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Assessment Of Ferritin And Lead Levels In Children Living In An Informal Urban Settlement In Kenya, Geoffrey Omuse, Daniel Maina, Maureene Ondayo, Stanley Onyango, Syama Sinuff, Alex Mugo, Pauline Samia, William Macharia Aug 2024

Assessment Of Ferritin And Lead Levels In Children Living In An Informal Urban Settlement In Kenya, Geoffrey Omuse, Daniel Maina, Maureene Ondayo, Stanley Onyango, Syama Sinuff, Alex Mugo, Pauline Samia, William Macharia

Pathology, East Africa

Background: Childhood lead exposure from recycling used lead-acid batteries (ULAB) in unregulated areas is a significant cause of lead toxicity, particularly in low and middle-income countries. This study aimed to assess the proportion of children with increased blood lead levels (BLLs) in an informal settlement where ULAB recycling occurs.

Methodology: This was a descriptive study conducted in Nairobi county, Kenya. Children aged 6 months to 7 years were recruited after obtaining written informed consent, completion of a questionnaire and collection of samples for complete blood count, ferritin, and lead analysis.

Results: Out of 215 children, 17 (8.0%) had BLLs ≥ …


Cancer Care Terminology In African Languages, Hannah Simba, Miriam Mutebi, Moses Galukande, Yahya Mahamat-Saleh, Elom Aglago, Adamu Addissie, Lidya Genene Abebe, Justina Onwuka Aug 2024

Cancer Care Terminology In African Languages, Hannah Simba, Miriam Mutebi, Moses Galukande, Yahya Mahamat-Saleh, Elom Aglago, Adamu Addissie, Lidya Genene Abebe, Justina Onwuka

General Surgery, East Africa

Importance: Effective communication between patients and health care teams is essential in the health care setting for delivering optimal cancer care and increasing cancer awareness. While the significance of communication in health care is widely acknowledged, the topic is largely understudied within African settings.

Objective: To assess how the medical language of cancer and oncology translates into African languages and what these translations mean within their cultural context.

Design, etting, and participants: In this multinational survey study in Africa, health professionals, community health workers, researchers, and scientists involved in cancer care and research and traditional healers were invited to participate …


Outcomes Of Different Steroid Dosing Regimens In Critical Covid-19 Pneumonia At A Kenyan Hospital: A Retrospective Cohort Study, John Odhiambo, Jasmit Shah, Nancy Kunyiha, Felix Riunga, Charles Makasa Aug 2024

Outcomes Of Different Steroid Dosing Regimens In Critical Covid-19 Pneumonia At A Kenyan Hospital: A Retrospective Cohort Study, John Odhiambo, Jasmit Shah, Nancy Kunyiha, Felix Riunga, Charles Makasa

Internal Medicine, East Africa

Background: Among therapeutic options for severe and critical COVID- 19 infection, dexamethasone six milligrams once daily for ten days has demonstrated mortality benefit and is guideline recommended at this dose. In practice, variable doses of steroids have been used, especially in critical care settings. Our study aimed to determine the pattern of steroid dosing and outcomes in terms of critical care mortality, occurrence of dysglycaemias, and occurrence of superadded infections in patients with critical COVID-19.

Methods: A retrospective cohort study was carried out on all eligible patients admitted to the Aga Khan University Hospital, Nairobi, with critical COVID-19 between 1st …


Inspire : Vol 7 Issue 7, Department Of Medicine Jul 2024

Inspire : Vol 7 Issue 7, Department Of Medicine

INSPIRE – Department of Medicine Archives

  • Message from the Chair
  • Medicine at National and International Forums
  • Question Development Retreat
  • Cardiology team achieves Platinum Performance Award!
  • Facebook live session
  • Dr Javaid A Khan takes Charge!
  • Featured Faculty: Dr. M Uzair Rauf
  • What Academics Are Reading This Month?
  • Upcoming event


Heparin-Binding Protein Stratifies Mortality Risk Among Ugandan Children Hospitalized With Respiratory Distress, Hridesh Mishra, Núria Balanza, Caroline Francis, Kathleen Zhong, Julie Wright, Andrea Conroy, Robert Opoka, Quique Bassat, Sophie Namasopo, Kevin Kain Jul 2024

Heparin-Binding Protein Stratifies Mortality Risk Among Ugandan Children Hospitalized With Respiratory Distress, Hridesh Mishra, Núria Balanza, Caroline Francis, Kathleen Zhong, Julie Wright, Andrea Conroy, Robert Opoka, Quique Bassat, Sophie Namasopo, Kevin Kain

Paediatrics and Child Health, East Africa

Background Current prognostic tools do not reliably and objectively identify children with pneumonia at risk of a severe or life-threatening episode. Heparin-binding protein (HBP) is a host immune protein that is released in response to infection. We hypothesized that measuring HBP concentrations at hospital admission could help risk-stratify children with pneumonia and identify those at higher risk of an adverse prognosis.

Methods We evaluated the prognostic accuracy of HBP for predicting in-hospital mortality among children with respiratory distress, and whether HBP could improve the accuracy of validated composite clinical severity scores.

Results Of 778 Ugandan children under 5 years of …


Role Of Hospital Leadership In Pandemic Preparedness: Experience At A Tertiary Hospital In Kenya During The Covid-19 Pandemic, Lucy Wangari, William Macharia, Benjamin Wachira, Jemimah Kimeu, Boniface Mativa, Lukoye Atwoli Jul 2024

Role Of Hospital Leadership In Pandemic Preparedness: Experience At A Tertiary Hospital In Kenya During The Covid-19 Pandemic, Lucy Wangari, William Macharia, Benjamin Wachira, Jemimah Kimeu, Boniface Mativa, Lukoye Atwoli

Emergency Medicine, East Africa

Introduction Pandemic preparedness refers to being ready for, responding to and recovering from public health crises, and is integral for health security. Hospital leadership is a critical building block of an effective healthcare system, providing policy, accountability and stewardship in a health crisis.

Objectives and methods We aimed to describe the leadership and governance structures put in place at the Aga Khan University Hospital, Nairobi, a private not-for-profit tertiary healthcare facility, following the COVID-19 pandemic. We reviewed over 200 hospital documents archived in the COVID-19 repository including those received from the Kenya Ministry of Health, emails, memos, bulletins, meeting minutes, …


Interdisciplinary Perspectives On Multimorbidity In Africa: Developing An Expanded Conceptual Model, Justin Dixon, Ben Morton, Misheck Nkhata, Alan Silman, Ibrahim Simiyu, Stephen Spencer, Myrna Van Pinxteren, Edna Bosire, Christopher Bunn, Claire Calderwood Jul 2024

Interdisciplinary Perspectives On Multimorbidity In Africa: Developing An Expanded Conceptual Model, Justin Dixon, Ben Morton, Misheck Nkhata, Alan Silman, Ibrahim Simiyu, Stephen Spencer, Myrna Van Pinxteren, Edna Bosire, Christopher Bunn, Claire Calderwood

Brain and Mind Institute

Multimorbidity is an emerging challenge for health systems globally. It is commonly defined as the co-occurrence of two or more chronic conditions in one person, but its meaning remains a lively area of academic debate, and the utility of the concept beyond high-income settings is uncertain. This article presents the findings from an interdisciplinary research initiative that drew together 60 academic and applied partners working in 10 African countries to answer the questions: how useful is the concept of multimorbidity within Africa? Can the concept be adapted to context to optimise its transformative potentials? During a three-day concept-building workshop, we …


Predictors Of Hiv Knowledge, Perceived Stigma And Risk Among Transport Workers In Mbarara City, Southwestern Uganda, Benjamin Betunga, Lilian Nuwabaine, Eve Katushabe, Grace Among, Grace Nakate, Ahmed Sarki, Diana Mbattude, Mary Namuguzi, John Baptist Asiimwe Jun 2024

Predictors Of Hiv Knowledge, Perceived Stigma And Risk Among Transport Workers In Mbarara City, Southwestern Uganda, Benjamin Betunga, Lilian Nuwabaine, Eve Katushabe, Grace Among, Grace Nakate, Ahmed Sarki, Diana Mbattude, Mary Namuguzi, John Baptist Asiimwe

School of Nursing & Midwifery, East Africa

Background: The human immunodeficiency virus (HIV) prevalence among transport workers in sub-Saharan Africa remains high, estimated at as high as 9.9% in western Uganda compared with the national prevalence of 5.4%. The prevalence of HIV among transport workers has been partly attributed to the level of knowledge regarding HIV prevention, perceived HIV risk, and stigma. Accordingly, these have been linked to high-risk HIV transmission behaviours that increase the chances of acquiring HIV among adults. Therefore, this study investigated the predictors of HIV knowledge, perceived HIV risk, and stigma among transport workers in Mbarara city in southwestern Uganda.

Methods: The …


Inspire : Vol 7 Issue 6, Department Of Medicine Jun 2024

Inspire : Vol 7 Issue 6, Department Of Medicine

INSPIRE – Department of Medicine Archives

  • Message from the Chair
  • Medicine at National and International Forums Digestive disease week (DDW) 2024
  • ACGME-I Self-Empowerment Workshop for Program Coordinators
  • The 2nd International Collaborative Mycology Conference
  • World hypertension day
  • Research Module
  • SIMPACT 2024
  • Combatting Corticosteroid Misuse: Safeguarding Skin Health in Pakistan
  • 2024 Inter Departmental Cricket Tournament
  • Featured Fellow: Dr. Shahid Khan
  • Poem Section
  • What Academics Are Reading


Associations Between Disordered Eating Behaviour And Sexual Behaviour Amongst Emerging Adults Attending A Tertiary Education Institution In Coastal Kenya, Stevenson Chea, Adama Kazienga, Eunice Oyugi, Isaac Menza, Carophine Nasambu, Fauz Ibrahim, Osman Abdullahi, Amin Hassan, Amina Abubakar, Kristien Michielsen Jun 2024

Associations Between Disordered Eating Behaviour And Sexual Behaviour Amongst Emerging Adults Attending A Tertiary Education Institution In Coastal Kenya, Stevenson Chea, Adama Kazienga, Eunice Oyugi, Isaac Menza, Carophine Nasambu, Fauz Ibrahim, Osman Abdullahi, Amin Hassan, Amina Abubakar, Kristien Michielsen

Institute for Human Development, East Africa

Background Sexual behavior (SB) is a well-documented pathway to HIV acquisition in emerging adults and remains common amongst African emerging adults. Previous research in high-income countries indicates a correlation between disordered eating behavior (DEB) and engaging in sexual behaviors. We aimed to describe the relationship between DEB and SB amongst emerging adults attending a tertiary educational institution at the Kenyan Coast.

Methods We applied a cross-sectional design nested in a young adults’ cohort study. Eligibility included sexually active emerging adults aged 18–24 years. Three DEBs (emotional, restrained and external eating) were assessed using the Dutch Eating Behavior Questionnaire and analysed …


Rare Presentation Of Central Nervous System Tuberculosis With Bilateral Anterior Cerebral Artery Aneurysm: A Case Report, Maryam Khalil, Mansoor Iqbal, Samer Naik, Ayma Khan Khan, Zakir Jan, Mazhar Badshah Jun 2024

Rare Presentation Of Central Nervous System Tuberculosis With Bilateral Anterior Cerebral Artery Aneurysm: A Case Report, Maryam Khalil, Mansoor Iqbal, Samer Naik, Ayma Khan Khan, Zakir Jan, Mazhar Badshah

Pakistan Journal of Neurological Sciences (PJNS)

Central Nervous System tuberculosis (CNS TB) with intracranial aneurysms is rare and needs prompt diagnosis and early management. The presence of un-ruptured or ruptured aneurysms in the presence of CNS infection is difficult to treat in both acute settings and long-term management because of possible complications prevention. A female of 70 years of age presented with a history of fever, headache, vomiting, and altered sensorium for one week with GCS of 13/15, later developing paraparesis. She was diagnosed to have CNS tuberculosis with complicating bilateral anterior communicating artery (ACA) aneurysms. She was managed conservatively in our hospital and was referred …


Neurocognitive Outcome Following Tuberculous Meningitis Treatment: A Systematic Review, Muhammad Ilham Dhiya Rakasiwi, Erlina Burhan, Afid Brilliana Putra, Ihya Fakhrurizal Amin, Nadhif Wiratara Jun 2024

Neurocognitive Outcome Following Tuberculous Meningitis Treatment: A Systematic Review, Muhammad Ilham Dhiya Rakasiwi, Erlina Burhan, Afid Brilliana Putra, Ihya Fakhrurizal Amin, Nadhif Wiratara

Pakistan Journal of Neurological Sciences (PJNS)

Background and objective: Tuberculous meningitis (TBM) is an infectious disease of the central nervous system that remains to be a global health challenge. Patients who survive after experiencing TBM have a risk of developing functional, cognitive and psychological disorders that can affect daily activities. The objective of this study is to present a comprehensive review of data on cognitive outcome after TBM infection.

Method: We conducted a systematic literature search to identify studies addressing cognitive outcomes in adult TBM patients. Following a systematic literature search (PubMed, Scopus, EBSCO), studies were reviewed by independent reviewers to assess eligibility for inclusion. Three …


Accuracy Of Phq-9 Against Psychiatric Diagnosis For Depression Among People Living With Hiv: A Multicounty Cross-Sectional Study, Marcel Yotebieng, Natalia Zotova, Charlotte Bernard, Suzanne Goodrich, Rogers Awoh, Dana Watnick, Dominique Nsonde, Elodie Moungang, Julie Noumedem, Lukoye Atwoli Jun 2024

Accuracy Of Phq-9 Against Psychiatric Diagnosis For Depression Among People Living With Hiv: A Multicounty Cross-Sectional Study, Marcel Yotebieng, Natalia Zotova, Charlotte Bernard, Suzanne Goodrich, Rogers Awoh, Dana Watnick, Dominique Nsonde, Elodie Moungang, Julie Noumedem, Lukoye Atwoli

Internal Medicine, East Africa

Objective: The aim of this study was to assess the performance of the 9-item Patient Health questionnaire (PHQ-9) against psychiatrist diagnosis in PLWH.

Design: Cross-sectional analysis of data collected between January 2018 and July 2022 across five sites in Cameroon, Cote d’Ivoire, Kenya, Senegal, and the Republic of Congo. Participants were ≥18 years and receiving HIV care at the participating site. PHQ-9 was administered by study staff followed by a psychiatrist’s evaluation within 3 days.

Results: Overall, 778 participants with complete data were included: 297 (38.2%) in Cameroon, 132 (17.0%) in Congo, 148 (19.0%) in Cote d’Ivoire, …


Scaling Antimicrobial Resistance Surveillance Nationally: The Case Of The Fleming Fund In Kenya, Mitchelle Kasudi, Dishon Muloi, Murungi Maurice, Allan Azegele, Romona Ndanyi, Revathi Gunturu, Loice Ombajo, Emmanuel Tanui, Robert Onsare, Geoffrey Omuse Jun 2024

Scaling Antimicrobial Resistance Surveillance Nationally: The Case Of The Fleming Fund In Kenya, Mitchelle Kasudi, Dishon Muloi, Murungi Maurice, Allan Azegele, Romona Ndanyi, Revathi Gunturu, Loice Ombajo, Emmanuel Tanui, Robert Onsare, Geoffrey Omuse

Pathology, East Africa

Rising levels of antimicrobial resistance (AMR) in both humans and animals have reached alarming levels and are being recognized as a serious incremental threat to global food security, animal health and public health. The One Health approach recognizes the interconnectedness of human, animal and environmental health, and that AMR can be spread between different species and environments. The Fleming Fund, a UK Overseas Development Aid program managed by the UK’s Department of Health and Social Care, aims to improve AMR and antimicrobial use (AMU) surveillance data in Africa and Asia by generating, sharing, and using data to improve antimicrobial use …


Development Of An Online Teaching Platform To Improve Access To Postgraduate Pathology Training In Sub-Saharan Africa, Richard Byers, Anita Byers, Chibamba Mumba, Angela Mutuku, Jennifer Singer-Rupp, Michael Wilson, Kenneth Fleming, Shahin Sayed May 2024

Development Of An Online Teaching Platform To Improve Access To Postgraduate Pathology Training In Sub-Saharan Africa, Richard Byers, Anita Byers, Chibamba Mumba, Angela Mutuku, Jennifer Singer-Rupp, Michael Wilson, Kenneth Fleming, Shahin Sayed

Pathology, East Africa

Background: Resource barriers to the provision of accessible training in cancer diagnosis in lower- and middle-income countries (LMICs) limit the potential of African health systems. Long-term provision via teaching visits from senior pathologists and trainee foreign placements is unsustainable due to the prohibitive costs of travel and subsistence. Emerging eLearning methods would allow pathologists to be trained by experts in a cheaper, more efficient, and more scalable way.

Purpose: This study aimed to develop an online teaching platform, starting with hematopathology, for trainee pathologists in sub-Saharan Africa, initially in Nairobi, Kenya, and Lusaka, Zambia.

Methods: Course materials …


Long-Term Healthcare Utilisation, Costs And Quality Of Life After Invasive Group B Streptococcus Disease: A Cohort Study In Five Low-Income And Middle-Income Countries, Farah Seedat, Simon Procter, Ziyaad Dangor, Shannon Leahy, Sridhar Santhanam, Hima John, Quique Bassat, Celine Aerts, Amina Abubakar, Carophine Nasambu May 2024

Long-Term Healthcare Utilisation, Costs And Quality Of Life After Invasive Group B Streptococcus Disease: A Cohort Study In Five Low-Income And Middle-Income Countries, Farah Seedat, Simon Procter, Ziyaad Dangor, Shannon Leahy, Sridhar Santhanam, Hima John, Quique Bassat, Celine Aerts, Amina Abubakar, Carophine Nasambu

Institute for Human Development, East Africa

Introduction There are no published data on the long-term impact of invasive group B Streptococcus disease (iGBS) on economic costs or health-related quality of life (HRQoL) in low-income and middle-income countries. We assessed the impact of iGBS on healthcare utilisation, costs and HRQoL in Argentina, India, Kenya, Mozambique and South Africa.

Methods Inpatient and outpatient visits, out-of-pocket (OOP) healthcare payments in the 12 months before study enrolment, and health-state utility of children and caregivers (using the EuroQol 5-Dimensions-3-Level) were collected from iGBS survivors and an unexposed cohort matched on site, age at recruitment and sex. We used logistic or Poisson …


Male Infertility: A Retrospective Review Of Laboratory Charts At A Tertiary Teaching Hospital In Nairobi City County, Festus Mulakoli, Doris Machaki, Abednego Ongeso, Maureen Akolo, Ruth Wagathu May 2024

Male Infertility: A Retrospective Review Of Laboratory Charts At A Tertiary Teaching Hospital In Nairobi City County, Festus Mulakoli, Doris Machaki, Abednego Ongeso, Maureen Akolo, Ruth Wagathu

School of Nursing & Midwifery, East Africa

Background: Globally, approximately 50 million couples experience one form of infertility, and 10 million cases of subfertility have been reported in sub-Saharan Africa. Infertility is characterized by a lack of clinical conception among couples who live together for more than one year with regular coitus, without the use of contraception. Factors related to fertility vary by sex and geographical region. These factors include age, lifestyle, infectious diseases, and genetic disorders. In African culture, children are considered a simple inheritance and a measure of masculinity, so efforts are needed to address the growing problem of male infertility in this context. …


The 2022 Symposium On Dementia And Brain Aging In Low- And Middle-Income Countries: Highlights On Research, Diagnosis, Care, And Impact, Raj Kalaria, Gladys Maestre, Simin Mahinrad, Daisy Acosta, Rufus Akinyemi, Suvarna Alladi, Ricardo Allegri, Faheem Arshad, Wambui Karanja, Chinedu Momoh May 2024

The 2022 Symposium On Dementia And Brain Aging In Low- And Middle-Income Countries: Highlights On Research, Diagnosis, Care, And Impact, Raj Kalaria, Gladys Maestre, Simin Mahinrad, Daisy Acosta, Rufus Akinyemi, Suvarna Alladi, Ricardo Allegri, Faheem Arshad, Wambui Karanja, Chinedu Momoh

Brain and Mind Institute

Two of every three persons living with dementia reside in low- and middle-incomecountries (LMICs). The projected increase in global dementia rates is expected toaffect LMICs disproportionately. However, the majority of global dementia care costsoccur in high-income countries (HICs), with dementia research predominantly focus-ing on HICs. This imbalance necessitates LMIC-focused research to ensure thatcharacterization of dementia accurately reflects the involvement and specificities ofdiverse populations. Development of effective preventive, diagnostic, and therapeu-tic approaches for dementia in LMICs requires targeted, personalized, and harmonizedefforts. Our article represents timely discussions at the 2022 Symposium on Demen-tia and Brain Aging in LMICs that identified the foremost …


Psychiatric Morbidity Among Patients On Treatment For Tuberculosis At A Tertiary Referral Hospital In Western Kenya, Robina Momanyi, Edith Kwobah, Philip Owiti, Henry Nyamogoba, Lukoye Atwoli May 2024

Psychiatric Morbidity Among Patients On Treatment For Tuberculosis At A Tertiary Referral Hospital In Western Kenya, Robina Momanyi, Edith Kwobah, Philip Owiti, Henry Nyamogoba, Lukoye Atwoli

Internal Medicine, East Africa

Background Mental disorders account for nine percent of the overall global burden of disease and are among the top ten leading causes of disability. Mental illness and tuberculosis share risk factors including poverty, overcrowding, stigma, poor nutrition, substance use and retro-viral disease co-infection. Presence of mental illness in tuberculosis delays health-seeking, affects drug adherence, increases cost of treatment, prolongs disease duration, lowers quality of life, and increases mortality. Early diagnosis, linkage, and treatment of psychiatric morbidity among patients with tuberculosis would improve outcomes for both. This study thus aimed to determine the prevalence and factors associated with psychiatric morbidity among …


Sexual Satisfaction, An Indicator Of Sexual Health And Well-Being? Insights From Sti/Hiv Prevention Research In European Men Who Have Sex With Men, Karel Blondeel, Massimo Mirandola, Lorenzo Gios, Cinta Folch, Christiana Noestlinger, Maddalena Cordioli, Petra Sutter, Marleen Temmerman, Igor Toskin May 2024

Sexual Satisfaction, An Indicator Of Sexual Health And Well-Being? Insights From Sti/Hiv Prevention Research In European Men Who Have Sex With Men, Karel Blondeel, Massimo Mirandola, Lorenzo Gios, Cinta Folch, Christiana Noestlinger, Maddalena Cordioli, Petra Sutter, Marleen Temmerman, Igor Toskin

Centre of Excellence in Women and Child Health

Introduction Although sexual health has been holistically defined to include sexual satisfaction, it has been largely absent in health services and sexual and reproductive health and rights programmes in many parts of the world. We propose sexual satisfaction as a useful indicator, as one of the proxy measures for sexual health and well-being and as a component of well-being in general.

Methods The Sialon II project is a multicentre biological and behavioural cross-sectional community-based survey implemented across 13 European cities during 2013–2014 among men who have sex with men. Sexual satisfaction was explored using one single item: ‘How satisfied are …


Post-Vaccination Sars-Cov-2 Igg Spike Antibody Responses Among Clinical And Non-Clinical Healthcare Workers At A Tertiary Facility In Kenya, Lucy Wangari, Geoffrey Omuse, Rodney Adam, George Ongete, Cyrus Matheka, Patrick Mugaine, Shahin Sayed, Daniel Maina Apr 2024

Post-Vaccination Sars-Cov-2 Igg Spike Antibody Responses Among Clinical And Non-Clinical Healthcare Workers At A Tertiary Facility In Kenya, Lucy Wangari, Geoffrey Omuse, Rodney Adam, George Ongete, Cyrus Matheka, Patrick Mugaine, Shahin Sayed, Daniel Maina

Pathology, East Africa

Introduction: Following the coronavirus disease 19 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, vaccination became the main strategy against disease severity and even death. Healthcare workers were considered high-risk for infection and, thus, were prioritised for vaccination.

Methods: A follow-up to a SARS-CoV-2 seroprevalence study among clinical and non-clinical HCWs at the Aga Khan University Hospital, Nairobi, we assessed how vaccination influenced SARS-CoV-2 anti-spike IgG antibody responses and kinetics. Blood samples were drawn at two points spanning 6 to 18 months post-vaccination, and SARS-CoV-2 spike antibody levels were determined by enzyme-linked immunosorbent assay.

Results: Almost all participants, …


Adaptation Of The Client Diagnostic Questionnaire For East Africa, Edith Kamaru Kwobah, Suzanne Goodrich, Jayne Lewis Kulzer, Michael Kanyesigye, Sarah Obatsa, Julius Cheruiyot, Lorna Kiprono, Colma Kibet, Felix Ochieng, Lukoye Atwoli Mar 2024

Adaptation Of The Client Diagnostic Questionnaire For East Africa, Edith Kamaru Kwobah, Suzanne Goodrich, Jayne Lewis Kulzer, Michael Kanyesigye, Sarah Obatsa, Julius Cheruiyot, Lorna Kiprono, Colma Kibet, Felix Ochieng, Lukoye Atwoli

Internal Medicine, East Africa

Research increasingly involves cross-cultural work with non-English-speaking populations, necessitating translation and cultural validation of research tools. This paper describes the process of translating and criterion validation of the Client Diagnostic Questionnaire (CDQ) for use in a multisite study in Kenya and Uganda. The English CDQ was translated into Swahili, Dholuo (Kenya) and Runyankole/Rukiga (Uganda) by expert translators. The translated documents underwent face validation by a bilingual committee, who resolved unclear statements, agreed on final translations and reviewed back translations to English. A diagnostic interview by a mental health specialist was used for criterion validation, and Kappa statistics assessed the strength …


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, …


Assessing Pattern Of The Pediatric Multisystem Inflammatory Syndrome (Pmis) In Children During The Covid-19 Pandemic: Experience From The Emergency Department Of Tertiary Care Center Of A Low-Middle-Income Country, Saleem Akhtar, Iqra Anis, Kumar Nirdosh, Muhammad Ihsan Tayyab Ihsan, Ahmed Raheem Buksh, Surraiya Bano Feb 2024

Assessing Pattern Of The Pediatric Multisystem Inflammatory Syndrome (Pmis) In Children During The Covid-19 Pandemic: Experience From The Emergency Department Of Tertiary Care Center Of A Low-Middle-Income Country, Saleem Akhtar, Iqra Anis, Kumar Nirdosh, Muhammad Ihsan Tayyab Ihsan, Ahmed Raheem Buksh, Surraiya Bano

Department of Paediatrics and Child Health

Background: Pediatric Multisystem Inflammatory Syndrome (PMIS) is a hyperinflammatory condition affecting multiple organs in children, often resembling incomplete Kawasaki Disease during later phases of COVID-19 infection. Data on PMIS in low-middle-income countries, particularly in emergency department settings, is limited.
Objectives: This prospective observational study at Aga Khan University Hospital, Karachi, aimed to determine the frequency, clinical presentation patterns, and laboratory parameters of children with PMIS visiting the emergency department during the COVID-19 pandemic. Secondary objectives included assessing factors associated with in-hospital mortality.
Methods: From March 2020 to September 2021, patients meeting World Health Organization PMIS criteria were enrolled. COVID-19 testing …


Prevalence Of Dengue Virus Among Healthy Blood Donors In Mombasa County, Kenya, Festus Mulakoli, George Gachara, Eric Ndombi, Samoel Khamadi Feb 2024

Prevalence Of Dengue Virus Among Healthy Blood Donors In Mombasa County, Kenya, Festus Mulakoli, George Gachara, Eric Ndombi, Samoel Khamadi

School of Nursing & Midwifery, East Africa

Introduction: Dengue fever (DF) is a viral infection caused by a flavivirus called Dengue virus. The virus has four known serotypes (named DENV 1-4) that circulate between humans and Aedes mosquitoes throughout the tropical region of the world. The virus is transmitted primarily by the bite of an infected Aedes aegypti or, to a lesser extent, Aedes albopictus. Current evidence from published case studies shows that blood transfusions can transmit Dengue infection in hyperendemic regions in the tropics. It is important to note that 75% of people infected with DENV show no symptoms. Therefore, an infected individual could …


Metabolic Syndrome And Obesity Among Marginalised School-Going Adolescents In Karachi, Pakistan: A Cross-Sectional Study, Hina Sharif, Sana Sharif Sheikh, Tooba Seemi, Hira Naeem, Unab Khan, Shah Sumaya Jan Feb 2024

Metabolic Syndrome And Obesity Among Marginalised School-Going Adolescents In Karachi, Pakistan: A Cross-Sectional Study, Hina Sharif, Sana Sharif Sheikh, Tooba Seemi, Hira Naeem, Unab Khan, Shah Sumaya Jan

Department of Family Medicine

Background: Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors which increase the likelihood of developing type 2 diabetes and cardiovascular disease. This study aimed to determine the prevalence of MetS among adolescents living in slums aged 11-18 years in Karachi, Pakistan.
Methods: Data were collected from 689 adolescents attending five schools in two slum areas of Karachi, Korangi and Baldia, from February 2023 to March 2023. Measurements of weight, height, waist circumference, and blood pressure were obtained from the study participants. Blood samples were collected to assess fasting plasma glucose, High density lipoprotein HDL-cholesterol, and triglyceride levels as …


Diagnostic Accuracy Of Intraoperative Frozen Section For Margin Evaluation Of Oral Cavity Squamous Cell Carcinoma, Javaria P. Ali, Bakhtawar Allauddin Mallick, Khushbakht Rashid, Umair Arshad Malik, Atif Ali Hashmi, Shamail Zia, Muhammad Irfan, Amir Khan, Naveen Faridi Feb 2024

Diagnostic Accuracy Of Intraoperative Frozen Section For Margin Evaluation Of Oral Cavity Squamous Cell Carcinoma, Javaria P. Ali, Bakhtawar Allauddin Mallick, Khushbakht Rashid, Umair Arshad Malik, Atif Ali Hashmi, Shamail Zia, Muhammad Irfan, Amir Khan, Naveen Faridi

Section of Internal Medicine

Objectives: Intraoperative frozen-section evaluation is a valuable technique for detecting positive margins intraoperatively for oral squamous cell carcinoma. We conducted this study to determine the diagnostic accuracy of frozen section in detecting margin status and the effect of tumor grade and stage on diagnostic accuracy.
Results: A total of 251 biopsy-proven cases of oral squamous cell carcinoma were included in this study. The tissue specimen resected during surgery was sent to the laboratory for frozen section evaluation. The frozen section results were then compared with the permanent section results to determine the sensitivity, specificity, positive predictive value, negative predictive value, …


Building Research Capacity In Low- And Middle-Income Countries And Pandemic Preparedness: Lessons Learned And Future Directions, Peter H. Kilmarx, Karen A. Goralesk, Erum Khan, John F. Lindo, Nancy Gore Saravia Jan 2024

Building Research Capacity In Low- And Middle-Income Countries And Pandemic Preparedness: Lessons Learned And Future Directions, Peter H. Kilmarx, Karen A. Goralesk, Erum Khan, John F. Lindo, Nancy Gore Saravia

Department of Pathology and Laboratory Medicine

Research capacity is a critical component of pandemic preparedness, as highlighted by the challenges faced during the Ebola outbreak in West Africa. Recent global initiatives, such as the Research & Development Task Force of the Global Health Security Agenda and the World Health Assembly's resolution on strengthening clinical trials, emphasize the need for robust research capabilities. This Perspective discusses the experiences of leaders in infectious disease research and capacity building in low- and middle-income countries, focusing on Colombia, Jamaica, and Pakistan. These case studies underscore the importance of collaborative efforts, interdisciplinary training, and global partnerships in pandemic response. The experiences …


Factors Associated With Hiv Testing Among Pregnant Women In Rwanda: A Nationwide Cross-Sectional Survey, Lilian Nuwabaine, Joseph Kawuki, Angella Namulema, John Baptist Asiimwe, Quraish Sserwanja, Ghislaine Gatasi, Elorm Donkor Jan 2024

Factors Associated With Hiv Testing Among Pregnant Women In Rwanda: A Nationwide Cross-Sectional Survey, Lilian Nuwabaine, Joseph Kawuki, Angella Namulema, John Baptist Asiimwe, Quraish Sserwanja, Ghislaine Gatasi, Elorm Donkor

School of Nursing & Midwifery, East Africa

Human immunodeficiency virus (HIV) testing during pregnancy is crucial for the prevention of mother-to-child transmission of HIV, through aiding prompt treatment, care, and support. However, few studies have explored HIV testing among pregnant women in Rwanda. This study, therefore, aimed to determine the prevalence and associated factors of HIV testing among pregnant women in Rwanda. We used secondary data from the 2020 Rwanda Demographic and Health Survey (RDHS), comprising 870 pregnant women. Multistage stratified sampling was used by the RDHS team to select participants. We conducted bivariable and multivariable logistic regression to explore factors associated with HIV testing using SPSS …


Exploring The Role Of Information And Communication Technologies In Allergic Rhinitis In Specialist Centers: Patient Perspectives On Usefulness, Value, And Impact On Healthcare, Ivan Cherrez-Ojeda, Jean Bousquet, Zouina Sarfraz, Azza Sarfraz, Monica Rodriguez Gonzales, Anna Bedbrook, Nelson Rosario, Benjamin Zepeda-Ortega, Guillermo Guidos, Ulbio Alcivar Molina Jan 2024

Exploring The Role Of Information And Communication Technologies In Allergic Rhinitis In Specialist Centers: Patient Perspectives On Usefulness, Value, And Impact On Healthcare, Ivan Cherrez-Ojeda, Jean Bousquet, Zouina Sarfraz, Azza Sarfraz, Monica Rodriguez Gonzales, Anna Bedbrook, Nelson Rosario, Benjamin Zepeda-Ortega, Guillermo Guidos, Ulbio Alcivar Molina

Department of Paediatrics and Child Health

Introduction: Information and communication technologies (ICTs) improve patient-centered care and are routinely used in Allergic Rhinitis (AR), but patients' preferences and attitudes are unexplored. This study examines AR-related information preferences and ICT use by AR patients.
Methods: A survey-based cross-sectional study was carried out in Ecuador from July to September 2019 in seven centers of reference for allergic disease. Participants were 18 years or older, diagnosed with AR and had access to ICT and the Internet. Descriptive and binomial logistic regressions were performed. A value of less than 0.05 was considered statistically significant.
Results: 217 patients were included. 47% (n …