Open Access. Powered by Scholars. Published by Universities.®

Medicine and Health Sciences Commons

Open Access. Powered by Scholars. Published by Universities.®

Aga Khan University

Discipline
Keyword
Publication Year
Publication
Publication Type
File Type

Articles 1 - 30 of 8494

Full-Text Articles in Medicine and Health Sciences

The Prevalence Of Stress And Stressors Among Pediatric Oncology Nurses Working In Pediatric Oncology Units In Pakistan - An Analytical Cross-Sectional Study, Shenila Anwarali Mar 2024

The Prevalence Of Stress And Stressors Among Pediatric Oncology Nurses Working In Pediatric Oncology Units In Pakistan - An Analytical Cross-Sectional Study, Shenila Anwarali

Theses & Dissertations

Introduction: Pediatric oncology nurses in Pakistan are at the forefront of caring for young cancer patients. In Pakistan, thousands of children are diagnosed with cancer every year, however the country's healthcare system lacks a comprehensive National cancer registry. Pediatric oncology nurses face high stress levels due to the demanding nature of their work, lack of specialized training, and communication challenges with patients and families. This study aims to explore the prevalence of stress and its predictors among these nurses in Pakistan, addressing a significant research gap.
Purpose: The purpose for the study was to measure stress and identify its predictors …


Abdominal Wall Endometriosis In Cesarean Scar: A Case Report, Willbroad Kyejo, Brenda Moshi, Euphraim Massanga, Gregory Ntiyakunze, Miriam Mgonja, Munawar Kaguta, Ernest Mdachi Mar 2024

Abdominal Wall Endometriosis In Cesarean Scar: A Case Report, Willbroad Kyejo, Brenda Moshi, Euphraim Massanga, Gregory Ntiyakunze, Miriam Mgonja, Munawar Kaguta, Ernest Mdachi

Obstetrics and Gynaecology, East Africa

Abdominal wall endometriosis refers to the presence of endometrial tissue within surgical scars, most commonly occurring following gynecological procedures such as cesarean sections. This case report presents a rare case of abdominal wall endometriosis in a cesarean scar. The patient, a 32-year-old woman with a history of two previous cesarean sections, presented with cyclic pain and swelling in the lower abdominal region. Physical examination revealed a tender, well-defined mass within the cesarean scar. Surgical excision of the mass was performed, and histopathological examination confirmed the presence of endometrial tissue. This case highlights the importance of considering abdominal wall endometriosis in …


Factors Associated With Late Diagnosis Of Cervical Cancer At Two National Referral Hospitals, Kenya 2017: A Case Control Study., Valerian Mwenda, Martin Mwangi, Gladwell Gathecha, Joseph Kibachio, Robert Too, Zeinab Gura, Marleen Temmerman Mar 2024

Factors Associated With Late Diagnosis Of Cervical Cancer At Two National Referral Hospitals, Kenya 2017: A Case Control Study., Valerian Mwenda, Martin Mwangi, Gladwell Gathecha, Joseph Kibachio, Robert Too, Zeinab Gura, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Cervical cancer is the leading cause of cancer mortality among women in Kenya. Two thirds of cervical cancer cases in Kenya are diagnosed in advanced stages. We aimed to identify factors associated with late diagnosis of cervical cancer, to guide policy interventions.

Methods: An unmatched case control study (ratio 1:2) was conducted among women aged ≥ 18 years with cervical cancer at Kenyatta National and Moi Teaching and Referral Hospitals. We defined a case as patients with International Federation of Gynecology and Obstetrics (FIGO) stage ≥ 2A and controls as those with stage ≤ 1B. A structured questionnaire was …


Scopes Of Practice For Advanced Practice Nursing And Advanced Practice Midwifery In Kenya: A Gap Analysis, Eunice Ndirangu, Rachel Kimani, Catherine Onyancha, Bernard Mutwiri, Beatrice May, Isabel Kambo, Nicholas Koech, Ann Mukuna, Colette Henderson, Constance Shumba Mar 2024

Scopes Of Practice For Advanced Practice Nursing And Advanced Practice Midwifery In Kenya: A Gap Analysis, Eunice Ndirangu, Rachel Kimani, Catherine Onyancha, Bernard Mutwiri, Beatrice May, Isabel Kambo, Nicholas Koech, Ann Mukuna, Colette Henderson, Constance Shumba

School of Nursing & Midwifery, East Africa

Background: There is increasing global evidence on the impact of advanced nursing andmidwifery practitioners, and Kenya’s healthcare system has an excellent opportunity todevelop scopes of practice and other regulatory frameworks for the integration of theseroles.

Objective: The primary purpose of this gap analysis was to explore the existing evidenceon opportunities and threats toward the integration of the advanced practice nursing(APN) and advanced practice midwifery (APM) roles in Kenya’s healthcare system.

Methods: The study team conducted a structured electronic database search of PubMed,CINAHL, Scopus, EBSCOhost Academic Search Complete, and PsycINFO to retrievearticles and credible websites for reports highlighting the opportunities …


Surgical Site Infections Post Cesarean Section And Associated Risk Factors: A Retrospective Case-Control Study At A Tertiary Hospital In Kenya., David Odada, Jasmit Shah, Annastacia Mbithi, Reena Shah Mar 2024

Surgical Site Infections Post Cesarean Section And Associated Risk Factors: A Retrospective Case-Control Study At A Tertiary Hospital In Kenya., David Odada, Jasmit Shah, Annastacia Mbithi, Reena Shah

School of Nursing & Midwifery, East Africa

Background: Surgical site infection is a common healthcare-associated infection that affects maternal health, yet it can be prevented or controlled. Caesarian sections are most likely to develop surgical site infections. The rates of delivery by caesarian section in reported to be higher that the acceptable rates in some healthcare facilities. Risk factors for surgical site infections can be identified and modified to reduce the occurrence of surgical site infections. This study aims to determine the risk factors that contribute to surgical site infections post caesarian section in a tertiary teaching hospital in Kenya.

Methods: This was a retrospective case-control (1:2 …


Quality Indicators In Surgical Oncology: Systematic Review Of Measures Used To Compare Quality Across Hospitals, Megan Mcleod, Kari Leung, C S. Pramesh, Peter Kingham, Miriam Mutebi, Julie Torode, Andre Ilbawi, Jade Chakowa, Richard Sullivan, Ajay Aggarwal Mar 2024

Quality Indicators In Surgical Oncology: Systematic Review Of Measures Used To Compare Quality Across Hospitals, Megan Mcleod, Kari Leung, C S. Pramesh, Peter Kingham, Miriam Mutebi, Julie Torode, Andre Ilbawi, Jade Chakowa, Richard Sullivan, Ajay Aggarwal

General Surgery, East Africa

Background: Measurement and reporting of quality indicators at the hospital level has been shown to improve outcomes and support patient choice. Although there are many studies validating individual quality indicators, there has been no systematic approach to understanding what quality indicators exist for surgical oncology and no standardization for their use. The aim of this study was to review quality indicators used to assess variation in quality in surgical oncology care across hospitals or regions. It also sought to describe the aims of these studies and what, if any, feedback was offered to the analysed groups.

Methods: A literature search …


Quantifying Health Facility Service Readiness For Small And Sick Newborn Care: Comparing Standards-Based And Who Level-2 + Scoring For 64 Hospitals Implementing With Nest360 In Kenya, Malawi, Nigeria, And Tanzania, Rebecca E. Penzias, Christine Bohne, Edith Gicheha, Elizabeth Molyneux, David Gathara, Samuel K. Ngwala, Evelyn Zimba, Ekran Rashid, Opeyemi Odedere, Olabisi Dosunmu Mar 2024

Quantifying Health Facility Service Readiness For Small And Sick Newborn Care: Comparing Standards-Based And Who Level-2 + Scoring For 64 Hospitals Implementing With Nest360 In Kenya, Malawi, Nigeria, And Tanzania, Rebecca E. Penzias, Christine Bohne, Edith Gicheha, Elizabeth Molyneux, David Gathara, Samuel K. Ngwala, Evelyn Zimba, Ekran Rashid, Opeyemi Odedere, Olabisi Dosunmu

Paediatrics and Child Health, East Africa

Background: Service readiness tools are important for assessing hospital capacity to provide quality small and sick newborn care (SSNC). Lack of summary scoring approaches for SSNC service readiness means we are unable to track national targets such as the Every Newborn Action Plan targets.

Methods: A health facility assessment (HFA) tool was co-designed by Newborn Essential Solutions and Technologies (NEST360) and UNICEF with four African governments. Data were collected in 68 NEST360-implementing neonatal units in Kenya, Malawi, Nigeria, and Tanzania (September 2019-March 2021). Two summary scoring approaches were developed: a) standards-based, including items for SSNC service readiness by health system …


Assessing The Influence Of Covid-19 Lockdown Measures On Cognition And Behavior In School Age Children In Arba Minch Health And Demographic Surveillance Site, Southern Ethiopia: A Cross-Sectional Study, Befikadu Tariku Gutema, Eshetu Zerihun Tariku, Zeleke Aschalew Melketsedik, Bruno Levecke, Stefaan De Henauw, Amina Abubakar, Souheila Abbeddou Mar 2024

Assessing The Influence Of Covid-19 Lockdown Measures On Cognition And Behavior In School Age Children In Arba Minch Health And Demographic Surveillance Site, Southern Ethiopia: A Cross-Sectional Study, Befikadu Tariku Gutema, Eshetu Zerihun Tariku, Zeleke Aschalew Melketsedik, Bruno Levecke, Stefaan De Henauw, Amina Abubakar, Souheila Abbeddou

Institute for Human Development

Ethiopian schools were closed for nearly 40 weeks as a measure to control the COVID-19 pandemic. The objective of the study was to evaluate the role of COVID-19 pandemic’s restrictive measures on cognition and behavioral difficulties of schoolchildren in Arba Minch Health and Demographic Surveillance Site. Two cross-sectional surveys were conducted in November 2019 (pre-COVID-19-lockdown) and November 2020 (post-COVID-19 lockdown). Data were collected both at the school and homes of the children. Cognitive development of the children was assessed using digit span, Raven’s coloured progressive matrices (RCPM) and Visual search using cancellation task. Behavioral difficulties score of the children was …


Use Of Mobile Technology To Identify Behavioral Mechanisms Linked To Mental Health Outcomes In Kenya: Protocol For Development And Validation Of A Predictive Model., Willie Njoroge, Rachel Maina, Lukoye Atwoli, Elena Frank, Zhenke Wu, Anthony Ngugi, Srijan Sen, Linda Khakali, Andrew Aballa, James Orwa, Zul Merali Mar 2024

Use Of Mobile Technology To Identify Behavioral Mechanisms Linked To Mental Health Outcomes In Kenya: Protocol For Development And Validation Of A Predictive Model., Willie Njoroge, Rachel Maina, Lukoye Atwoli, Elena Frank, Zhenke Wu, Anthony Ngugi, Srijan Sen, Linda Khakali, Andrew Aballa, James Orwa, Zul Merali

Brain and Mind Institute

Objective: This study proposes to identify and validate weighted sensor stream signatures that predict near-term risk of a major depressive episode and future mood among healthcare workers in Kenya.

Approach: The study will deploy a mobile application (app) platform and use novel data science analytic approaches (Artificial Intelligence and Machine Learning) to identifying predictors of mental health disorders among 500 randomly sampled healthcare workers from five healthcare facilities in Nairobi, Kenya.

Expectation: This study will lay the basis for creating agile and scalable systems for rapid diagnostics that could inform precise interventions for mitigating depression and ensure a healthy, resilient …


A Systematic Review Of Measures Of Healthcare Workers’ Vaccine Confidence, Kofoworola Akinsola, Ayobami Bakare, Elisa Gobbo, Carina King, Claudia Hanson, Adegoke Falade, Sibylle Herzig Van Wees Mar 2024

A Systematic Review Of Measures Of Healthcare Workers’ Vaccine Confidence, Kofoworola Akinsola, Ayobami Bakare, Elisa Gobbo, Carina King, Claudia Hanson, Adegoke Falade, Sibylle Herzig Van Wees

Centre of Excellence in Women and Child Health

Healthcare workers (HCW) perceptions toward vaccines influence patient and community vaccine decision making. In an era of rising vaccine hesitancy, understanding HCW vaccine confidence is critical. This systematic review aims to review instruments that have been validated to measure HCW vaccine confidence. We conducted a search in five databases in June 2023. Data was descriptively synthesized. Twelve articles describing 10 different tools were included. Most tools included dimensions or items on vaccine knowledge (n = 9), safety (n = 8), vaccine usefulness (n = 8), recommendation behavior (n = 8), and self-vaccination practice (n = 7). All, except one study, …


Nurses’ And Clients’ Perspectives After Engagement In The Co-Designing Of Solutions To Improve Provider-Client Relationships In Maternal And Child Healthcare: A Human-Centered Design Study In Rural Tanzania, Kahabi Isangula, Eunice Pallangyo, Eunice Ndirangu Mar 2024

Nurses’ And Clients’ Perspectives After Engagement In The Co-Designing Of Solutions To Improve Provider-Client Relationships In Maternal And Child Healthcare: A Human-Centered Design Study In Rural Tanzania, Kahabi Isangula, Eunice Pallangyo, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Background

There has been a persistent increase in clients’ dissatisfaction with providers’ competencies in maternal and child healthcare (MCH). Existing interventions have failed to address the complexity of provider-client relationships. Therefore, targeted, contextualized innovative solutions that place providers and clients at the forefront as agents of change in optimizing intervention design and implementation are needed. The study team adopted a co-design strategy as part of Human- Centered Design (HCD) approach, where MCH nurses, clients, and stakeholders partnered to design an intervention package to improve provider-client relationships in rural Tanzania.

Objective

This paper explored nurses’, clients’, and MCH stakeholders’ perspectives following …


A Case Of Parkinsonian Symptoms Secondary To Chronic Subdural Hematoma, Willbroad Kyejo, Frank Swai, Clement Mugisha, Philip Adebayo Mar 2024

A Case Of Parkinsonian Symptoms Secondary To Chronic Subdural Hematoma, Willbroad Kyejo, Frank Swai, Clement Mugisha, Philip Adebayo

Internal Medicine, East Africa

Chronic subdural hematoma is a known neurosurgical entity often associated with a spectrum of neurological manifestations. While primarily recognized for its characteristic accumulation of blood between the dura mater and arachnoid membrane, emerging literature suggests a rare association between chronic subdural hematoma and Parkinsonian symptoms. This report aims to underscore this unique neurological relationship by presenting a case of a 70-year-old male who developed Parkinsonism following chronic subdural hematoma post-head trauma. This case underscores the rare association between chronic subdural hematoma and Parkinsonian symptoms, emphasizing the importance of timely diagnosis and intervention in managing such cases.


Entrance Surface Air Kerma To Patients During Digital Radiographic Examinations In Tanzania, Atumaini Makoba, Ahmed Jusabani, Wilbroad Muhogora, Abdallah Kileo, Musa Ndukeki, Huruma Mammba, Hilda Makungu, Haika Maro, Erick Onoka, Miguta Ngulimi Mar 2024

Entrance Surface Air Kerma To Patients During Digital Radiographic Examinations In Tanzania, Atumaini Makoba, Ahmed Jusabani, Wilbroad Muhogora, Abdallah Kileo, Musa Ndukeki, Huruma Mammba, Hilda Makungu, Haika Maro, Erick Onoka, Miguta Ngulimi

Imaging & Diagnostic Radiology, East Africa

The aim of this study was to determine the entrance surface air kerma (ESAK) in adult patients during digital radiography and to evaluate the optimisation potential in five common X-ray examinations in Tanzania. Based on a sample of 240–610 patients, ESAK was estimated using X-ray tube output measurements, patient information and backscatter factors. The results show that the mean ESAK values were higher or comparable to data from the literature. The diagnostic reference values of ESAK for digital radiography were 0.31 mGy (chest PA), 4 mGy (lumbar spine AP), 5.4 mGy (lumbar spine LAT), 3.8 mGy (abdomen AP) and 2.4 …


Post-Mortem Investigation Of Deaths Due To Pneumonia In Children Aged 1–59 Months In Sub-Saharan Africa And South Asia From 2016 To 2022: An Observational Study, Sana Mahtab, Dianna Blau, Zachary Madewell, Ikechukwu Ogbuanu, Julius Ojulong, Sandra Lako, Hailemariam Legesse, Joseph Bangura, Quique Bassat, R Gunturu Mar 2024

Post-Mortem Investigation Of Deaths Due To Pneumonia In Children Aged 1–59 Months In Sub-Saharan Africa And South Asia From 2016 To 2022: An Observational Study, Sana Mahtab, Dianna Blau, Zachary Madewell, Ikechukwu Ogbuanu, Julius Ojulong, Sandra Lako, Hailemariam Legesse, Joseph Bangura, Quique Bassat, R Gunturu

Pathology, East Africa

Background: The Child Health and Mortality Prevention Surveillance (CHAMPS) Network programme undertakes post-mortem minimally invasive tissue sampling (MITS), together with collection of ante-mortem clinical information, to investigate causes of childhood deaths across multiple countries. We aimed to evaluate the overall contribution of pneumonia in the causal pathway to death and the causative pathogens of fatal pneumonia in children aged 1–59 months enrolled in the CHAMPS Network.

Methods: In this observational study we analysed deaths occurring between Dec 16, 2016, and Dec 31, 2022, in the CHAMPS Network across six countries in sub-Saharan Africa (Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and …


Image-Based Multiplex Immune Profiling Of Cancer Tissues: Translational Implications. A Report Of The International Immuno-Oncology Biomarker Working Group On Breast Cancer., Chowdhury Arif Jahangir, David B. Page, Glenn Broeckx, Claudia A. Gonzalez, Caoimbhe Burke, Clodagh Murphy, Jorge S. Reis-Filho, Amy Ly, Paul Harms, Shahin Sayed Mar 2024

Image-Based Multiplex Immune Profiling Of Cancer Tissues: Translational Implications. A Report Of The International Immuno-Oncology Biomarker Working Group On Breast Cancer., Chowdhury Arif Jahangir, David B. Page, Glenn Broeckx, Claudia A. Gonzalez, Caoimbhe Burke, Clodagh Murphy, Jorge S. Reis-Filho, Amy Ly, Paul Harms, Shahin Sayed

Pathology, East Africa

Recent advances in the field of immuno-oncology have brought transformative changes in the management of cancer patients. The immune profile of tumours has been found to have key value in predicting disease prognosis and treatment response in various cancers. Multiplex immunohistochemistry and immunofluorescence have emerged as potent tools for the simultaneous detection of multiple protein biomarkers in a single tissue section, thereby expanding opportunities for molecular and immune profiling while preserving tissue samples. By establishing the phenotype of individual tumour cells when distributed within a mixed cell population, the identification of clinically relevant biomarkers with high-throughput multiplex immunophenotyping of tumour …


Dental Caries In Children With Sickle Cell Disease And Its Association With The Use Of Hydroxyurea And Penicillin Prophylaxis In Dar Es Salaam, Irene Kida Minja, Evarist Mulyahela Wilson, Ferdinand M. Machibya, Agnes Jonathan, Fortunata Cornel, Paschal Ruggajo, Julie Makani, Ferdinand M. Machibya Mar 2024

Dental Caries In Children With Sickle Cell Disease And Its Association With The Use Of Hydroxyurea And Penicillin Prophylaxis In Dar Es Salaam, Irene Kida Minja, Evarist Mulyahela Wilson, Ferdinand M. Machibya, Agnes Jonathan, Fortunata Cornel, Paschal Ruggajo, Julie Makani, Ferdinand M. Machibya

Internal Medicine, East Africa

Purpose.

This comparative study sets out to report dental caries status among individuals with Sickle Cell Disease (HbSS) against those with sickle cell trait (HbSA) and those without the disease (HbAA) as controls. The study further assessed the impact of penicillin chemoprophylaxis and hydroxyurea use on dental caries among Sickle Cell Disease participants.

Methods.

This was a comparative cross-sectional study in which 93 children aged 30 to 60 months were recruited. There were 60 participating children who had SCD (HbSS), 17 with SCD trait (HbAS) and 16 were without SCD or SC trait (HbAA). A questionnaire was used to record …


National Non-Communicable Diseases Conferences- A Platform To Inform Policies And Practices In Tanzania, Davis E. Amani, Harrieth P. Ndumwa, Jackline E. Ngowi, Belinda J. Njiro, Castory Munishi, Erick A. Mboya, Doreen Mloka, Amani I. Kikula, Emmanuel Balandya, Paschal Ruggajo Mar 2024

National Non-Communicable Diseases Conferences- A Platform To Inform Policies And Practices In Tanzania, Davis E. Amani, Harrieth P. Ndumwa, Jackline E. Ngowi, Belinda J. Njiro, Castory Munishi, Erick A. Mboya, Doreen Mloka, Amani I. Kikula, Emmanuel Balandya, Paschal Ruggajo

Internal Medicine, East Africa

Background:

Non-communicable diseases (NCDs) arise from diverse risk factors with differences in the contexts and variabilities in regions and countries. Addressing such a complex challenge requires local evidence. Tanzania has been convening stakeholders every year to disseminate and discuss scientific evidence, policies, and implementation gaps, to inform policy makers in NCDs responses. This paper documents these dissemination efforts and how they have influenced NCDs response and landscape in Tanzania and the region.

Methods:

Desk review was conducted through available MOH and conference organizers’ documents. It had both quantitative and qualitative data. The review included reports of the four NCDs conferences, …


Effectiveness Of Blended Pedagogy For Radiographic Interpretation Skills In Operative Dentistry - A Comparison Of Test Scores And Student Experiences At An Undergraduate Dental School In Pakistan, Marium Iqbal, Jacqueline Maria Dias, Amber Shahmim Sultan, Hussain Ahmed Raza, Laeeq Uz Zaman Feb 2024

Effectiveness Of Blended Pedagogy For Radiographic Interpretation Skills In Operative Dentistry - A Comparison Of Test Scores And Student Experiences At An Undergraduate Dental School In Pakistan, Marium Iqbal, Jacqueline Maria Dias, Amber Shahmim Sultan, Hussain Ahmed Raza, Laeeq Uz Zaman

Department for Educational Development

Background: Utilizing Blended pedagogy (BP) in radiographic skills may prove to be an effective teaching strategy. However, studies on the use of BP in dentistry are quite limited in Pakistan, where teaching has mostly been via traditional Didactic Lectures (DL); and radiographic interpretation skills of undergraduate dental students are suboptimal. Therefore, this study aims to assess whether utilizing BP to teach radiographic interpretation skills is an effective teaching methodology in Pakistan.
Methods: This mixed-method study was conducted on final year dental students at Jinnah Medical and Dental College (JMDC). Two groups of students were utilized for this study, one taught …


Association Of Cardiovascular Risk Profile With Premature All-Cause And Cardiovascular Mortality In Us Adults: Findings From A National Study, Ryan T. Nguyen, Vardhmaan Jain, Isaac Acquah, Safi U. Khan, Tarang Parekh, Mohamad Taha, Salim S. Virani, Michael J. Blaha, Khurram Nasir, Zulqarnain Javed Zulqarnain Javed Feb 2024

Association Of Cardiovascular Risk Profile With Premature All-Cause And Cardiovascular Mortality In Us Adults: Findings From A National Study, Ryan T. Nguyen, Vardhmaan Jain, Isaac Acquah, Safi U. Khan, Tarang Parekh, Mohamad Taha, Salim S. Virani, Michael J. Blaha, Khurram Nasir, Zulqarnain Javed Zulqarnain Javed

Office of the Provost

Objective: To assess the association between cardiovascular risk factor (CRF) profile and premature all-cause and cardiovascular disease (CVD) mortality among US adults (age < 65).
Methods: This study used data from the National Health Interview Survey from 2006 to 2014, linked to the National Death Index for non-elderly adults aged < 65 years. A composite CRF score (range = 0-6) was calculated, based on the presence or absence of six established cardiovascular risk factors: hypertension, diabetes, hypercholesterolemia, smoking, obesity, and insufficient physical activity. CRF profile was defined as "Poor" (≥ 3 risk factors), "Average" (1-2), or "Optimal" (0 risk factors). Age-adjusted mortality rates (AAMR) were reported across CRF profile categories, separately for all-cause and CVD mortality. Cox proportional hazard models were used to evaluate the association between CRF profile and all-cause and CVD mortality.
Results: Among 195,901 non-elderly individuals (mean age: 40.4 ± 13.0, 50% females and 70% Non-Hispanic (NH) White adults), 24.8% had optimal, 58.9% average, and 16.2% poor CRF profiles, respectively. Participants with poor CRF profile were more likely to be NH Black, have lower educational attainment and lower income compared to those with …


Inspire : Vol 7 Issue 2, Department Of Medicine Feb 2024

Inspire : Vol 7 Issue 2, Department Of Medicine

INSPIRE

  • Message from the Chair
  • Medicine at National and International Forum
  • IHME (University of Washington) team members AKU visit By M Hassan Raja & Asim Shai
  • Revolutionizing Skin Health Education through Moulage
  • ID section | Consultative meeting
  • What Academics Are Reading?
  • Upcoming events


Knowledge, Attitudes And Beliefs Toward Polypharmacy Among Older People Attending Family Medicine Clinic, Nairobi, Kenya, Maureen Kamau, Njeri Nyanja, Adelaide Lusambili, Jacob Shabani, Gulnaz Mohamoud Feb 2024

Knowledge, Attitudes And Beliefs Toward Polypharmacy Among Older People Attending Family Medicine Clinic, Nairobi, Kenya, Maureen Kamau, Njeri Nyanja, Adelaide Lusambili, Jacob Shabani, Gulnaz Mohamoud

Family Medicine, East Africa

Background Life expectancy has increased over the last century among older people, particularly those aged over 60 years. Aging is associated with increased disability, multiple chronic conditions, and increased use of health services managed with polypharmacy. There are few studies on polypharmacy and aging in sub-Saharan Africa, and it is unclear what older people know and their attitudes toward polypharmacy. This paper presents findings from a study that aimed to understand older people’s knowledge, attitudes and beliefs about polypharmacy.

Methods A qualitative study using in-depth interviews of 15 patients aged 60 years and older who were taking more than five …


Early Goal-Directed Hemostatic Therapy For Severe Acute Bleeding Management In The Intensive Care Unit: A Narrative Review., Tomaz Crochemore, Klaus Görlinger, Marcus Lance Feb 2024

Early Goal-Directed Hemostatic Therapy For Severe Acute Bleeding Management In The Intensive Care Unit: A Narrative Review., Tomaz Crochemore, Klaus Görlinger, Marcus Lance

Anaesthesiology, East Africa

This is a narrative review of the published evidence for bleeding management in critically ill patients in different clinical settings in the intensive care unit (ICU). We aimed to describe “The Ten Steps” approach to early goal-directed hemostatic therapy (EGDHT) using point-of-care testing (POCT), coagulation factor concentrates, and hemostatic drugs, according to the individual needs of each patient. We searched National Library of Medicine, MEDLINE for publications relevant to management of critical ill bleeding patients in different settings in the ICU. Bibliographies of included articles were also searched to identify additional relevant studies. English-language systematic reviews, meta-analyses, randomized trials, observational …


Correction: Prevalence Of Lifestyle Cardiovascular Risk Factors And Estimated Framingham 10-Year Risk Scores Of Adults With Psychotic Disorders Compared To Controls At A Referral Hospital In Eldoret, Kenya., Edith Kwobah, Nastassja Koen, Ann Mwangi, Lukoye Atwoli, Dan Stein Feb 2024

Correction: Prevalence Of Lifestyle Cardiovascular Risk Factors And Estimated Framingham 10-Year Risk Scores Of Adults With Psychotic Disorders Compared To Controls At A Referral Hospital In Eldoret, Kenya., Edith Kwobah, Nastassja Koen, Ann Mwangi, Lukoye Atwoli, Dan Stein

Brain and Mind Institute

No abstract provided.


Impact Of Point-Of-Care Ultrasound Use On Patient Referral Decisions In Rural Kenya: A Mixed Methods Study., Grace Wanjiku, Gregory Bell, Sonja Kapadia, Benjamin Wachira Feb 2024

Impact Of Point-Of-Care Ultrasound Use On Patient Referral Decisions In Rural Kenya: A Mixed Methods Study., Grace Wanjiku, Gregory Bell, Sonja Kapadia, Benjamin Wachira

Emergency Medicine, East Africa

Background: Point-of-care ultrasound (POCUS) is recognized as a key imaging modality to bridge the diagnostic imaging gap in Low- and Middle-Income Countries (LMICs). POCUS use has been shown to impact patient management decisions including referral for specialist care. This study explored the impact of POCUS use on referral decisions among trained healthcare providers working in primary rural and peri-urban health facilities in Kenya.

Methods: A concurrent mixed methods approach was used, including a locally developed survey (N=38) and semistructured interviews of POCUS trained healthcare providers (N=12). Data from the survey was descriptively analyzed and interviews were evaluated through the framework …


Utility Of The 3di Short Version In The Identification And Diagnosis Of Autism In Children At The Kenyan Coast., Patricia Kipkemoi, Symon Kariuki, Joseph Gona, Felicita Wangeci Mwangi, Martha Kombe, Collins Kipkoech, Paul Mwangi, William Mandy, Amina Abubakar, Charles Newton Feb 2024

Utility Of The 3di Short Version In The Identification And Diagnosis Of Autism In Children At The Kenyan Coast., Patricia Kipkemoi, Symon Kariuki, Joseph Gona, Felicita Wangeci Mwangi, Martha Kombe, Collins Kipkoech, Paul Mwangi, William Mandy, Amina Abubakar, Charles Newton

Institute for Human Development

Introduction: The precise epidemiological burden of autism is unknown because of the limited capacity to identify and diagnose the disorder in resource-constrained settings, related in part to a lack of appropriate standardised assessment tools and health care experts. We assessed the reliability, validity, and diagnostic accuracy of the Developmental Diagnostic Dimensional Interview (3Di) in a rural setting on the Kenyan coast.

Methods: Using a large community survey of neurodevelopmental disorders (NDDs), we administered the 3Di to 2,110 children aged between 6 years and 9 years who screened positive or negative for any NDD and selected 242 who had specific symptoms …


Prevalence And Factors Associated With Frailty Among Older Adults Living With Hiv Compared To Their Uninfected Peers From The Kenyan Coast, Patrick Nzivo Mwangala, Carophine Nasambu, Ryan G. Wagner, Charles R. Newton, Amina Abubakar Feb 2024

Prevalence And Factors Associated With Frailty Among Older Adults Living With Hiv Compared To Their Uninfected Peers From The Kenyan Coast, Patrick Nzivo Mwangala, Carophine Nasambu, Ryan G. Wagner, Charles R. Newton, Amina Abubakar

Institute for Human Development

Objectives: a) To document the prevalence and correlates of frailty among older adults living with HIV (OALWH) and their uninfected peers, and b) Investigate HIV status as an independent predictor of frailty.

Methods: This cross-sectional study was conducted between 2020 and 2021 at the Kenyan coast among 440 older adults aged ≥50 years (257 OALWH). Frailty was assessed using the Reported Edmonton Frail Scale. Logistic regression was used to examine the correlates of frailty.

Results: The prevalence of frailty was significantly higher among OALWH (24%) than their uninfected peers (13%). HIV seropositivity was not independently associated with frailty. Sleeping difficulties, …


Women In Health And Their Economic, Equity And Livelihood Statuses During Emergency Preparedness And Response (Wheeler) Protocol: A Mixed Methods Study In Kenya., Evaline Chepchirchir Langat, Bilali Yusuf Mazoya, Pauline Oginga, Ferdinand Okwaro, Norah Matheka, Irene Kibara, Rhoda Otieno, Michaela Mantel, Robert Lorway, Marleen Temmerman Feb 2024

Women In Health And Their Economic, Equity And Livelihood Statuses During Emergency Preparedness And Response (Wheeler) Protocol: A Mixed Methods Study In Kenya., Evaline Chepchirchir Langat, Bilali Yusuf Mazoya, Pauline Oginga, Ferdinand Okwaro, Norah Matheka, Irene Kibara, Rhoda Otieno, Michaela Mantel, Robert Lorway, Marleen Temmerman

Centre of Excellence in Women and Child Health

Introduction: Kenya reported its first COVID-19 case on 13 March 2020. Pandemic-driven health system changes followed and unforeseen societal, economic and health effects reported. This protocol aims to describe the methods used to identify the gender equality and health equity gaps and possible disproportional health and socioeconomic impacts experienced by paid and unpaid (community health volunteer) female healthcare providers in Kilifi and Mombasa Counties, Kenya during the COVID-19 pandemic.

Methods and analysis: Participatory mixed methods framed by gender analysis and human-centred design will be used. Research implementation will follow four of the five phases of the human-centred design approach. Community …


Challenges And Opportunities For Improving Access To Adolescent And Youth Sexual And Reproductive Health Services And Information In The Coastal Counties Of Kenya: A Qualitative Study., Evaline Chepchirchir Langat, Abdu Mohiddin, Flaura Kidere, Anisa Omar, Job Akuno, Violet Naanyu, Marleen Temmerman Feb 2024

Challenges And Opportunities For Improving Access To Adolescent And Youth Sexual And Reproductive Health Services And Information In The Coastal Counties Of Kenya: A Qualitative Study., Evaline Chepchirchir Langat, Abdu Mohiddin, Flaura Kidere, Anisa Omar, Job Akuno, Violet Naanyu, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: Globally, adolescents and youth experience high unmet need for sexual and reproductive health (SRH) information and services. In Kenya, evidence shows that more than half of teenage pregnancies are unintended and that half of all new HIV infections occur in people ages 15-24-year-olds, with the majority of those being female. The coastal counties in Kenya record a relatively high adolescent pregnancy rate and higher rates of unmet need for contraception for all women of reproductive age compared to the national average. This study focused on gaining a deeper understanding of the existing challenges to and opportunities for accessing SRH …


Making Cities Mental Health Friendly For Adolescents And Young Adults, Pamela Y. Collins, Moitreyee Sinha, Tessa Concepcion, George Patton, Thaisa Way, Layla Mccay, Augustina Mensa-Kwao, Helen Herrman, Evelyne De Leeuw, Lukoye Atwoli Feb 2024

Making Cities Mental Health Friendly For Adolescents And Young Adults, Pamela Y. Collins, Moitreyee Sinha, Tessa Concepcion, George Patton, Thaisa Way, Layla Mccay, Augustina Mensa-Kwao, Helen Herrman, Evelyne De Leeuw, Lukoye Atwoli

Brain and Mind Institute

Urban life shapes the mental health of city dwellers, and although cities provide access to health, education and economic gain, urban environments are often detrimental to mental health1,2. Increasing urbanization over the next three decades will be accompanied by a growing population of children and adolescents living in cities3. Shaping the aspects of urban life that influence youth mental health could have an enormous impact on adolescent well-being and adult trajectories4. We invited a multidisciplinary, global group of researchers, practitioners, advocates and young people to complete sequential surveys to identify and prioritize the characteristics of a mental health-friendly city for …


Child Deaths Caused By Klebsiella Pneumoniae In Sub-Saharan Africa And South Asia: A Secondary Analysis Of Child Health And Mortality Prevention Surveillance (Champs) Data., Jennifer Verani, Dianna Blau, Emily Gurley, Victor Akelo, Nega Assefa, Vicky Baillie, Quique Bassat, Mussie Berhane, James Bunn, R Gunturu Feb 2024

Child Deaths Caused By Klebsiella Pneumoniae In Sub-Saharan Africa And South Asia: A Secondary Analysis Of Child Health And Mortality Prevention Surveillance (Champs) Data., Jennifer Verani, Dianna Blau, Emily Gurley, Victor Akelo, Nega Assefa, Vicky Baillie, Quique Bassat, Mussie Berhane, James Bunn, R Gunturu

Pathology, East Africa

Background; Klebsiella pneumoniae is an important cause of nosocomial and community-acquired pneumonia and sepsis in children, and antibiotic-resistant K pneumoniae is a growing public health threat. We aimed to characterize child mortality associated with this pathogen in seven high-mortality settings.

Methods; We analysed Child Health and Mortality Prevention Surveillance (CHAMPS) data on the causes of deaths in children younger than 5 years and stillbirths in sites located in seven countries across sub-Saharan Africa (Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa) and south Asia (Bangladesh) from Dec 9, 2016, to Dec 31, 2021. CHAMPS sites conduct active surveillance for …