment is a key pillar in the management and control of TB. Service delivery within the treatment facilities plays an important role in ensuring treatment adherence by TB patients. A prospective cohort study involving 25 health facilities, 25 facility in-charge officers and 291 patients diagnosed as new sputum smear positive (SM+) between December 2014 and July 2015 was undertaken. The aim of the study was to estimate the median time to treatment interruption, associated factors and overall predictors of non-adherence to TB treatment. A total of 19 (6.5%) treatment interruptions were observed. The median time to default was 56 [95% CI, 36-105] days. Treatment in a non-public facility [AOR=0.210, 95% CI (0.046-0.952)] and facilities perceived to have adequate number of health care workers to offer Directly Observed Therapy (DOT) [AOR=0.195, 95% CI (0.068-0.56)] showed a lower odds of treatment interruption whereas attainment of secondary level education [AOR=5.28, 95% CI (1.18-23.59)] indicated a higher odds of treatment interruption. Non-clinical aspects of health care service delivery influence patient adherence to TB treatment. Health seeking behavior of groups considered to be high risk for treatment interruption should be incorporated into the design and delivery of TB treatment
Prevalence and Factors Associated With Herbal Medicine Use among HIV Positive Patients on Highly Active Antiretroviral Therapy in Selected Hospitals in Nairobi County
No full textBackground: Traditional remedies have been used for many years in Africa to treat various ailments before the introduction of conventional medicines into the continent. Concurrent use of traditional herbal medicines (THM) with highly active antiretroviral therapy (HAART) is widespread among HIV infected patients. Studies done in different parts of the world show conflicting health outcomes among HIV positive patients using HAART and herbal medicine concurrently with some reporting better health outcomes while others report increased risk of adverse drug reactions. However, the extent of THM use is not known in most settings in Sub-Saharan Africa Kenya included. This study aimed to determine the prevalence and factors associated with THM use among HIV infected patients on highly active antiretroviral therapy (HAART) attending two comprehensive care centers in Nairobi County. Methods: A descriptive cross-sectional study was conducted at Kenyatta National Teaching and Referral Hospital and Mbagathi District Hospital. From the two centers a total of 370 participants were selected via systematic random sampling. The participants included were those aged 18 years and above, on HAART, and had consented to participate in the study. Data was collected using an interviewer-administered semi-structured questionnaire seeking information on herbal medicine use, socio-demographic and economic factors associated with herbal medicine use and the association between herbal medicine use and occurrence of adverse drug reactions. THM use referred to someone who had ever used or was currently using herbal medicine while on highly active antiretroviral therapy (HAART) by the time of the study. Data was captured in excel sheet and exported to STATA for analysis. Results: The study established that the prevalence of herbal medicine use among HIV positive patients taking HAART was 15.5%. About 77.8% of the patients who had used herbal medicine had never disclosed to the doctor or any health care worker at the CCC about their herbal medicine use. Herbal medicine use led to decreased adherence to HAART. The longer the duration between HIV diagnosis and HAART start, the more likely a HIV positive patient was to use herbal medicine. Patients who use herbal medicine with HAART were more likely to experience adverse drug reactions. There were 59.7% participants who had good /fair adherence while 40.3% had poor adherence. Majority of those who had poor adherence had significantly higher proportion of side effects as compared to those had good/fair adherence. Conclusion: The prevalence of THM use among participants on HAART was high. This raises clinical and pharmacological concerns that need attention by the health care service providers. Keywords: Herbal Medicine, HIV, Antiretroviral Therapy DOI: 10.7176/JBAH/9-4-1
Utilization and Satisfaction with Community Health Worker Services amongst Caregivers of Children under Five in Mwea West, Kirinyaga County
No full textCHWs provide a possible solution for delivery of promotive and preventive interventions which have the potential to improve child health
Predictors of uptake of eye examination in people living with diabetes mellitus in three counties of Kenya.
No full textBACKGROUND: Diabetic retinopathy (DR) is a significant public health concern that is potentially blinding. Clinical practice guidelines recommend annual eye examination of patients with diabetes for early detection of DR. Our aim was to identify the demand-side factors that influence uptake of eye examination among patients already utilizing diabetes services in three counties of Kenya. METHODS: We designed a clinic based cross-sectional study and used three-stage sampling to select three counties, nine diabetes clinics in these counties and 270 patients with diabetes attending these clinics. We interviewed the participants using a structured questionnaire. The two outcomes of interest were 'eye examination in the last 12 months' and 'eye examination ever'. The exposure variables were the characteristics of participants living with diabetes. RESULTS: The participants had a mean age of 53.3 years (SD 14.1) and an average interval of 4 months between visits to the diabetes clinic. Only 25.6% of participants had ever had an eye examination in their lifetime, while 13.3% had it in the preceding year. The independent predictors of uptake were referral by diabetes services, patient knowledge of diabetes eye complications, comorbid hypertension and urban or semi-urban residence. CONCLUSIONS: We conclude that access to retinal examination for DR is low in all three counties. An intervention that increases the knowledge of patients with diabetes about eye complications and promotes referral of patients with diabetes for eye examination may improve access to annual eye examination for DR
Emerg Infect Dis
No full textInsecticide resistance might reduce the efficacy of malaria vector control. In 2013 and 2014, malaria vectors from 50 villages, of varying pyrethroid resistance, in western Kenya were assayed for resistance to deltamethrin. Long-lasting insecticide-treated nets (LLIN) were distributed to households at universal coverage. Children were recruited into 2 cohorts, cleared of malaria-causing parasites, and tested every 2 weeks for reinfection. Infection incidence rates for the 2 cohorts were 2.2 (95% CI 1.9-2.5) infections/person-year and 2.8 (95% CI 2.5-3.0) infections/person-year. LLIN users had lower infection rates than non-LLIN users in both low-resistance (rate ratio 0.61, 95% CI 0.42-0.88) and high-resistance (rate ratio 0.55, 95% CI 0.35-0.87) villages (p = 0.63). The association between insecticide resistance and infection incidence was not significant (p = 0.99). Although the incidence of infection was high among net users, LLINs provided significant protection (p = 0.01) against infection with malaria parasite regardless of vector insecticide resistance
Peer-support to increase uptake of screening for diabetic retinopathy: process evaluation of the DURE cluster randomized trial.
No full textBACKGROUND: There is limited evidence on how implementation of peer support interventions influences effectiveness, particularly for individuals with diabetes. We conducted a cluster randomized controlled trial to compare the effectiveness of a peer-led health education package versus usual care to increase uptake of screening for diabetic retinopathy (DR). METHODS: Our process evaluation used a mixed-method design to investigate the recruitment and retention, reach, dose, fidelity, acceptability, and context of implementation, and was guided by the Consolidated Framework for Implementation Research (CFIR). We reviewed trial documents, conducted semi-structured interviews with key informants (n = 10) and conducted four focus group discussions with participants in both arms of the trial. Three analysts undertook CFIR theory-driven content analysis of the qualitative data. Quantitative data was analyzed to provide descriptive statistics relevant to the objectives of the process evaluation. RESULTS: The trial had positive implementation outcomes, 100% retention of clusters and 96% retention for participants, 83% adherence to delivery of content of group talks (fidelity), and 78% attendance (reach) to at least 50% (3/6) of the group talks (dose). The data revealed that intervention characteristics, outer setting, inner setting, individual characteristics, and process (all the constructs of CFIR) influenced the implementation. There were more facilitators than barriers to the implementation. Facilitators included the relative advantage of the intervention compared with current practice (intervention characteristics); awareness of the growing prioritization of diabetes in the national health policy framework (outer setting); tension for change due to the realization of the vulnerability to vision loss from DR (inner setting); a strong collective sense of accountability of peer supporters to implement the intervention (individual characteristics); and regular feedback on the progress with implementation (process). Potential barriers included the need to queue at the eye clinic (intervention characteristic), travel inconveniences (inner setting), and socio-political disruption (outer setting). CONCLUSIONS: The intervention was implemented with high retention, reach, fidelity, and dose. The CFIR provided a valuable framework for evaluating contextual factors that influenced implementation and helped to understand what adaptations may be needed during scale up. TRIAL REGISTRATION: Pan African Clinical Trials Registry: PACTR201707002430195 registered 15 July 2017
