Medicine and Health Sciences Commons^™

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 …

Clinicopathologic Features Of Renal Cell Carcinomas Seen At The Aga Khan University Hospital In Kenya, Anderson Mutuiri, Samuel Gakinya

Pathology, East Africa

Introduction: Kidney cancer accounted for 1. 8% of global cancer deaths according to Globocan 2020 estimates, with most of these being renal cell carcinomas. Lower rates of renal cell carcinoma are reported for Africa and these are expected to change for a combination of reasons. The clinical and morphologic characteristics of renal cell carcinoma seen within Kenya have not been described before. This study aims to partially fill this gap.

Materials and methods: This was a cross-sectional descriptive study examining electronic histopathology reports from the Aga Khan University Hospital Nairobi Laboratory for the period January 2016 to May 2022.

Results: …

Informing Healthcare Operations With Integrated Pathology, Clinical, And Epidemiology Data: Lessons From A Single Institution In Kenya During Covid-19 Waves, Allan Njau, Jemimah Kimeu, Jaimini Gohil, David Nganga

Pathology, East Africa

Pathology, clinical care teams, and public health experts often operate in silos. We hypothesized that large data sets from laboratories when integrated with other healthcare data can provide evidence that can be used to optimize planning for healthcare needs, often driven by health-seeking or delivery behavior. From the hospital information system, we extracted raw data from tests performed from 2019 to 2021, prescription drug usage, and admission patterns from pharmacy and nursing departments during the COVID-19 pandemic in Kenya (March 2020 to December 2021). Proportions and rates were calculated. Regression models were created, and a t-test for differences between …

Covid-19 Vaccine Hesitancy Among Non-Refugees And Refugees In Kenya, Ryan Rego, Anthony Ngugi, Antonia Johanna Sophie Delius, Stanley Luchters, Joseph C. Kolars, Furqan B. Irfan, Eileen Weinheimer-Haus, Amina Abubakar, Reena Shah, Ji Zhu

Population Health, East Africa

Factors associated with COVID-19 vaccine hesitancy (which we define as refusal to be vaccinated when asked, resulting in delayed or non- vaccination) are poorly studied in sub-Saharan Africa and among refugees, particularly in Kenya. Using survey data from wave five (March to June 2021) of the Kenya Rapid Response Phone Survey (RRPS), a household survey representative of the population of Kenya, we estimated the self-reported rates and factors associated with vaccine hesitancy among non-refugees and refugees in Kenya. Non-refugee households were recruited through sampling of the 2015/16 Kenya Household Budget Survey and random digit dialing. Refugee households were recruited through …

Cervical Cancer Programme, Kenya, 2011–2020: Lessons To Guide Elimination As A Public Health Problem, Valerian Mwenda, Woki Mburu, Joan-Paula Bor, Mary Nyangasi, Marc Arbyn, Steven Weyers, Philippe Tummers, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Cervical cancer is the leading cause of cancer mortality in Kenya, with an estimated 3,200 deaths in 2020. Kenya has implemented cervical cancer interventions for more than a decade. We describe the evolution of the cervical cancer programme over the last 20 years and assess its performance.

Methods: We searched the Ministry of Health’s archives and website (2000–2021) for screening policy documents and assessed them using seven items: situational analysis, objectives, key result areas, implementation framework, resource considerations, monitoring and evaluation and definition of roles/responsibilities. In addition, a trend analysis was performed targeting screening and disease burden indicators in …

Evaluation Of Sibel’S Advanced Neonatal Epidermal (Anne) Wireless Continuous Physiological Monitor In Nairobi, Kenya, Jesse Coleman, Amy Sarah Ginsburg, William Macharia, Roseline Ochieng, Dorothy Chomba, Guohai Zhou, Dustin Dunsmuir, Shuai Xu, J. Mark Ansermino

Paediatrics and Child Health, East Africa

Background: Neonatal multiparameter continuous physiological monitoring (MCPM) technologies assist with early detection of preventable and treatable causes of neonatal mortality. Evaluating accuracy of novel MCPM technologies is critical for their appropriate use and adoption.

Methods: We prospectively compared the accuracy of Sibel’s Advanced Neonatal Epidermal (ANNE) technology with Masimo’s Rad-97 pulse CO-oximeter with capnography and Spengler’s Tempo Easy reference technologies during four evaluation rounds. We compared accuracy of heart rate (HR), respiratory rate (RR), oxygen saturation (SpO₂), and skin temperature using Bland-Altman plots and root-mean-square deviation analyses (RMSD). Sibel’s ANNE algorithms were optimized between each round. …

Cardiovascular Risk Factors And Markers Of Myocardial Injury And Inflammation In People Living With Hiv In Nairobi, Kenya: A Pilot Cross-Sectional Study, Hassan Adan Ahmed, Jeilan Mohamed, Isaiah G. Akuku, Kuan Ken Lee, Shirjel R. Alam, Pablo Perel, Jasmit Shah, Mohammed K. Ali, Sherry Eskander, Michael H. Chung

Internal Medicine, East Africa

Objectives: To determine the prevalence of cardiovascular disease (CVD) risk factors and explore associations with high-sensitivity cardiac troponin I (hscTnI) and high-sensitivity C-reactive protein (hsCRP) in people living with HIV (PLHIV) in Kenya.

Design: Pilot cross-sectional study.

Setting: Data were collected from community HIV clinics across two sites in Nairobi, Kenya, from July 2019 to May 2020.

Participants: Convenience sample of 200 PLHIV (≥30 years with no prior history of CVD).

Outcome measures: Prevalence of cardiovascular risk factors and its association with hsTnI and hsCRP levels.

Results: Across 200 PLHIV (median age 46 years, IQR 38–53; 61% women), the …

The Kenya Uk Breast Cancer Awareness Week: Curriculum Codesign And Codelivery With Direct And Lived Experience Of Breast Cancer Diagnosis And Management, Bahaty Riogi, Carlo Ross, Miriam Mutebi, Rajiv V. Dave

General Surgery, East Africa

Global health education holds a paradox: the provision of global health degrees focusing on challenges in low-income and middle-income countries has increased in high-income countries, while those in these low-income and middle-income countries lack access to contribute their expertise, creating an ‘information problem’. Breast cancer is a pressing global health priority, which requires curriculum design, implementation, ownership and leadership by those with direct and lived experience of breast cancer.

The Kenya-UK Breast Cancer Awareness Week was conceptualised following the signing of the Memorandum of Understanding between the Kenyan and UK governments launching the Kenya UK Health Alliance. This alliance aims …

Perceptions And Knowledge Towards Covid-19 Vaccine Hesitancy Among A Subpopulation Of Adults In Kenya: An English Survey At Six Healthcare Facilities, Jasmit Shah, Abdulaziz Mansur Abeid, Karishma Sharma, Soraiya Manji, Jamila Nambafu, Robert Korom, Keya Patel, Rajiv Patel, Reena Shah, Sayed Karar

Brain and Mind Institute

Background: Vaccine hesitancy, as defined by the WHO, is the reluctance or refusal to vaccinate despite the availability of vaccines and is one of the ten threats to global health in 2019. Vaccine hesitancy remains a complex matter influenced by multiple factors, especially in sub-Saharan Africa.

Methods: We conducted a cross-sectional study between November 2021 and January 2022 among the general adult public seeking care at six different healthcare facilities in Kenya. The survey, in English, consisted of questions based on demographics, knowledge, and attitudes, including hesitancy towards the COVID-19 vaccine.

Results: Of the 3996 surveys collected, 55.1% were from …

The Status And Future Of Emergency Care In The Republic Of Kenya, J. Austin Lee, Grace Wanjiku, Naomi Nduku, Adam R. Aluisio, Ramu Kharel, John Tabu Simiyu, Benjamin Wachira

Emergency Medicine, East Africa

Kenya is a rapidly developing country with a growing economy and evolving health care system. In the decade since the last publication on the state of emergency care in Kenya, significant developments have occurred in the country's approach to emergency care. Importantly, the country decentralized most health care functions to county governments in 2013. Despite the triple burden of traumatic, communicable, and non-communicable diseases, the structure of the health care system in the Republic of Kenya is evolving to adapt to the important role for the care of emergent medical conditions. This report provides a ten-year interval update on the …

Increased Condom Use Among Key Populations Using Oral Prep In Kenya: Results From Large Scale Programmatic Surveillance, Griffins O. Manguro, Abednego M. Musau, Daniel K. Were, Soud Tengah, Brian Wakhutu, Jason Reed, Marya Plotkin, Stanley Luchters, Peter Gichangi, Marleen Temmerman

Institute for Human Development

Background: Female sex workers (FSW) and men having sex with men (MSM) in Kenya have high rates of HIV infection. Following a 2015 WHO recommendation, Kenya initiated national scale-up of pre-exposure prophylaxis (PrEP) for all persons at high-risk. Concerns have been raised about PrEP users’ potential changes in sexual behaviors such adopting condomless sex and multiple partners as a result of perceived reduction in HIV risk, a phenomenon known as risk compensation. Increased condomless sex may lead to unintended pregnancies and sexually transmitted infections and has been described in research contexts but not in the programmatic setting. This study …

Clinical Characteristics Of Peripheral Neuropathy In Kenyan Patients With Hiv Infection Compared With Patients With Concurrent Hiv Infection And Diabetes Mellitus, Pascal Kuka, Jasmit Shah, Uazman Alam, Reena Shah, Dilraj Sokhi

Internal Medicine, East Africa

Introduction: Persons living with human immunodeficiency virus (HIV) are living longer and at risk of non-communicable diseases, including diabetes mellitus (DM). Both HIV and DM place patients at risk of peripheral neuropathy (PN). Our aim was to demonstrate the prevalence and characteristics of PN in our population of patients with HIV infection compared with concomitant HIV and DM.

Methods: A prospective cross-sectional study was performed at the Aga Khan Hospital in Nairobi, Kenya. Data were collected on demographics and characteristics of DM and HIV. Symptoms and signs of PN were evaluated by Neuropathy Symptom Score, Neuropathy Disability Score, …

Clinical Feasibility Of A Contactless Multiparameter Continuous Monitoring Technology For Neonates In A Large Public Maternity Hospital In Nairobi, Kenya, Amy Sarah Ginsburg, Sahar Zandi Nia, Dorothy Chomba, Dustin Dunsmuir, Mary Waiyego, Jesse Coleman, Roseline Ochieng, Sichen Liu, Guohai Zhou, J. Mark Ansermino, William Macharia

Paediatrics and Child Health, East Africa

Multiparameter continuous physiological monitoring (MCPM) technologies are critical in the clinical management of high-risk neonates; yet, these technologies are frequently unavailable in many African healthcare facilities. We conducted a prospective clinical feasibility study of EarlySense’s novel under-mattress MCPM technology in neonates at Pumwani Maternity Hospital in Nairobi, Kenya. To assess feasibility, we compared the performance of EarlySense’s technology to Masimo’s Rad-97 pulse CO-oximeter with capnography technology for heart rate (HR) and respiratory rate (RR) measurements using up-time, clinical event detection performance, and accuracy. Between September 15 and December 15, 2020, we collected and analyzed 470 hours of EarlySense data from …

Missed Opportunities For Family Planning Counselling Among Postpartum Women In Eleven Counties In Kenya, Mary N. Thiongo, Peter B. Gichangi, Michael Waithaka, Amy Tsui, Linnea A. Zimmerman, Scott Radloff, Marleen Temmerman, Saifuddin Ahmed

Obstetrics and Gynaecology, East Africa

Background: Mothers may access medical facilities for their babies and miss opportunities to access family planning (FP) services. This study was undertaken to describe missed opportunities for FP among women within the extended (0–11months) postpartum period from counties participating in Performance Monitoring and Accountability 2020 (PMA2020) surveys.

Design and setting: This study analysed cross-sectional household survey data from 11 counties in Kenya between 2014 and 2018. PMA2020 uses questions extracted from the Demographic and Health survey (DHS) and DHS defnitions were used. Multivariable logistic regression was used for inferential statistics with p-value of <0.05 considered to be signifcant.

Participants: Women aged 15-49 years …

Qualitative Study Exploring The Feasibility, Usability And Acceptability Of Neonatal Continuous Monitoring Technologies At A Public Tertiary Hospital In Nairobi, Keny, Mai-Lei Woo Kinshella, Violet Naanyu, Dorothy Chomba, Mary Waiyego, Jessica Rigg, Jesse Coleman, Bella Hwang, J. Mark Ansermino, William Macharia, Amy Sarah Ginsburg

Paediatrics and Child Health, East Africa

Objective: To assess the feasibility, usability and acceptability of two non-invasive, multiparameter, continuous physiological monitoring (MCPM) technologies for use in neonates within a resource-constrained healthcare setting in sub-Saharan Africa.

Design: A qualitative study using in-depth interviews and direct observations to describe healthcare professional and caregiver perspectives and experiences with investigational MCPM technologies from EarlySense and Sibel compared with selected reference technologies.

Setting: Pumwani Maternity Hospital is a public, high-volume, tertiary hospital in Nairobi, Kenya.

Participants: In-depth interviews were conducted with five healthcare administrators, 12 healthcare providers and 10 caregivers. Direct observations were made of healthcare providers using the technologies on …

Psychosocial And Mental Health Challenges Faced By Emerging Adults Living With Hiv And Support Systems Aiding Their Positive Coping: A Qualitative Study From The Kenyan Coast, Moses K. Nyongesa, Carophine Nasambu, Rachael Mapenzi, Hans M. Koot, Pim Cuijpers, Charles R. J. C. Newton, Amina Abubakar

Institute for Human Development

Background: In sub-Saharan Africa, there is little data on the challenges faced by young people living with HIV tran- sitioning into adult life. Adapting the socio-ecological framework, this qualitative study investigated the challenges faced by emerging adults living with HIV from a rural Kenyan setting. Additionally, the study explored support systems that aid positive coping among these young adults.

Methods: In April 2018, in-depth interviews were conducted with a convenience sample of 22 young adults living with HIV (12 females), 18–24 years old, from rural Kilifi, coast of Kenya. Data were analyzed thematically using NVIVO 11 software.

Results …