Medicine and Health Sciences Commons^™

Large Scale Genetic Research On Neuropsychiatric Disorders In African Populations Is Needed, Shareefa Dalvie, Nastassja Koen, Laramie Duncan, Catherine Abbo, Dickens Akena, Lukoye Atwoli, Bonginkosi Chiliza, Kirsten A. Donald, Eugene Kinyanda, Christine Lochner

Internal Medicine, East Africa

In recent years there have been significant insights into the complex aetiologies of neurodevelopmental brain disorders. For example, neuropsychiatric genetics has achieved success with the identification of 108 loci for schizophrenia (Schizophrenia Working Group of the Psychiatric Genomics Consortium, 2014). Furthermore, meta-analyses of genomewide association study (GWAS) results encompassing thousands of samples have been completed for other psychiatric disorders including attention-deficit/hyperactivity disorder (ADHD), autism

Does Upgrade To Tri-Ventricular Pacemaker Improve Long-Term Clinical Response In Non-Responders To Biventricular Cardiac Resynchronization Therapy?, Sharon Hw Man, Jeilan Mohamed, Shoaib Siddiqui, G. André Ng

Internal Medicine, East Africa

Up to one third of patients with biventricular (BiV) cardiac resynchronization therapy (CRT) are non-responders.1 § Greater clinical response to CRT has been shown in patients given TriV CRT compared to BiV CRT as de novo device therapy. 2 This abstract investigates if upgrade to TriV CRT in non-responders to BiV CRT will improve long-term clinical outcome

Atrial Fibrillation In Sub-Saharan Africa: Epidemiology, Unmet Needs, And Treatment Options, Bruce Sheldon Stambler, Mzee Ngunga

Internal Medicine, East Africa

Health care in Sub-Saharan Africa is being challenged by a double burden of disease as lifestyle diseases common in the developed world, such as stroke and atrial fibrillation (AF), increase, while, simultaneously, health issues of the developing world in terms of communicable disease persist. The prevalence of AF is lower in Africa than in the developed world but is expected to increase significantly over the next few decades. Patients with AF in Africa tend to be younger and have a higher prevalence of rheumatic valvular heart disease than patients with AF in other regions. Permanent AF is the most prevalent …

Characterization Of In-Hospital Cardiac Arrest In Adult Patients At A Tertiary Hospital In Kenya, Benjamin Wachira

Internal Medicine, East Africa

Background:In-hospital cardiac arrest (IHCA) is defined as a cardiac arrest that occurs in a hospital and for which resuscitation is attempted. Despite the increased morbidity and mortality, IHCA incidence and outcomes remain largely unknown especially in sub-Saharan Africa. This study describes the baseline characteristics, prearrest physiological parameters and the rate of survival to hospital discharge of adult patients with an IHCA at a tertiary hospital in Kenya.

Methods:This was a retrospective chart review. Data on patient characteristics, pre-arrest physiological parameters and discharge condition were collected on all patients 18 years of age or older with an IHCA at …

Symptoms Of Depression Among Patients Attending A Diabetes Care Clinic In Rural Western Kenya, Kristen Shirey, Simon M. Manyara, Lukoye Atwoli, Ryan Tomlin, Benson Gakinya, Stephanie Cheng, Jemima Kamano, Jeremiah Laktabai, Sonak Pastakia

Internal Medicine, East Africa

Objective: The prevalence of diabetes in sub-Saharan Africa is rising, but its relationship to depression is not well-characterized. This report describes depressive symptom prevalence and associations with adherence and outcomes among patients with diabetes in a rural, resource-constrained setting.

Methods: In the Webuye, Kenya diabetes clinic, we conducted a chart review, analyzing data including medication adherence, hemoglobin A1c (HbA1c), clinic attendance, and PHQ-2 depression screening results.

Results: Among 253 patients, 20.9% screened positive for depression. Prevalence in females was higher than in males; 27% vs 15% (p = 0.023). Glycemic control trends were better in those screening negative; at 24 …

Association Between Traumatic Events And Post-Traumatic Stress Disorder: Results From The Esemed-Spain Study, B Olaya, J Alonso, Lukoye Atwoli, R C. Kessler, G Vilagut, J M. Haro

Internal Medicine, East Africa

Background: The relative importance of traumatic events (TEs) in accounting for the social burden of post-traumatic stress disorder (PTSD) could vary according to cross-cultural factors. In that sense, no such studies have yet been conducted in the Spanish general population. The present study aims to determine the epidemiology of trauma and PTSD in a Spanish community sample using the randomly selected TEs method.

Methods: The European Study of the Epidemiology of Mental Disorders (ESEMeD)-Spain is a cross-sectional household survey of a representative sample of adult population. Lifetime prevalence of self-reported TEs and lifetime and 12-month prevalence of PTSD were evaluated …

Uchunguzi (Journal Watchmontre De Journal) March 2015, Benjamin Wachira

Internal Medicine, East Africa

Uchunguzi means investigation in Swahili and provides a summary of some of the most recent international literature as presented in other leading journals, but with an emphasis on what is relevant to our continent.

Initial Impressions And Review Of Literature Concerning Factors Affecting The Use Of Palliative Care Assessment Tools In An African Setting, John Weru

Internal Medicine, East Africa

Introduction: Quality palliative care encompasses early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. Despite the importance of symptom assessment in palliative care, use of assessment tools in practice is limited. The aim of this study was to assess factors that influence use of symptom assessment tools.

Methodology: 1:1 interviews were conducted using a guideline developed by the researcher. Ten participants who met the inclusion criteria were interviewed. The data was recorded and then transcribed with topics and issues being isolated and grouped together into themes.

Findings: The themes were perception of palliative …

Uchunguzi (Journal Watch/Montre De Journal) September 2015, Benjamin Wachira

Internal Medicine, East Africa

Uchunguzi means investigation in Swahili and provides a summary of some of the most recent international literature as presented in other leading journals, but with an emphasis on what is relevant to our continent.

Uchunguzi (Journal Watch/Montre De Journal) June 2015, Benjamin Wachira

Internal Medicine, East Africa

Uchunguzi means investigation in Swahili and provides a summary of some of the most recent international literature as presented in other leading journals, but with an emphasis on what is relevant to our continent.

Gender Differences In Clinical Characteristics And Outcome Of Acute Heart Failure In Sub-Saharan Africa: Results Of The Thesus-Hf Study, Okechukwu S. Ogah, Beth A. Davison, Karen Sliwa, Bongani M. Mayosi, Albertino Damasceno, Mahmoud U. Sani, Charles Mondo, Anastase Dzudie, Dike B. Ojji, Charles Kouam, Ahmed Suliman, Neshaad Schrueder, Gerald Yonga, Sergine Abdou Ba, Fikru Maru, Bekele Alemayehu, Christopher Edwards, Gad Cotter

Internal Medicine, East Africa

Background: The impact of gender on the clinical characteristics, risk factors, co-morbidities, etiology, treatment and outcome of acute heart failure in sub-Saharan Africa has not been described before. The aim of this study was to evaluate the sex diffe rences in acute heart failure in sub-Saharan Africa using the data from The sub-Saharan Africa Survey of Heart Failure (THESUS-HF).

Methods and results: 1,006 subjects were recruited into this prospective multicenter, international observational heart failure survey. The mean age of total population was 52.4 years (54.0 years for men and 50.7 years for women). The men were significantly older (p …

Building Comprehensive And Sustainable Health Informatics Institutions In Developing Countries: Moi University Experience, Martin C. Were, Abraham Siika, Paul O. Ayuo, Lukoye Atwoli, Fabian Esamai

Internal Medicine, East Africa

Current approaches for capacity building in Health Informatics (HI) in developing countries mostly focus on training, and often rely on support from foreign entities. In this paper, we describe a comprehensive and multidimensional capacity-building framework by Lansang & Dennis, and its application for HI capacity building as implemented in a higher-education institution in Kenya. This framework incorporates training, learning-by-doing, partnerships, and centers of excellence. At Moi University (Kenya), the training dimensions include an accredited Masters in HI Program, PhD in HI, and HI short courses. Learning-by-doing occurs through work within MOH facilities at the AMPATH care and treatment program serving …