Journal articles: 'Backache, Treatment. Kenya, Nairobi'

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Jepchumba, Violet, Simon Karanja, Evans Amukoye, Lawrence Muthami, and Hillary Kipruto. "Timing and Determinants of Tuberculosis Treatment Interruption in Nairobi County, Kenya." International Journal of Public Health Science (IJPHS) 6, no. 3 (September 1, 2017): 203. http://dx.doi.org/10.11591/ijphs.v6i3.8475.

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Tuberculosis (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.

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Gichangi, P., K. Fonck, C. Sekande-Kigondu, J. Ndinya-Achola, J. Bwayo, D. Kiragu, P. Claeys, and M. Temmerman. "Partner notification of pregnant women infected with syphilis in Nairobi, Kenya." International Journal of STD & AIDS 11, no. 4 (April 1, 2000): 257–61. http://dx.doi.org/10.1258/0956462001915660.

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We examined partner notification among syphilitic pregnant women in Nairobi. At delivery, 377 women were found to be rapid plasma reagin (RPR) reactive. Data were available for 94% of the partners of women who were tested during pregnancy; over 67% of the partners had received syphilis treatment while 23% had not sought treatment mainly because they felt healthy. Six per cent of the women had not informed their partners as they feared blame and/or violence. Adverse pregnancy outcome was related to lack of partner treatment during pregnancy (7% versus 19%, odds ratio (OR) 3.0, 95% confidence interval (CI) 0.9- 10.0). Our data suggest that messages focusing on the health of the unborn child have a positive effect on partner notification and innovative and locally adapted strategies for partner notification need more attention.

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Ballard, R. C., Htun Ye, A. Matta, Y. Dangor, and F. Radebe. "Treatment of chancroid with azithromycin." International Journal of STD & AIDS 7, no. 1_suppl (January 1996): 9–12. http://dx.doi.org/10.1258/0956462961917230.

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A randomized, comparative study undertaken in Nairobi, Kenya and a non-comparative evaluation undertaken in Carletonville, South Africa have both shown that a single oral dose of azithromycin 1 g is effective in the treatment of the genital ulcer disease (GUD), chancroid, with cure rates of 89% and 92% recorded respectively. While treatment failure was associated with human immunodeficiency virus seropositivity and lack of circumcision in Kenya, no such association could be found in the South African study. In both series, azithromycin treatment resulted in cure of both Haemophilus ducreyi culture-positive and culture-negative cases of GUD, including two cases subsequently diagnosed as lymphogranuloma venereum. A combination of single-dose azithromycin with single-dose benzathine penicillin may provide effective ‘single-visit’ syndromic treatment for GUD in many developing countries.

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Gitari, Anderson, James Nguhiu, Vijay Varma, and Eddy Mogoa. "Occurrence, treatment protocols, and outcomes of colic in horses within Nairobi County, Kenya." Veterinary World 10, no. 10 (October 2017): 1255–63. http://dx.doi.org/10.14202/vetworld.2017.1255-1263.

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van de Vijver, Steven J. M., Samuel O. Oti, Charles Agyemang, Gabriela B. Gomez, and Catherine Kyobutungi. "Prevalence, awareness, treatment and control of hypertension among slum dwellers in Nairobi, Kenya." Journal of Hypertension 31, no. 5 (May 2013): 1018–24. http://dx.doi.org/10.1097/hjh.0b013e32835e3a56.

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Wachira, Benjamin W., Ramadhani O. Abdalla, and Lee A. Wallis. "Westgate Shootings: An Emergency Department Approach to a Mass-casualty Incident." Prehospital and Disaster Medicine 29, no. 5 (September 10, 2014): 538–41. http://dx.doi.org/10.1017/s1049023x1400096x.

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AbstractAt approximately 12:30 pm on Saturday September 21, 2013, armed assailants attacked the upscale Westgate shopping mall in the Westlands area of Nairobi, Kenya. Using the seven key Major Incident Medical Management and Support (MIMMS) principles, command, safety, communication, assessment, triage, treatment, and transport, the Aga Khan University Hospital, Nairobi (AKUH,N) emergency department (ED) successfully coordinated the reception and care of all the casualties brought to the hospital.This report describes the AKUH,N ED response to the first civilian mass-casualty shooting incident in Kenya, with the hope of informing the development and implementation of mass-casualty emergency preparedness plans by other EDs and hospitals in Kenya, appropriate for the local health care system.WachiraBW, AbdallaRO, WallisLA. Westgate shootings: an emergency department approach to a mass-casualty incident. Prehosp Disaster Med. 2014;29(5):1-4.

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Kusimba, J., H. A. C. M. Voeten, H. B. O'Hara, J. M. Otido, J. D. F. Habbema, J. O. Ndinya-Achola, and J. J. Bwayo. "Traditional healers and the management of sexually transmitted diseases in Nairobi, Kenya." International Journal of STD & AIDS 14, no. 3 (March 1, 2003): 197–201. http://dx.doi.org/10.1258/095646203762869223.

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To describe the role of traditional healers in STD case management, in-depth interviews were held with 16 healers (seven witchdoctors, five herbalists and four spiritual healers) in four slum areas in Nairobi, Kenya. All healers believed that STDs are sexually transmitted and recognized the main symptoms. The STD-caseload varied largely, with a median of one patient per week. Witchdoctors and herbalists dispensed herbal medication for an average of seven days, whereas spiritual healers prayed. Thirteen healers gave advice on sexual abstinence during treatment, 11 on contact treatment, four on faithfulness and three on condom use. All healers asked patients to return for review and 13 reported referring patients whose conditions persist to public or private health care facilities. Thus, traditional healers in Nairobi play a modest but significant role in STD management. Their contribution to STD health education could be strengthened, especially regarding the promotion of condoms and faithfulness.

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Mawioo, Peter M., Christine M. Hooijmans, Hector A. Garcia, and Damir Brdjanovic. "Microwave treatment of faecal sludge from intensively used toilets in the slums of Nairobi, Kenya." Journal of Environmental Management 184 (December 2016): 575–84. http://dx.doi.org/10.1016/j.jenvman.2016.10.019.

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Koech, Emily, Kristen A. Stafford, Immaculate Mutysia, Abraham Katana, Marline Jumbe, Patrick Awuor, Marie-Claude Lavoie, Caroline Ngunu, David J. Riedel, and Sylvia Ojoo. "Factors Associated with Loss to Follow-Up Among Patients Receiving HIV Treatment in Nairobi, Kenya." AIDS Research and Human Retroviruses 37, no. 9 (September 1, 2021): 642–46. http://dx.doi.org/10.1089/aid.2020.0292.

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Mengo, Doris Mueni, Sam Kariuki, Ann Muigai, and Gunturu Revathi. "Trends in Salmonella enteric serovar Typhi in Nairobi, Kenya from 2004 to 2006." Journal of Infection in Developing Countries 4, no. 06 (May 9, 2010): 393–96. http://dx.doi.org/10.3855/jidc.503.

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Background: Typhoid fever is a global health problem. The World Health Organization (WHO) estimates that the current annual global burden of typhoid is approximately 22 million new cases, 5% of which are fatal. Methodology: To assess the trends in antibiotic resistance in 100 Salmonella enterica serovar Typhi strains were isolated from the blood of patients in Nairobi, Kenya, from 2004 to 2006. All isolates were tested against ampicilin, chloramphenic, nalidixic acid, ciprofloxacin, cotrimoxazole, cefuroxime, cefriaxone, amoxycillin/clavulanic acid, tetracycline and gentamycin. Susceptibility and resistance were determined using MIC and disk diffusion tests. Results: From 2004 to 2006 a total of 100 strains were studied; 70% of the isolates were multidrug resistant (MDR) while 15% of the isolates were sensitive to all drugs tested. Of 13 isolates that were resistant to ciprofloxacin and nalidixic acid by disk diffusion, 11 had an MIC of 0. 25 µg/ml while two isolates had an MIC of 1.00 µg,/ml. Resistance in ampicillin decreased from 88% in 2004 to 64% in 2005; this increased to 76% in 2006. Similar trends were observed for four other antibiotics tested. Conclusion: The prescription of first-line antibiotics used in the treatment of S. Typhi should be stopped temporarily. Drugs such as cipfloxacin would be useful in the treatment of typhoid caused by MDR S. Typhi. There is need to monitor the resistance in flouroquinolones as resistance to these drugs has been observed and they are the current drugs used to treat typhoid.

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Kahiga, Naomi, Hellen Mberia, and Kyalo Wa Ngula. "Influence of Consequences Frame on the Perception of Obesity among Middle-aged Women in Nairobi County, Kenya." International Journal of Communication and Public Relation 5, no. 1 (December 17, 2020): 1. http://dx.doi.org/10.47604/ijcpr.1182.

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Purpose: To establish the influence of consequences frame on the perception of obesity among middle-aged women in Nairobi County, Kenya. Methodology: This study applied the one-group pretest-posttest experimental design. In the one-group pretest-posttest experimental design all study participants provided with the same treatment and assessment. The researcher therefore, collected data using the pre-and posttest questionnaires. The treatment administered was a television program titled Slimpossible, which showcased middle-aged Kenyan women suffering from the stigma of obesity who were participating in a competition to lose their weight. The multi-stage cluster sampling technique was applied in this study. Out of the target population of 1848 participants, the study sample was 317 academic female staff found in three public universities in Nairobi County, Kenya. The data was analyzed using the Statistical Package for Social Sciences (SPSS) version 23.0. The analysis applied descriptive statistics and the inferential analysis tools such as the Factor analysis (The Keiser-Meyer –Olkin (KMO) test), Pearson’s correlation coefficient and regression analysis (logical regression). Findings: The study sought to establish the influence of consequences frame on the perception of obesity among middle-aged women in Nairobi County, Kenya. Therefore, the study found that the physical consequences, psychological consequences and social consequences significantly influenced the perception of obesity, except for economic consequences, which had no relationship with the dependent variable. Unique contribution to theory, practice and policy: In terms of contribution to theory, this study emanated from the media framing theory, where it provided consequences frame as one among five frames, mentioned by an American political scientist known as Robert Entman in 1993. Its contribution to practice, this study recommends media involvement in developing well-research journalistic stories, documentaries and the use of educative programming to highlight on the consequences of obesity.

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Irungu, Beatrice Njeri, Lilian C. Koech, Joyce M. Ondicho, and Lucia K. Keter. "Quality assessment of selected co-trimoxazole suspension brands marketed in Nairobi County, Kenya." PLOS ONE 16, no. 9 (September 22, 2021): e0257625. http://dx.doi.org/10.1371/journal.pone.0257625.

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Introduction Quality of medicines in both developed and developing countries is sometimes compromised due to infiltration of counterfeit, substandard or degraded medicines into the markets. It is a public health concern as poor quality medicines endanger public health where patients are exposed to chemical toxins and/or sub-therapeutic doses. This could lead to reduced treatment efficacy and promote development of drug resistance. Co-trimoxazole, a fixed dose combination of sulfamethoxazole and trimethoprim, is a broad spectrum for bacterial diseases and is also used as a prophylaxis for opportunistic infections in HIV infected individuals. This study evaluated quality of selected co-trimoxazole suspension brands marketed in Nairobi County, Kenya. Methods A total of 106 samples were collected, categorized into 15 brands and evaluated for active pharmaceutical ingredient content (API) and pH following United States Pharmacopeia. Assay for API was conducted using High Performance Liquid Chromatography. Results were compared with pharmacopeia references. Visual examination of labels and confirmation of retention status of the brands with Pharmacy and Poisons Board retention register was carried out. Results The samples were primarily of local origin (86.7%). On October 23, 2019, retention status of six of the fifteen brands documented were no longer listed in the Pharmacy and Poisons Board retention register. Of the 106 samples tested 70.6% and 86.8% were compliant with United States Pharmacopeia (USP) specifications for pH and API respectively while 84.0% adhered to packaging and labelling requirements. Conclusion This study has demonstrated that majority of co-trimoxazole suspensions tested were compliant with USP requirements. Additionally, it has provided evidence of poor quality co-trimoxazole medicines that could compromise treatment of infectious diseases in children. This emphasizes the need for regular quality assurance tests to ensure only quality medicines are in the market.

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Otieno, Phelgona A., Pamela K. Kohler, Rose K. Bosire, Elizabeth R. Brown, Steven W. Macharia, and Grace C. John-Stewart. "Determinants of failure to access care in mothers referred to HIV treatment programs in Nairobi, Kenya." AIDS Care 22, no. 6 (May 12, 2010): 729–36. http://dx.doi.org/10.1080/09540120903373565.

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Ng'ang'a, Peter M., Arild Stenvik, Florence Ohito, and Björn Ögaard. "The need and demand for orthodontic treatment in 13- to 15-year-olds in Nairobi, Kenya." Acta Odontologica Scandinavica 55, no. 5 (January 1997): 325–28. http://dx.doi.org/10.3109/00016359709114972.

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Moses, S., E. N. Ngugi, A. Costigan, C. Kariuki, I. Maclean, R. C. Brunham, and F. A. Plummer. "Response of a sexually transmitted infection epidemic to a treatment and prevention programme in Nairobi, Kenya." Sexually Transmitted Infections 78, Supplement 1 (April 1, 2002): i114—i120. http://dx.doi.org/10.1136/sti.78.suppl_1.i114.

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Trinh, T. Tony, Nelly Yatich, Richard Ngomoa, Christine J. McGrath, Barbra A. Richardson, Samah R. Sakr, Agnes Langat, Grace C. John-Stewart, and Michael H. Chung. "Partner Disclosure and Early CD4 Response among HIV-Infected Adults Initiating Antiretroviral Treatment in Nairobi Kenya." PLOS ONE 11, no. 10 (October 6, 2016): e0163594. http://dx.doi.org/10.1371/journal.pone.0163594.

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Omulo, Sylvia, Margaret Oluka, Loice Ombajo, Eric Osoro, Rosaline Kinuthia, Anastasia Guantai, Linus Ndegwa, et al. "Point-Prevalence Surveys of Antibiotic Use at Three Large Public Hospitals in Kenya." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s353—s354. http://dx.doi.org/10.1017/ice.2020.971.

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Background: Antibiotics are the most prescribed medicines worldwide, accounting for 20%–30% of total drug expenditures in most settings. Antimicrobial stewardship activities can provide guidance for the most appropriate antibiotic use. Objective: In an effort to generate baseline data to guide antimicrobial stewardship recommendations, we conducted point-prevalence surveys at 3 hospitals in Kenya. Methods: Sites included referral hospitals located in Nairobi (2,000 beds), Eldoret (900 beds) and Mombasa (700 beds). [Results are presented in this order.] Hospital administrators, heads of infection prevention and control units, and laboratory department heads were interviewed about ongoing antimicrobial stewardship activities, existing infection prevention and control programs, and microbiology diagnostic capacities. Patient-level data were collected by a clinical or medical officer and a pharmacist. A subset of randomly selected, consenting hospital patients was enrolled, and data were abstracted from their medical records, treatment sheets, and nursing notes using a modified WHO point-prevalence survey form. Results: Overall, 1,071 consenting patients were surveyed from the 3 hospitals (n = 579, n = 263, and n = 229, respectively) of whom >60% were aged >18 years and 53% were female. Overall, 489 of 1,071 of patients (46%) received ≥1 antibiotic, of whom 254 of 489 (52%) received 1 antibiotic, 201 of 489 (41%) received 2 antibiotics, 31 of 489 (6%) received 3 antibiotics, and 3 of 489 (1%) received 4 antibiotics. Antibiotic use was higher among those aged <5 years: 150 of 244 (62%) compared with older individuals (337 of 822, 41%). Amoxicillin/clavulanate was the most commonly used antibiotic (66 of 387, 17%) at the largest hospital (in Nairobi) whereas ceftriaxone was the most common at the other 2 facilities: 57 of 184 (31%) in Eldoret and 55 of 190 (29%) in Mombasa. Metronidazole was the next most commonly prescribed antibiotic (15%–19%). Meropenem was the only carbapenem reported: 22 of 387 patients (6%) in Nairobi, 2 of 190 patients (1%) in Eldoret, and 8 of 184 patients (4%) in Mombasa. Stop dates or review dates were not indicated for 106 of 390 patients (27%) in Nairobi, 75 of 190 patients (40%) in Eldoret, and 113 of 184 patients (72%) in Mombasa receiving antibiotics. Of 761 antibiotic prescriptions, 45% had a least 1 missed dose. Culture and antibiotic susceptibility tests were limited to 50 of 246 patients (20%) in Nairobi, 17 of 124 patients (14%) in Eldoret, and 23 of 119 patients (19%) in Mombasa who received antibiotics. The largest hospital had an administratively recognized antimicrobial stewardship committee. Conclusions: The prevalence of antibiotic use found by our study was 46%, generally lower than the rates reported in 3 similar studies from other African countries, which ranged from 56% to 65%. However, these survey findings indicate that ample opportunities exist for improving antimicrobial stewardship efforts in Kenya considering the high usage of empiric therapy and low microbiologic diagnostic utilization.Funding: NoneDisclosures: None

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Kahiga, Naomi, Hellen Mberia, and Kyalo Wa Ngula. "INFLUENCE OF CULTURAL DYNAMICS ON THE RELATIONSHIP BETWEEN MEDIA FRAMING AND THE PERCEPTION OF OBESITY AMONG MIDDLE-AGED WOMEN IN NAIROBI COUNTY, KENYA." International Journal of Communication and Public Relation 6, no. 1 (March 12, 2021): 18–44. http://dx.doi.org/10.47604/ijcpr.1236.

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Purpose: To assess the moderating influence of cultural dynamics on the relationship between media framing and the perception of obesity among middle-aged women in Nairobi County, Kenya. Methodology: This study applied the one-group pretest-posttest experimental design. In the one-group pretest-posttest experimental design all study participants provided with the same treatment and assessment. The researcher therefore, collected data using the pre-and posttest questionnaires. The treatment administered was a television program titled Slimpossible, which showcased middle-aged Kenyan women suffering from the stigma of obesity who were participating in a competition to lose their weight. The multi-stage cluster sampling technique was applied in this study. Out of the target population of 1848 participants, the study sample was 317 academic female staff found in three public universities in Nairobi County, Kenya. In this research study, the analysis applied descriptive statistics and the inferential analysis tools such as the Factor analysis (The Keiser-Meyer –Olkin (KMO) test), Pearson’s correlation coefficient and regression analysis (logical regression). Findings: The study sought to assess the moderating influence of cultural dynamics on the relationship between media framing and the perception of obesity among middle-aged women in Nairobi County, Kenya. Therefore, the finding also brought about interactions between cultural dynamics and the independent media frames in connection to the perception of obesity. It was concluded that the perception of obesity from the African culture and Western culture was different. The respondents had positive outlook on middle-aged obese women opposed to the dictates of Western culture. Unique contribution to theory, practice and policy: In terms of contribution to theory, this study emanated from the cross-cultural communication theory. The theory recognizes the value of culture and how it relates to people’s perception on obesity. Hurn and Tomalin (2013) opined that some of the most strategic researchers in the field of cross-cultural communication include Edward Hall, Mildred Hall and Geert Hofstede in the 1950s.

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Kemoi, Edson K., Andrew Nyerere, and Christine C. Bii. "Triazole-Resistant Aspergillus fumigatus from Fungicide-Experienced Soils in Naivasha Subcounty and Nairobi County, Kenya." International Journal of Microbiology 2018 (June 26, 2018): 1–6. http://dx.doi.org/10.1155/2018/7147938.

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The mainstay in prevention and treatment of aspergillosis is the use triazole drugs. In Kenya, the use of agricultural azole is one of the predisposing factors in development of resistance. One hundred fifty-six (156) experienced soils were collected from agricultural farms and cultured on Sabouraud DextroseAagar. The study isolated 48 yielded Aspergillus fumigatus and 2 A. flavus. All the isolates were subjected to antifungal susceptibility testing against three triazoles: posaconazole, voriconazole, and itraconazole. Out of the isolates, 3 had MIC of 32 and 1 had MIC of 16 against itraconazole, and 1 isolate had MIC of 32 against posaconazole. CYP51A gene was sequenced, and TR34/L98H mutation was identified. Triazole resistance existing in Kenya calls for rational use of azole-based fungicides in agriculture over concerns of emerging antifungal resistance in clinical practice.

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North, Carol S., Betty Pfefferbaum, Pushpa Narayanan, Samuel Thielman, Gretchen McCoy, Cedric Dumont, Aya Kawasaki, Natsuko Ryosho, and Edward L. Spitznagel. "Comparison of post-disaster psychiatric disorders after terrorist bombings in Nairobi and Oklahoma City." British Journal of Psychiatry 186, no. 6 (June 2005): 487–93. http://dx.doi.org/10.1192/bjp.186.6.487.

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BackgroundAfrican disaster-affected populations are poorly represented in disaster mental health literature.AimsTo compare systematically assessed mental health in populations directly exposed to terrorist bombing attacks on two continents, North America and Africa.MethodStructured diagnostic interviews compared citizens exposed to bombings of the US Embassy in Nairobi, Kenya (n=227) and the Oklahoma City Federal Building (n=182).ResultsPrevalence rates of post-traumatic stress disorder (PTSD) and major depression were similar after the bombings. No incident (new since the bombing) alcohol use disorders were observed in either site. Symptom group C was strongly associated with PTSD in both sites. The Nairobi group relied more on religious support and the Oklahoma City group used more medical treatment, drugs and alcohol.ConclusionsPost-disaster psycho-pathology had many similarities in the two cultures; however, coping responses and treatment were quite different. The findings suggest potential for international generalisability of post-disaster psychopathology, but confirmatory studies are needed.

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Song’oro, Edinah, Andrew Nyerere, Gabriel Magoma, and Revathi Gunturu. "Occurrence of Highly Resistant Microorganisms in Ruai Wastewater Treatment Plant and Dandora Dumpsite in Nairobi County, Kenya." Advances in Microbiology 09, no. 05 (2019): 479–94. http://dx.doi.org/10.4236/aim.2019.95029.

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Nzengy'a, Daniel Muasya, and B. E. L. Wishitemi. "The performance of constructed wetlands for, wastewater treatment: a case study of Splash wetland in Nairobi Kenya." Hydrological Processes 15, no. 17 (2001): 3239–47. http://dx.doi.org/10.1002/hyp.185.

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Irekwa, Robinson M., Perpetual Ndung'u, Peter Kipkemboi, Tonny Teya, Anne Wanjiru Mwangi, Matthew Mutinda, Caroline Njoroge, Joanne Yego, Irumva Vanessa, and Samson Muuo Nzou. "Identification of Mycoplasma genitalium from clinical swabs by direct PCR." F1000Research 8 (November 26, 2019): 1993. http://dx.doi.org/10.12688/f1000research.21218.1.

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Mycoplasma genitalium is one of the smallest self-replicating organisms. It is an obligate parasite found in the human genital tract. In men, the bacteria cause both acute and chronic non-gonococcal urethritis (NGU). In women, it has been associated with pelvic inflammatory disease and cervicitis among other related infections. Treatment of M. genitalium related infections has been effective using antibiotics such as the macrolides (e.g. azithromycin) and fluoroquinolones. However, there have been recorded cases of resistance to these antibiotics in various parts of the world as a result of a mutation in the 23SrRNA gene, although the antibiotic resistance has not been well established. The aim of this study was to detect M. genitalium in 352 swab samples collected from a clinic for sex workers in Nairobi, Kenya. DNA was extracted from the swabs and stored as a crude extract at -31°C. The swab lysates were subjected to direct polymerase chain reaction using primers that specifically target the 16S rRNA gene for M. genitalium. A total of 29 samples tested positive for M. genitalium. The data results showed a M. genitalium prevalence of 8.24% among sex workers in Nairobi, Kenya.

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Nyakang'o, J. B., and J. J. A. van Bruggen. "Combination of a Well Functioning Constructed Wetland with a Pleasing Landscape Design in Nairobi, Kenya." Water Science and Technology 40, no. 3 (August 1, 1999): 249–56. http://dx.doi.org/10.2166/wst.1999.0169.

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The constructed wetland consists of a combination of a sub-surface horizontal flow system (VSB) planted with Typha, followed by a series of three pond systems planted with a variety of plants, including ornamental plants. The plant species include Typha, Cyperus latifolius, Cyperus papyrus, Hydrocotyle, Hydrocleis and Pontederia. The wetland is treating wastewater from a restaurant (The Carnivore) and a swimming pool resort with recreational facilities (Splash), both in Nairobi, Kenya. The wetland is designed to treat wastewater as well as to provide an aesthetically pleasing and environmentally sensitive landscape with ponds and ornamental plants for recreation. The 0.5 ha wetland is designed for 1,200 population equivalents, and has a high treatment efficiencies for BOD5, SS, COD, faecal coliforms, Kj-N, NH4-N and o-PO4 of 98, 85, 96, 99, 90, 92 and 88% removal. An attempt has been made to determine a mass balance for the system. Most of the nitrogen and phosphorus is deposited in the soil of both the subsurface horizontal flow constructed wetland and the ponds. Some nitrogen is removed by denitrification, only 6% of it is retained by the plants. The sediments play therefore, a major role in the removal of the nutrients. The constructed wetland attracts many birds (128 bird species have been reported) and amphibians. The overall impression of the wetland is that the dual function of beauty and wastewater treatment is achieved.

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Junglen, Katherine, Leandra Rhodes-Dicker, Barbara J. Ward, Emily Gitau, Wali Mwalugongo, Lindsay Stradley, and Evan Thomas. "Characterization and Prediction of Fecal Sludge Parameters and Settling Behavior in Informal Settlements in Nairobi, Kenya." Sustainability 12, no. 21 (October 30, 2020): 9040. http://dx.doi.org/10.3390/su12219040.

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The safe management of fecal sludge (FS) relies on different treatments, processes, and disposal options in different contexts. Waste transfer stations can improve FS management particularly in resource-constrained areas, including low-income urban informal settlements, by providing a safe discharge and treatment location. Low-footprint options for FS treatment are sensitive to the characteristics of incoming FS, which are typically highly variable, difficult to predict, and differ significantly from the characteristics of traditional wastewater. The success of low-footprint technologies relies on the monitoring of incoming FS characteristics, such as total solids (TS), total suspended solids (TSS), chemical oxygen demand (COD), ammonia, electrical conductivity (EC), and pH. Monitoring the characteristics of incoming FS typically relies on the use of a laboratory, which can be expensive and time-consuming, particularly in resource-constrained areas. Useful correlations between easy to measure parameters and difficult to measure parameters may provide useful information related to the monitoring of FS, while reducing the need for laboratory analysis. In this paper, we describe a sampling campaign at a waste transfer station in Nairobi, Kenya managed by Sanergy Inc., to characterize and observe settling behavior of FS collected from manually emptied pit latrines. The investigation found that easy to measure parameters (e.g., TS, turbidity) could be used to approximate difficult to measure parameters (COD, TSS). Additionally, rapid measurements (turbidity) could be used to approximate time-intensive parameters (TS, COD, TSS) to aid in the design, operation and monitoring of FS treatment facilities in resource and space-constrained areas.

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Laving, Ahmed, Rose Kamenwa, Shahin Sayed, Andrew Nyerere Kimang'a, and Gunturu Revathi. "Effectiveness of sequential v. standard triple therapy for treatment of Helicobacter pylori infection in children in Nairobi, Kenya." South African Medical Journal 103, no. 12 (October 23, 2013): 921. http://dx.doi.org/10.7196/samj.7012.

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Raguenaud, M., R. Zachariah, M. Massaquoi, V. Ombeka, H. Ritter, and J. M. Chakaya. "High adherence to anti-tuberculosis treatment among patients attending a hospital and slum health centre in Nairobi, Kenya." Global Public Health 3, no. 4 (October 2008): 433–39. http://dx.doi.org/10.1080/17441690802063205.

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Makworo, Drusilla, and Theresa Odero. "Caring for HIV-positive children: healthcare providers' pre-and post-disclosure experiences in Nairobi, Kenya." African Journal of Midwifery and Women's Health 13, no. 3 (July 2, 2019): 1–7. http://dx.doi.org/10.12968/ajmw.2018.0022.

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Background The number of children living with HIV has increased worldwide, largely due to improvements in antiretroviral therapy. Most of these children are living in sub-Saharan Africa. The rate of disclosure to children of their HIV-positive status is low in low-resource countries compared to high-resource countries. Aim To explore health professionals' experiences of caring for HIV-positive children before and after their HIV-positive status was disclosed to them. The health professionals included nurses, counsellors, nutritionists, social workers, pharmacists and clinicians with at least 1 year of experience at the paediatric section of the comprehensive care centre. Methods Nine health professionals were interviewed. Findings Results revealed that there were more challenges before disclosure than after. The main challenge was communicating with the children. The children's main concerns before disclosures included the reason for treatment and its duration, and clinic follow-up. Conclusions Health professionals should be trained on the benefits of HIV disclosure to children, in order to allow for open and direct communication between healthcare providers, parents/carers and children.

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Nduba, V. N., C. W. Mwachari, A. S. Magaret, D. R. Park, A. Kigo, T. M. Hooton, and C. R. Cohen. "Placebo found equivalent to amoxicillin for treatment of acute bronchitis in Nairobi, Kenya: a triple blind, randomised, equivalence trial." Thorax 63, no. 11 (November 1, 2008): 999–1005. http://dx.doi.org/10.1136/thx.2008.097311.

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Chung, Michael H., Rachel Silverman, Ingrid A. Beck, Nelly Yatich, Sandra Dross, Jennifer McKernan-Mullin, Stephen Bii, et al. "Increasing HIV-1 pretreatment drug resistance among antiretroviral-naïve adults initiating treatment between 2006 and 2014 in Nairobi, Kenya." AIDS 30, no. 10 (June 2016): 1680–82. http://dx.doi.org/10.1097/qad.0000000000001110.

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Mulinge, Erastus, Cecilia Mbae, Benjamin Ngugi, Tabitha Irungu, Elizabeth Matey, and Samuel Kariuki. "Entamoeba species infection in patients seeking treatment for diarrhea and abdominal discomfort in Mukuru informal settlement in Nairobi, Kenya." Food and Waterborne Parasitology 23 (June 2021): e00122. http://dx.doi.org/10.1016/j.fawpar.2021.e00122.

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Kemoi, Edson K., Andrew Nyerere, Uwe Gross, Oliver Bader, Tohru Gonoi, and Christine C. Bii. "Diversity of Azoles Resistant Aspergillus Species Isolated from Experience and Naïve Soils in Nairobi County and Naivasha Sub-County Kenya." European Scientific Journal, ESJ 13, no. 36 (December 31, 2017): 301. http://dx.doi.org/10.19044/esj.2017.v13n36p301.

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New triazole antifungals voriconazole, itraconazole and posaconazole are recommended for prophylaxis and treatment of both invasive and chronic fungal infections such as aspergillosis and aspergilloma. Emergence of azole-resistant among A. fumigatus isolates have been reported in other countries including Tanzania ascribed to either previous antifungal treatment, prophylaxis or triazoles use in agriculture. The use of azole based fungicides in the robust horticulture in Kenya is a significant risk factor for antifungal resistance. The study proposes to analyze environmental isolates of Aspergillus fumigatus, Aspergillus flavus and Aspergillus niger for the presence of resistance against the triazoles antifungals. Fungicide naïve soils were obtained from uncultivated virgin fields while fungicide experience soils were collected from flower, agricultural and horticultural fields and greenhouses within Naivasha sub-county and Nairobi County. The fungal isolates were subjected to antifungal susceptibility to triazoles using broth micro dilution method. A total of 492 samples were analyzed in Nairobi, 52 isolates were identified and they resistance were as follow: A. fumigatus (32%), A. niger (26.09%), A. flavus (33.33%) and A .terreus (0%) and in Naivasha 44 isolates were isolated out of which 25 were A. fumigatus and its resistance was at 36%. Data were analyses using student T test and showed they no different between resistant and susceptible isolates from the two location. Data generated will serve to inform on the current status of triazoles resistance pattern and to raise concern emerging antifungal resistance in clinical practice.

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Blanton, Elizabeth, Natalie Wilhelm, Ciara O'Reilly, Everline Muhonja, Solomon Karoki, Maurice Ope, Daniel Langat, et al. "A rapid assessment of drinking water quality in informal settlements after a cholera outbreak in Nairobi, Kenya." Journal of Water and Health 13, no. 3 (December 30, 2014): 714–25. http://dx.doi.org/10.2166/wh.2014.173.

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Populations living in informal settlements with inadequate water and sanitation infrastructure are at risk of epidemic disease. In 2010, we conducted 398 household surveys in two informal settlements in Nairobi, Kenya with isolated cholera cases. We tested source and household water for free chlorine residual (FCR) and Escherichia coli in approximately 200 households. International guidelines are ≥0.5 mg/L FCR at source, ≥0.2 mg/L at household, and <1 E. coli/100 mL. In these two settlements, 82% and 38% of water sources met FCR guidelines; and 7% and 8% were contaminated with E. coli, respectively. In household stored water, 82% and 35% met FCR guidelines and 11% and 32% were contaminated with E. coli, respectively. Source water FCR ≥0.5 mg/L (p = 0.003) and reported purchase of a household water treatment product (p = 0.002) were associated with increases in likelihood that household stored water had ≥0.2 mg/L FCR, which was associated with a lower likelihood of E. coli contamination (p < 0.001). These results challenge the assumption that water quality in informal settlements is universally poor and the route of disease transmission, and highlight that providing centralized water with ≥0.5 mg/L FCR or (if not feasible) household water treatment technologies reduces the risk of waterborne cholera transmission in informal settlements.

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Nyaoke, Borna A., Marianne W. Mureithi, and Caryl Beynon. "Factors associated with treatment type of non-malarial febrile illnesses in under-fives at Kenyatta National Hospital in Nairobi, Kenya." PLOS ONE 14, no. 6 (June 13, 2019): e0217980. http://dx.doi.org/10.1371/journal.pone.0217980.

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Oduor, Joseph Michael Ochieng', Nyamongo Onkoba, Fredrick Maloba, Washingtone Ouma Arodi, and Atunga Nyachieo. "Efficacy of lytic Staphylococcus aureus bacteriophage against multidrug-resistant Staphylococcus aureus in mice." Journal of Infection in Developing Countries 10, no. 11 (November 24, 2016): 1208–13. http://dx.doi.org/10.3855/jidc.7931.

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Introduction: The use of bacteriophages as an alternative treatment method against multidrug-resistant bacteria has not been explored in Kenya. This study sought to determine the efficacy of environmentally obtained lytic bacteriophage against multidrug-resistant Staphylococcus aureus (MDRSA) bacterium in mice. Methodology: Staphylococcus aureus bacterium and S. aureus-specific lytic phage were isolated from sewage and wastewater collected within Nairobi County, Kenya. Thirty mice were randomly assigned into three groups: MDRSA infection group (n = 20), phage-infection group (n = 5), and non-infection group (n = 5). The MDRSA infection group was further subdivided into three groups: clindamycin treatment (8 mg/kg; n = 5), lytic phage treatment (108 PFU/mL (n = 5), and a combination treatment of clindamycin and lytic phage (n = 5). Treatments were done at either 24 or 72 hours post-infection (p.i), and data on efficacy, bacterial load, and animal physical health were collected. Results: Treatment with phage was more effective (100%) than with clindamycin (62.25% at 24 hours p.i and 87.5% at 72 hours p.i.) or combination treatment (75% at 24 hours p.i. and 90% at 72 hours p.i.) (p < 0.001). Conclusions: The results show that the environmentally obtained S. aureus lytic bacteriophage has therapeutic potential against MDRSA bacterium in mice.

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EVENS, EMILY, ROSE OTIENO-MASABA, MARGARET EICHLEAY, DONNA McCARRAHER, GWYN HAINSWORTH, CATE LANE, MARGARET MAKUMI, and PAMELA ONDUSO. "POST-ABORTION CARE SERVICES FOR YOUTH AND ADULT CLIENTS IN KENYA: A COMPARISON OF SERVICES, CLIENT SATISFACTION AND PROVIDER ATTITUDES." Journal of Biosocial Science 46, no. 1 (June 10, 2013): 1–15. http://dx.doi.org/10.1017/s0021932013000230.

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SummaryUnsafe abortion accounts for 35% of maternal mortality in Kenya. Post-abortion care (PAC) reduces maternal death and provides an opportunity to prevent unwanted pregnancies. Few studies have documented how the receipt of PAC services varies by client age. In this study, descriptive data were collected from clients, providers and eight health facilities in Kenya's Central and Nairobi provinces to examine receipt of PAC services by client age, client satisfaction and provider attitudes. Delivery of PAC treatment, pain management, HIV and STI services and violence screening did not vary by age. However, fewer youth between the ages of 15 and 24 received a contraceptive method compared with adult clients (35% versus 48%; p=0.02). Forty-nine per cent of youth reported not using a family planning method due to fears of infertility, side-effects or lack of knowledge compared with 22% of adults. Additional efforts are needed in Kenya to bolster the family planning services that young PAC clients receive and increase the uptake of contraception.

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Cheboi, Juliana J., Miriam G. Kinyua, Paul K. Kimurto, Oliver K. Kiplaga, Fredrick Ng’an’ga, and Sita R. Ghimire. "Biochemical composition of pigeonpea genotypes in Kenya." November 2019, no. 13(11):2019 (November 20, 2019): 1848–55. http://dx.doi.org/10.21475/ajcs.19.13.11.p1886.

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Pigeonpea is an important crop in semi-arid tropics and sub-tropics. The improvement and utilization of this crop in East Africa can enhance food and nutrition security. A study was carried out to examine variation in biochemical composition (crude protein, total phenols, total flavonoid and total anti-oxidant activity) of 55 pigeonpea genotypes grown in Kabete field station during the long rains of April-September 2017. The experiment was set up in a randomized complete block design with three replications. After harvest, 100g of dry seed samples were collected for biochemical analyses. The biochemical analyses were performed at nutrition platform of Biosciences eastern and central Africa- International Livestock Research Institute (BecA-ILRI) Hub, Nairobi, Kenya. Treatment means were separated based on Tukey test using Genstat, SAS and R software. The genotypes varied significantly (P≤0.05) for all the parameters measured with a mean of 20.88 g/100g, 46.21 mg/100g, 23.98 mg/100g and 38.13 mg/100g for crude protein, total phenol, total flavonoid and total anti-oxidant activity, respectively. Advanced elite materials out performed for all parameters analyzed except for crude protein with a mean of 59.57 mg/100g, 26.64 mg/100g and 30.23 mg/100g for total phenols, total flavonoid and total anti-oxidant activity, respectively. The total antioxidant activity had significantly positive correlation (P≤0.05) with total phenol, total flavonoid and crude protein. Similarly, total phenol and total flavonoid had significantly positive correlation (≤0.05). The results revealed that the advanced elite materials contain high phenolics and antioxidant activity that contribute to lowering oxidation of free radicals due to their redox properties. Therefore, these germplasm are valuable genetic resources for improving pigeonpea varieties for nutritional qualities.

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Wambalaba, Francis W., Barbara Son, Akosa E. Wambalaba, Dorothy Nyong’o, and Anyang’ Nyong’o. "Prevalence and Capacity of Cancer Diagnostics and Treatment: A Demand and Supply Survey of Health-Care Facilities in Kenya." Cancer Control 26, no. 1 (January 1, 2019): 107327481988693. http://dx.doi.org/10.1177/1073274819886930.

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The cancer incidence burden is expected to rise to over 85% in sub-Saharan Africa by 2030.1 This alarming trend underscores the need to develop evidence-based interventions that can effectively handle this volatile epidemic. The evidence generation entails the collection of adequate information on burden, pattern, and prevalence of cancer relative to capacity to promote effective decision-making. Accordingly, this study documents the prevalence and types of cancer in Kenya (demand side) and to determine the diagnostic and treatment capacity of the various health facilities to handle cancer cases (supply side). To investigate demand and supply factors for cancer control, the study surveyed 7 of the 47 counties in Kenya during 2013 to 2014. It sampled 1048 patients with cancer records and 12 health-care facilities. The study found that the most frequent age for female patients was at age 52, while for men was at age 62. The most prevalent cancer in women was breast cancer and cancer of the cervix, while for men was cancer of the esophagus and prostate. It was also found that children and rural populations were more vulnerable than it was thought, hence defying the local perception that cancer inflicts only adults and those in urban areas. Accessing cancer screening and treatment was one of the major hurdles as most cancer care services in Kenya were concentrated within a 5-km radius of each other in Nairobi. The limited capacity with respect to diagnosis and treatment has implications to issues of access, proximity, and availability. It is critical that policy makers and practitioners closely review the current public and individual perceptions about the cancer problems and mitigation strategies.

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Kizito, Kibango Walter, Sophie Dunkley, Magdalene Kingori, and Tony Reid. "Lost to follow up from tuberculosis treatment in an urban informal settlement (Kibera), Nairobi, Kenya: what are the rates and determinants?" Transactions of the Royal Society of Tropical Medicine and Hygiene 105, no. 1 (January 2011): 52–57. http://dx.doi.org/10.1016/j.trstmh.2010.08.015.

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Malonza, Isaac M., Mark W. Tyndall, Jeckoniah O. Ndinya‐Achola, Ian Maclean, Siad Omar, Kelly S. MacDonald, Jos Perriens, et al. "A Randomized, Double‐Blind, Placebo‐Controlled Trial of Single‐Dose Ciprofloxacin versus Erythromycin for the Treatment of Chancroid in Nairobi, Kenya." Journal of Infectious Diseases 180, no. 6 (December 1999): 1886–93. http://dx.doi.org/10.1086/315133.

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Ongarora, Karumbi, Minnaard, Abuga, Okungu, and Kibwage. "Medicine Prices, Availability, and Affordability in Private Health Facilities in Low-Income Settlements in Nairobi County, Kenya." Pharmacy 7, no. 2 (April 24, 2019): 40. http://dx.doi.org/10.3390/pharmacy7020040.

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Medicine prices are a major determinant of access to healthcare. Owing to low availability of medicines in the public health facilities and poor accessibility to these facilities, most low-income residents pay out-of-pocket for health services and transport to the private health facilities. In low-income settlements, high retail prices are likely to push the population further into poverty and ill health. This study assessed the retail pricing, availability, and affordability of medicines in private health facilities in low-income settlements within Nairobi County. Medicine prices and availability data were collected between September and December 2016 at 45 private healthcare facilities in 14 of Nairobi’s low-income settlements using electronic questionnaires. The International Medical Products Price Guide provided international medicine reference prices for comparison. Affordability and availability proxies were calculated according to existing methods. Innovator brands were 13.8 times more expensive than generic brands. The lowest priced generics and innovator brands were, on average, sold at 2.9 and 32.6 times the median international reference prices of corresponding medicines. Assuming a 100% disposable income, it would take 0.03 to 1.33 days’ wages for the lowest paid government employee to pay for treatment courses of selected single generic medicines. Medicine availability in the facilities ranged between 2% and 76% (mean 43%) for indicator medicines. Prices of selected medicines varied within the 14 study regions. Retail medicine prices in the low-income settlements studied were generally higher than corresponding international reference prices. Price variations were observed across different regions although the regions comprise similar socioeconomic populations. These factors are likely to impact negatively on healthcare access.

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Wang’ombe, Joyce, and Beatrice Kathungu. "PALLIATIVE CARE RECOVERY OUTCOMES: NATURE OF RECOVERY OUTCOMES AMONG CANCER PATIENTS IN NAIROBI AND NYERI COUNTIES, KENYA." Journal of Health, Medicine and Nursing 6, no. 2 (March 12, 2021): 1–12. http://dx.doi.org/10.47604/jhmn.1244.

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Purpose: This study sought to find out nature of recovery outcomes among cancer patients attending palliative care in Nairobi and Nyeri County Methodology: The study adopted a correlation research design. The target population were the cancer patients, attending treatment at the three palliative care units in Nairobi and Nyeri Counties. Systematic random sampling technique was used in the study to obtain a sample of 96 participants. Semi structured questionnaires were used to collect data. Data was analysed using both descriptive and inferential statistics, namely Pearson Moment Correlation Coefficient(r). Findings: Result showed that, majority of the respondents (65.5%) had a low level of recovery outcomes, while 32.1% had a high level of recovery outcomes. results indicate that the lowest score on recovery outcomes was 31, while the highest score was 74. The mean score was 47.0+9.465, which indicates that the recovery outcomes fell in the low range. These findings were not unusual considering that most of the patients were newly diagnosed with cancer and for some respondent’s metastasis had set in. Conclusion: The study concluded that the two most significant challenges encountered in palliative care were, patient experiencing isolation and lacking finances. Provision of financial support and increasing the number of counselling sessions were suggested as possible strategies for enhancing patient recovery outcomes Recommendation: This study recommended that the palliative care units staff should encourage participation of family members, friends and significant others in the cancer continuum, so as to provide psychological and social support to patients Unique contribution to theory, practice and policy Patients under palliative care could adopt group psychotherapy, including cognitive-behavioural, informational, non-behavioral, social support, and using unusual treatments such as music and art therapy to curb cancer. More cancer related programs enhancing patients AQ should be put in place by the counsellors in order to increase the patients AQ in the palliative care units from moderate level to high level of AQ in order to boost recovery outcomes

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Gichangi, P., B. Estambale, J. Bwayo, K. Rogo, S. Ojwang, A. Opiyo, and M. Temmerman. "Knowledge and practice about cervical cancer and Pap smear testing among patients at Kenyatta National Hospital, Nairobi, Kenya." International Journal of Gynecologic Cancer 13, no. 6 (2003): 827–33. http://dx.doi.org/10.1136/ijgc-00009577-200311000-00014.

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Invasive cervical cancer (ICC) is the leading cause of cancer-related death among women in developing countries. Population-based cytologic screening and early treatment does reduce morbidity and mortality associated with cervical cancer. Some of the factors related to the success of such a program include awareness about cervical cancer and its screening. The objective of this study was to assess knowledge and practice about cervical cancer and Pap smear testing among cervical cancer and noncancer patients using a structured questionnaire to obtain information. Fifty-one percent of the respondents were aware of cervical cancer while 32% knew about Pap smear testing. There were no significant differences in knowledge between cervical cancer and noncancer patients. Health care providers were the principal source of information about Pap testing (82%). Only 22% of all patients had had a Pap smear test in the past. Patients aware of cervical cancer were more likely to have had a Pap smear test in the past. The level of knowledge is low among ICC and noncancer patients. There is need to increase the level of knowledge and awareness about ICC and screening among Kenyan women to increase uptake of the currently available hospital screening facilities.

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Ohabuneyi, Nnedinso, and Felix Ifeanyi Nwafor. "INVESTIGATION OF RISPERIDONE; CASE OF SELECTED PATIENTS FROM KENYA." International Medical Science Research Journal 1, no. 3 (June 23, 2020): 73–78. http://dx.doi.org/10.51594/imsrj.v1i3.67.

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Risperidone is considered as an atypical antipsychotic. It is considered as an effective treatment of psychotic disorders in adults. However, our understanding of its usage among young individuals is limited. In this study, the objective was to identify the safety profile of Risperidone among young children. Methodology wise, the study was conducted among children of less than 5 years old who were treating behavioral problems associated with various childhood disorders. The study was conducted in a hospital in Nairobi, Kenya. Common childhood disorders were diagnosed using the Diagnostic and Statistical Manual (DSM IV) and those associated with disruptive behavioral problems. We used Clinical Global Impression- Severity (CGI-S) and Improvement (CGI-I) scales for symptoms severity and improvement respectively. We took informed consents from parents of the children and initiated Risperidone. The total of 12 patients were included in the study consist of PDD (n=4), PDD plus ADHD (n=2), PDD plus ADHD plus Intellectual disability (n=2), Cerebral Palsy with Epilepsy (n=2) and Global developmental delay (n=2). Baseline and end point CGI scores were 5-6 and 1-2 respectively. Baseline investigations such as lipid profile, fasting blood sugar levels, Electro cardiogram (ECG) were recorded and compared before and after initiation of risperidone. Dose range of risperidone was 0.5-2mg per day. Common side effects were sedation and weight gain in a few patients only. No life-threatening side effects were noted. Our conclusion is that risperidone is well tolerated even in children below 5 years of age over a period of 1 year with improvement in target symptoms.

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McLigeyo, Angela, Jamilla Rajab, Mohammed Ezzi, Peter Oyiro, Yatich Bett, Andrew Odhiambo, Matilda Ong’ondi, Sitna Mwanzi, Mercy Gatua, and NAOthieno Abinya. "Cytopenia among CML Patients on Imatinib in Kenya: Types, Grades, and Time Course." Advances in Hematology 2020 (May 12, 2020): 1–5. http://dx.doi.org/10.1155/2020/7696204.

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Background. Imatinib mesylate is the gold standard for the treatment of all phases of Philadelphia-positive chronic myeloid leukemia. Patients on imatinib treatment may develop cytopenia due to drug toxicity. This study aimed to determine the types, grades, and time course of cytopenia in CML patients on imatinib at a Nairobi hospital. Methods. This was a cross-sectional descriptive study of adult patients aged ≥18 years followed up at the Glivec International Patient Access Program (GIPAP) clinic from 2007 to 2015. Patients who developed cytopenia within 12 months of initiating imatinib were eligible. Clinical and hematologic data were retrieved from the patients’ charts and entered into a study proforma. Measures of central tendency such as mean, median, mode, standard deviation, and variance were used for analysis. Results. Sixty three percent (63.6%) of the 94 patients developed a monocytopenia, with anemia seen in 34%, neutropenia in 27.6%, and thrombocytopenia in 8% of the 94 patients. Anemia plus neutropenia was the most common bicytopenia at 12.7%. Pancytopenia was seen in only 5 of the 94 patients. Most of the cytopenia was grades 2 and 3. Anemia was present at baseline while neutropenia and thrombocytopenia developed within 12 months of imatinib initiation. Anemia resolved during the first 12 months of therapy while neutropenia and thrombocytopenia resolved within 24–36 months of treatment. Conclusion. Monocytopenia, especially anemia, was the most common type of cytopenia. The cytopenia was predominantly grade 2, developed in majority of the patients within 6 months after imatinib initiation, and had resolved by 24–36 months after imatinib initiation.

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McConnell, Margaret, Claire Watt Rothschild, Allison Ettenger, Faith Muigai, and Jessica Cohen. "Free contraception and behavioural nudges in the postpartum period: evidence from a randomised control trial in Nairobi, Kenya." BMJ Global Health 3, no. 5 (October 2018): e000888. http://dx.doi.org/10.1136/bmjgh-2018-000888.

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BackgroundShort birth intervals are a major risk factor for poor maternal and newborn outcomes. Utilisation of modern contraceptive methods during the postpartum period can reduce risky birth intervals but contraceptive coverage during this critical period remains low.MethodsWe conducted a randomised controlled experiment to test whether vouchers for free contraception, provided with and without behavioural ‘nudges’, could increase modern contraceptive use in the postpartum period. 686 pregnant women attending antenatal care in two private maternity hospitals in Nairobi, Kenya, were enrolled in the study. The primary outcomes were the use of modern contraceptive methods at nearly 3 months and 6 months after expected delivery date (EDD). We tested the impact of a standard voucher that could be redeemed for free modern contraception, a deadline voucher that expired 2 months after delivery and both types of vouchers with and without a short message service (SMS) reminder, relative to a control group that received no voucher and no SMS reminder.ResultsBy nearly 6 months after EDD, we find that the combination of the standard voucher with an SMS reminder increased the probability of reporting utilisation of a modern contraceptive method by 25 percentage points (pp) (95% CI 6 pp to 44 pp) compared with the control group. Estimated impacts in other treatment arms were not statistically significantly different from the control group.ConclusionsReducing financial barriers to postpartum contraception alone may not be enough to encourage take-up. Programmes targeting the postpartum period should consider addressing behavioural barriers to take-up.

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Trinkaus, M. E., S. Sayed, S. Gakinya, W. Hanna, Z. Moloo, and Y. Rahim. "External quality assurance of breast cancer pathologic reporting in Kenya." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): e11586-e11586. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.e11586.

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e11586 Background: Eighty percent of women diagnosed with breast cancer (BC) in East Africa present with advanced disease; current literature suggests a preponderance of triple negative/basal like breast cancer in this subset of African women. These studies are limited by their retrospective nature, small numbers, and unclear quality of pathologic specimen reporting. The objective of this study is to provide external quality assurance (EQA), quality control, and validation of hormone receptor and Her2 status of breast cancer specimens from Kenya. Methods: 108 retrospectively identified BC tumour blocks from the Aga Khan University Hospital (Nairobi, Kenya) during 2006–2008 will undergo repeat pathologic assessment for estrogen receptor (ER), progesterone receptor (PR), and Her2 status at Sunnybrook Health Sciences Center (Toronto, Canada).Currently at the Aga Khan University Pathology Lab, ER,PR and Her2 testing is performed manually once every two weeks using Heat Induced Antigen Retrieval and Dako reagents including the ENVISION detection system. Parallel controls of known tissue reactivity are also run; however there is currently no formal EQA. Results: Results will be used to identify areas of improvement in specimen handling and pathology reporting. Conclusions: Standardized and accurate pathologic assessment of BC specimens in East Africa is essential for establishing centres of excellence in Kenya and the wider East African region for hormone receptor and Her2 neu analysis. Results would contribute to understanding the prevalence of triple negative disease in East Africa, lead to improved treatment recommendations and patient outcomes, and serve as a foundation for prospective studies in East Africa. No significant financial relationships to disclose.

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Kiarie, John, Gabriel Kirori, and David Wachira. "Influence of Point-Based Program on Financial Performance of Selected Firms in the Service Industry in Kenya." American Journal of Finance 6, no. 1 (July 20, 2021): 42–55. http://dx.doi.org/10.47672/ajf.749.

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Introduction: Points based programs are programs offered by service industries to their customers when they make a purchase. In Points based system, frequent customers earn points, which translate into some type of reward: discount, gifts, or special customer treatment, customer purchases toward a certain amount of points to redeem their reward. Purpose: This study sought to establish the influence of point-based program on financial performance of selected firms in the service industry in Kenya. Methodology: The research design adopted descriptive method of the study. The target population was three (3) telecommunication firms (Safaricom, Airtel and Telkom Kenya), 5 supermarkets and 18 Five Star hotels. The study used census survey method for telecommunication firms and all the 18 five-star hotels in Nairobi offering loyalty points and thus there was no sampling. The study used secondary data extracted from financial statements. The researcher used both descriptive and inferential statistics. Descriptive analysis and trend analysis of the dependent and the independent variable were conducted. Findings: The results showed that point-based program has a positive and significant relationship with financial performance of selected supermarkets in Kenya. Recommendations: The study recommended that it’s imperative for the policy makers such as Communication Authority of Kenya, Tourism Authority of Kenya and the ministry of trade to support the development and usage of point based programs among supermarkets firms in Kenya. This can be done in friendly manner such as avoiding overly broad and strong regulation of the point based programs. In this regard, the government and the law makers should ensure that they involve a variety of point based programs stakeholders in the regulatory process, so that their vision and needs can be fairly balanced with government interests.

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Koyio, Lucina N., Wil JM J. M. Van der Sanden, Andre Van der Ven, Nico Creugers, Matthias A. W. Merkx, and Jo E. Frencken. "Effect of education of primary health care workers on HIV-related oral lesions in Nairobi East district." Journal of Public Health Research 1, no. 2 (April 30, 2012): 20. http://dx.doi.org/10.4081/jphr.2012.e20.

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<em>Background</em>. An estimated 90% of HIV-infected people are likely to develop oral lesions in the course of HIV infection. Oro-pharyngeal candidiasis (OPC), an early marker for HIV-infection, can be diagnosed during an oral examination (OE). Primary healthcare (PHC) providers in Kenya are neither trained nor sufficiently equipped to perform this simple, cheap and non-invasive examination. The PHC system in Kenya offers an opportunity to integrate early recognition and management of oral lesions into general health care. This study aims to estimate the effect of a multifaceted intervention for PHC providers in training them to perform an OE. Specifically, our primary objective is to establish whether the intervention is effective in increasing: i) the frequency of early detection of HIV-related oral lesions; and ii) referral rates for HIV-testing. <em>Design and methods. </em>The study has been designed in two parts: a retrospective clinical data record study and a prospective cohort study with pre-post control group design, carried out in 2 administrative divisions in Nairobi East district. The intervention group will receive one day of training on recognition of HIV-related oral lesions and other common oral conditions. Reminder sessions will be held at individual health facilities. Routine tally sheets will be used to record all patients with HIV-related oral lesions, dental caries and periodontal disease. A convenience sample of all the PHC in a division will be used. It will not be possible to blind investigators or assessors. Expected impact of the study for Public Health. Early recognition and treatment of HIV infection influences long-term survival rates and will reduce healthcare expenditure.

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Njeru, C., and A. Migowa. "AB0993 A CASE SERIES OF KAWASAKI DISEASE FROM KENYA." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1790.3–1790. http://dx.doi.org/10.1136/annrheumdis-2020-eular.6345.

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Background:Kawasaki disease (KD) has been described across the globe, including the African continent, but none yet from Kenya.Objectives:To describe the clinical features and management strategies of pediatric patients diagnosed with Kawasaki Disease at a tertiary referral hospital in Kenya.Methods:A retrospective chart review was undertaken for the period January 2013 to December 2017 for all pediatric patients admitted at Aga Khan University Hospital Nairobi, Kenya. All medical records with a discharge diagnosis of Kawasaki disease were reviewed, de-identified and data extracted using a data collection tool.Results:Among the 15 cases identified, 8 (53%) had complete KD. The mean age was 1 year 10 months with a slight increase in males (53.3%). The mean duration of symptoms at diagnosis was 7.2 days (range 1-11 days). Fourteen patients (93.3%) received both intravenous immunoglobulin and aspirin but dosing varied from high dose aspirin (80-90 mg/kg/day) to low dose aspirin (3 mg/kg/day). Baseline cardiac evaluations were done among these 14 (93.3%) and one patient was found to have bilateral dilated coronaries. Only 5 patients (33.3%) had repeat echo examinations within 6 weeks after diagnosis all of which were normal.Conclusion:The challenges faced in the management of KD in Kenya include awareness of the disease, access and expertise to pediatric echocardiography, follow-up, access and cost of IVIG. Increasing awareness and improving health care resources is important in improving outcomes of KD in Kenya.Keywords: Kawasaki Disease, Pediatric Rheumatology, Kenya, Global Health, VasculitisReferences:[1]McCrindle BW, Rowley AH, Newburger JW, Burns JC, Bolger AF, Gewitz M, Baker AL, Jackson MA, Takahashi M, Shah PB, Kobayashi T, Wu MH, Saji TT, Pahl E. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association. Circulation. 2017;135(17):e927-e999.[2]Kawasaki T. Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children. Arerugi (Japanese) 1967;16:178–222.[3]Singh S, Sharma A, Jiao F. Kawasaki Disease: Issues in Diagnosis and Treatment – A Developing Country Perspective. Indian J Pediatr 2016:83(2):140–145.[4]Scuccimarri R. Kawasaki Disease. Pediatr Clin N Am 2012; 59:425–445.Disclosure of Interests:None declared

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