Medicine and Health Sciences Commons^™

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

Introduction: Lifestyle factors such as smoking, alcohol use, suboptimal diet, and inadequate physical activity have been associated with increased risk of cardiovascular diseases. There are limited data on these risk factors among patients with psychosis in low- and middle-income countries.

Objectives: This study aimed to establish the prevalence of lifestyle cardiovascular risk factors, and the 10-year cardiovascular risk scores and associated factors in patients with psychosis compared to controls at Moi Teaching and Referral Hospital in Eldoret, Kenya.

Methods: A sample of 297 patients with schizophrenia, schizoaffective disorder, or bipolar mood disorder; and 300 controls matched for age and sex …

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

Paediatrics and Child Health, 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-forprofit 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, …

Exploring The Experiences Of Clients Receiving Opioid Use Disorder Treatment At A Methadone Clinic In Kenya: A Qualitative Study, Sarah Kiburi, Jackline Mwangi, Geoffrey Maina

Internal Medicine, East Africa

Background: Assessing the experiences of individuals on methadone treatment is essential to help evaluate the treatment program’s efectiveness. This study aimed to explore the experiences of patients receiving methadone treatment at a clinic in Nairobi, Kenya.

Method: This study employed an exploratory qualitative study design. Through purposive sampling, participants were enrolled from individuals attending a methadone clinic for at least 2 years. Semi-structured individual interviews were used to collect data on substance use and experience before methadone treatment and experiences after starting methadone treatment, including benefts and challenges. Interviews were transcribed, and NVIVO 12 software was used to …

Covid-19 And Mental Well-Being Of Nurses In A Tertiary Facility In Kenya, Sayed Karar, Jasmit Shah, Zohray Talib

Internal Medicine, East Africa

Background: The 2019 coronavirus disease (COVID-19) epidemic is a global health emergency which has been shown to pose a great challenge to mental health, well-being and resilience of healthcare workers, especially nurses. Little is known on the impact of COVID-19 among nurses in sub-Saharan Africa.

Methods: A cross sectional study was carried out between August and November 2020 among nurses recruited from the Aga Khan University Hospital, Nairobi. The survey questionnaire consisted of six components- demographic and work title characteristics, information regarding care of COVID-19 patients, symptoms of depression, anxiety, insomnia, distress and burnout, measured using standardized questionnaires. Multivariable logistic …

A Prospective Observational Study Of Community Acquired Pneumonia In Kenya: The Role Of Viral Pathogens, Jamila Nambafu, Mary Achakolong, Fridah Mwendwa, Jumaa Bwika, Felix Riunga, Samuel Gitau, Hanika Patel, Rodney Adam

Internal Medicine, East Africa

Background: Lower respiratory tract infections continue to contribute significantly to morbidity and mortality across all age groups globally. In sub-Saharan Africa, many studies of community acquired pneumonia in adults have focused on HIV-infected patients and little attention has been given to risk factors and etiologic agents in an urban area with a more moderate HIV prevalence.

Methods: We prospectively enrolled 77 patients admitted to a 280 bed teaching hospital in Kenya with radiographically confirmed community acquired pneumonia from May 2019 to March 2020. The patients were followed for etiology and clinical outcomes. Viral PCR testing was performed using …

Metastatic Breast Cancer In Kenya: Presentation, Pathologic Characteristics, And Patterns-Findings From A Tertiary Cancer Center, Etoroabasi Ekpe, Asim Jamal, Jasmit Shah, Judith S. Jacobson, Shahin Sayed

Internal Medicine, East Africa

Purpose: The purpose of this research was to describe the sociodemographic and clinical characteristics of Kenyan women with metastatic breast cancer diagnosed and treated at Aga Khan University Hospital in Nairobi, Kenya from 2012 to 2018.

Patients and Methods: We reviewed charts of Kenyan women with metastatic breast cancer and analyzed sociodemographic data, breast cancer risk factors, and tumor characteristics associated with stage at diagnosis, receptor status (ie, estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 [HER2]), and site of metastasis using χ2, analysis of variance, two-sample t tests, and logistic regressions.

Results: A total of 125 …

The Effect Of A Preanaesthesia Clinic Consultation On Adult Patient Anxiety At A Tertiary Hospital In Kenya: A Cohort Study, Anthony Kamau, Vitalis Mung’Ayi, Gerald Yonga

Anaesthesiology, East Africa

Background: Preoperative anxiety is a common perioperative complication seen in approximately 11-80% of adults undergoing surgery. One of the goals of the preanaesthesia clinic is to allay anxiety. A preanaesthesia clinic evaluation has been shown to reduce anxiety however current studies on anxiety and the preanaesthesia clinic have not quantified this reduction.

Objective: To determine the reduction in anxiety in patients evaluated in the clinic versus those evaluated in the ward.

Methods: Fifty one adult patients with 28 patients in anaesthesia clinic (AC) group and 23 in the ward (W) group were sequentially recruited from both the surgical, gynaecology and …

Factors That Influence Advance Directives Completion Amongst Terminally Ill Patients At A Tertiary Hospital In Kenya, Stephen Omondi, John Weru, Asim Jamal, Gerald Yonga

Internal Medicine, East Africa

Background: An advance directive (AD) is a written or verbal document that legally stipulates a person’s health care preference while they are competent to make decisions for themselves and is used to guide decisions on lifesustaining treatment in the event that they become incapacitated. AD can take the form of a living will, a limitation of care document, a do-not-resuscitate order, or an appointment of a surrogate by durable power of attorney. The completion rate of AD varies from region to region, and it is influenced by multiple factors. The objectives of this study were to determine the proportion of …

Increasing Hiv-1 Pretreatment Drug Resistance Among Antiretroviral-Naïve Adults Initiating Treatment Between 2006 And 2014 In Nairobi, Kenya, Michael Chung, Silverman Rachel, Beck Ingrid, Yatich Nelly, Dross Sandra, Jennifer Mckernan-Mullin, Stephen Bii, Kenneth Tapia, Joshua Stern, Chohan Bhavna, Samah R. Sakr, James N. Kiarie

Internal Medicine, East Africa

Antiretroviral-naïve adults initiating antiretroviral therapy in Nairobi, Kenya were tested for HIV-1 drug resistance at codons K103N, Y181C, G190A, M184V, and K65R using an oligonucleotide ligation assay. Prevalence of pretreatment drug resistance increased from 3.89% in 2006 to 10.93% in 2014 (P < 0.001), and 95% of those with resistance had at least one nonnucleoside reverse transcriptase inhibitor mutation. Resistance to tenofovir (K65R) was found in 2014 but not in 2006.