Medicine and Health Sciences Commons^™

Prevalence And Outcome Of Asymptomatic Cryptococcal Antigenemia In Art Naive And Art Experienced Hiv Patients In Dar Es Salaam, Tanzania, Charles Mandela Makakala

Theses & Dissertations

Introduction: Cryptococcal meningitis (CM) is a highly fatal disease and contributes to about 20% of all-cause mortality in HIV/AIDS. Sub-Saharan Africa is facing substantial challenges in the treatment of the disease; the focus has been shifted towards prevention of the condition in ART-naive patients with CD4 counts of less than 100 cells/μL. Most studies and interventions have been conducted on ART-naive HIV patients despite there being cases and deaths due to cryptococcal meningitis among ART-experienced patients. Recent studies have shown that although there is an increase in ART coverage among HIV patients, this has not affected the incidence of cryptococcal …

Comparison Of The Sofa And Qsofa Scores In Predicting In-Hospital Mortality Among Adult Critical Care Patients With Suspected Infection., Mohammed Said

Theses & Dissertations

Background: Sepsis is global health priority and the commonest cause of death in critical care. SEPSIS 3 criteria introduced in 2016 is the latest tool in diagnosing sepsis, uses qSOFA and SOFA scores in place of the SIRS based definition for better prediction of mortality in patients with suspected infections. Their performance in predicting mortality in critical care units outside high- income countries remains largely unknown.

Objective: We compared the SOFA and qSOFA scores in predicting the hospital mortality of adult critical care patients admitted with suspected infection at the Aga Khan University Hospital Nairobi, Kenya.

Methods: We did a …

Disease Activity And Functional Status And Their Relation To Depression In Patients With Rheumatoid Arthritis, Joe Rosana Rakiro

Theses & Dissertations

Introduction: Rheumatoid Arthritis, one of the commonest forms of inflammatory arthritis, has significant societal impact with regards to cost, induction of disability and loss of productivity. This impact is magnified in the presence of comorbid mood disorders, as these constitute independent factors for unexplained flares and relapses.

Purpose: The primary purpose of this study was to determine the correlation between disease activity and depression in Rheumatoid Arthritis patients.

Methods: Patients with Rheumatoid Arthritis attending rheumatology clinic at Aga Khan University Hospital, Nairobi were recruited into the study. The patients’ disease activity and functional status were assessed using the Clinical Disease …

Eligibility And Patient Barriers To Peritoneal Dialysis In Patients With Advanced Chronic Kidney Disease, Saleem Mohamed Abdulkarim

Theses & Dissertations

Introduction: The burden of chronic kidney disease is on the rise in Kenya and is a significant cause of morbidity and mortality. While definitive treatment is renal transplantation, many patients require renal replacement therapy in the form of hemodialysis or peritoneal dialysis. The predominant modality utilized in Kenya is currently hemodialysis despite peritoneal dialysis having similar survival outcomes with the potential benefit of cost-effectiveness. There is need therefore to explore why peritoneal dialysis remains underutilized and whether patient factors may be contributory to barriers that limit the uptake of peritoneal dialysis.

Purpose: The main objective of this study is to …

Barriers To Definitive Hyper-Acute Management Of Stroke At A Tertiary Facility In Nairobi, Kenya, Caroline Wangui Mithi

Theses & Dissertations

Background: Stroke is a sudden neurological deficit due to a vascular cause, which can be ischaemic, haemorrhagic stroke or another cause. It is a leading cause of disability and long term functional impairment in the world. The definitive management of an acute ischaemic stroke is thrombolysis and/or mechanical thrombectomy, both of which has been shown to improve functional outcome but the utilization remains quite low in most hospitals, especially in Africa. This is due to certain pre-hospital and in-hospital barriers, and these factors have been shown to differ from country to country.

Objective: To determine the pre-hospital barriers that prevent …

Factors Associated With Cardiac Dysfunction Following Anthracyline-Based Chemotherapy In Adults In A Tertiary Hospital In Nairobi, Joseph Odunga Abuodha

Theses & Dissertations

Introduction: Anthracyclines are known to improve survival in some malignancies, but may also be associated with irreversible cardiotoxicity, which is partly dose dependent. Early detection of cardiotoxicity provides an opportunity for treatment adjustment. Several parameters predict development of clinically manifest cardiac dysfunction. The study aimed to evaluate clinical and echocardiographic parameters which predict development of cardiac dysfunction in a sub-Saharan African population.

Methods: Patients with a diagnosis of cancer and receiving anthracyclines at AKUH,N were evaluated if they met eligibility criteria (≥18years at first anthracycline administration, archived baseline echocardiogram, no prior history of heart disease or use of anthracyclines). …