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- Sub-Saharan Africa (2)
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- Implantable Cardioverter-Defibrillator (ICD) (1)
Articles 1 - 12 of 12
Full-Text Articles in Medicine and Health Sciences
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
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 …
Factors Associated With Non-Uptake Of Implantable Cardioverter-Defibrillator (Icd) Among Eligible Patients At A Tertiary Hospital In Kenya, Emmanuel Oluoch, Jasmit Shah, Jeilan Mohamed, Mohamed Varwani, Mzee Ngunga
Factors Associated With Non-Uptake Of Implantable Cardioverter-Defibrillator (Icd) Among Eligible Patients At A Tertiary Hospital In Kenya, Emmanuel Oluoch, Jasmit Shah, Jeilan Mohamed, Mohamed Varwani, Mzee Ngunga
Internal Medicine, East Africa
Background: Efficacy of Implantable Cardioverter-Defibrillator (ICD) implantation in both primary and secondary prevention of Sudden Cardiac Death (SCD) in at-risk population is well established. ICD implantation rates remain low particularly in Africa with a paucity of data regarding factors associated with non-uptake.
Objectives:The primary study objective was to determine the factors associated with non-uptake of ICD among heart failure (HF) patients with reduced ejection fraction (EF
Methods: This was a retrospective study among HF patients eligible for ICD implantation evaluated between 2018 to 2020. Comparison between ICD recipient and non-recipient categories was made to establish determinants of non-uptake.
Results: …
Access To Medicines For Parkinson's Disease In Kenya: A Qualitative Exploration, Natasha Fothergill-Misbah, Juzar Hooker, Judith Kwasa, Richard Walker
Access To Medicines For Parkinson's Disease In Kenya: A Qualitative Exploration, Natasha Fothergill-Misbah, Juzar Hooker, Judith Kwasa, Richard Walker
Internal Medicine, East Africa
Background: The accessibility of Parkinson’s disease medicines is limited across sub-Saharan Africa,which can have negative health, social and financial consequences for people with Parkinson’s disease andtheir families. However, there is a stark gap in the literature regarding the impact of poor access to medicineson individuals.
Objectives: The study objective was to understand the accessibility of Parkinson’s disease medicines in Kenyafrom the perspective of people with Parkinson’s disease, their caregivers and neurologists.MethodsMethods: In-depth qualitative interviews were conducted with 55 people with Parkinson’s disease, 23 caregiversand 8 neurologists to understand their experience regarding challenges with accessing Parkinson’s diseasemedicines and the health, social …
Clinical Presentation And Outcomes Of Care In Adults With Diabetic Ketoacidosis Pre-Covid-19 And During-Covid-19 At A Tertiary, Referral Hospital In Nairobi, Kenya, Sairabanu Sokwalla, Jasmit Shah, Sangeeta Chauhan, Reena Shah, Salim Surani, Eric Njenga, Nancy Kunyiha
Clinical Presentation And Outcomes Of Care In Adults With Diabetic Ketoacidosis Pre-Covid-19 And During-Covid-19 At A Tertiary, Referral Hospital In Nairobi, Kenya, Sairabanu Sokwalla, Jasmit Shah, Sangeeta Chauhan, Reena Shah, Salim Surani, Eric Njenga, Nancy Kunyiha
Internal Medicine, East Africa
Background: Prognosis of DKA has improved over time with the availability of evidence-based protocols and resources. However, in Kenya, there are limited resources for the appropriate diagnosis and management of DKA, mostly limited to tertiary-level referral facilities. This study aimed to review the clinical presentation, management, and outcomes of adult patients admitted with DKA and assess differences in these parameters before and during the COVID-19 pandemic.
Methods: This was a retrospective study of DKA admissions from January 2017 to December 2021. Patient data were retrieved from the medical records department using ICD-10 codes, and individual details were abstracted on clinical …
Kenyan Palliative Care Providers’ And Leaders’ Perceptions Of Palliative Care Research Needs And Support To Facilitate Rigorous Research, K. Cartmell, E. Doherty, Nancy Gikaara, Z. Ali, S. Qanungo, E. S. Melikam, R. A. Powell
Kenyan Palliative Care Providers’ And Leaders’ Perceptions Of Palliative Care Research Needs And Support To Facilitate Rigorous Research, K. Cartmell, E. Doherty, Nancy Gikaara, Z. Ali, S. Qanungo, E. S. Melikam, R. A. Powell
Internal Medicine, East Africa
Background: Palliative care (PC) can reduce symptom distress and improve quality of life for patients and their families experiencing life-threatening illness. While the need for PC in Kenya is high, PC service delivery and research is limited. Qualitative research is needed to explore potential areas for PC research and support needed to enable that research. This insight is critical for informing a national PC research agenda and mobilizing limited resources for conducting rigorous PC research in Kenya.
Objectives: To explore perceptions of priority areas for PC research and support needed to facilitate rigorous research from the perspective of Kenyan PC …
Social Support And The Effects Of The Covid-19 Pandemic Among A Cohort Of People Living With Hiv (Plwh) In Western Kenya, Adel Mburia-Mwalili, Karla D. Wagner, Edith Kamaru Kwobah, Lukoye Atwoli, Maurice Aluda, Brianna Simmons, Jayne Lewis-Kulzer, Suzanne Goodrich, Kara Wools-Kaloustian, Jennifer L. Syvertsen
Social Support And The Effects Of The Covid-19 Pandemic Among A Cohort Of People Living With Hiv (Plwh) In Western Kenya, Adel Mburia-Mwalili, Karla D. Wagner, Edith Kamaru Kwobah, Lukoye Atwoli, Maurice Aluda, Brianna Simmons, Jayne Lewis-Kulzer, Suzanne Goodrich, Kara Wools-Kaloustian, Jennifer L. Syvertsen
Internal Medicine, East Africa
As coronavirus disease (COVID-19) was declared a pandemic in 2020, countries around the world implemented various prevention strategies, such as banning of public and social gatherings, restriction in movement, etc. These efforts may have had a deleterious effect on already vulnerable populations, including people living with HIV (PLWH). PLWH were concerned about contracting COVID-19, the impact of COVID-19 on their social networks that provide social support, and the continued availability of antiretroviral medications during the pandemic. In addition, their mental health may have been exacerbated by the pandemic. The purpose of this study was to explore pandemic-related concerns among a …
Effect Of Care Environment On Educational Attainment Among Orphaned And Separated Children And Adolescents In Western Kenya, Dorothy Apedaile, Allison Delong, Edwin Sang, David Ayuku, Lukoye Atwoli, Omar Galárraga, Paula Braitstein
Effect Of Care Environment On Educational Attainment Among Orphaned And Separated Children And Adolescents In Western Kenya, Dorothy Apedaile, Allison Delong, Edwin Sang, David Ayuku, Lukoye Atwoli, Omar Galárraga, Paula Braitstein
Internal Medicine, East Africa
Background: There are approximately 140 million orphaned and separated children (OSCA) around the world. In Kenya, many of these children live with extended family while others live in institutions. Despite evidence that orphans are less likely to be enrolled in school than non-orphans, there is little evidence regarding the role of care environment. This evidence is vital for designing programs and policies that promote access to education for orphans, which is not only their human right but also an important social determinant of health. The purpose of this study was to compare educational attainment among OSCA living in Charitable …
Association Of Care Environment With Hiv Incidence And Death Among Orphaned, Separated, And Street-Connected Children And Adolescents In Western Kenya, Paula Braitstein, Allison Delong, David Ayuku, Mary Ott, Lukoye Atwoli, Omar Galárraga, Edwin Sang, Joseph Hogan
Association Of Care Environment With Hiv Incidence And Death Among Orphaned, Separated, And Street-Connected Children And Adolescents In Western Kenya, Paula Braitstein, Allison Delong, David Ayuku, Mary Ott, Lukoye Atwoli, Omar Galárraga, Edwin Sang, Joseph Hogan
Internal Medicine, East Africa
Importance: In 2015, there were nearly 140 million orphaned children globally, particularly in low- and middle-income regions, and millions more for whom the street is central to their everyday lives. A total of 16.6 million children were orphaned because of deaths associated with HIV/AIDS, of whom 90% live in sub-Saharan Africa. Although most orphaned and separated children and adolescents in this region are cared for by extended family, the large number of children requiring care has produced a proliferation of institutional care. Few studies have investigated the association between care environment and physical health among orphaned and separated youths in …
The Impact Of Scaling Up Cervical Cancer Screening And Treatment Services Among Women Living With Hiv In Kenya: A Modelling Study, Pablo Noel Perez-Guzman, Michael Chung, Hugo De Vuyst, Shona Dalal, Kennedy K. Mutai, Karanja Muthoni, Bartilol Kigen, Timothy B. Hallett, Mikaela Smit
The Impact Of Scaling Up Cervical Cancer Screening And Treatment Services Among Women Living With Hiv In Kenya: A Modelling Study, Pablo Noel Perez-Guzman, Michael Chung, Hugo De Vuyst, Shona Dalal, Kennedy K. Mutai, Karanja Muthoni, Bartilol Kigen, Timothy B. Hallett, Mikaela Smit
Internal Medicine, East Africa
Introduction: We aimed to quantify health outcomes and programmatic implications of scaling up cervical cancer (CC) screening and treatment options for women living with HIV in care aged 18–65 in Kenya.
Methods: Mathematical model comparing from 2020 to 2040: (1) visual inspection with acetic acid (VIA) and cryotherapy (Cryo); (2) VIA and Cryo or loop excision electrical procedure (LEEP), as indicated; (3) human papillomavirus (HPV)-DNA testing and Cryo or LEEP; and (4) enhanced screening technologies (either same-day HPV-DNA testing or digitally enhanced VIA) and Cryo or LEEP. Outcomes measured were annual number of CC cases, deaths, screening and treatment interventions, …
Clinical Features, Proximate Causes, And Consequences Of Active Convulsive Epilepsy In Africa, Symon M. Kariuki, William Matuja, Albert Akpalu, Angelina Kakooza-Mwesige, Martin Chabi, Ryan G. Wagner, Myles Connor, Eddie Chengo, Anthony K. Ngugi, Rachael Odhiambo, Christian Bottomley, Steven White, Josemir W. Sander, Brian G. R. Neville, Charles R. J. C. Newton
Clinical Features, Proximate Causes, And Consequences Of Active Convulsive Epilepsy In Africa, Symon M. Kariuki, William Matuja, Albert Akpalu, Angelina Kakooza-Mwesige, Martin Chabi, Ryan G. Wagner, Myles Connor, Eddie Chengo, Anthony K. Ngugi, Rachael Odhiambo, Christian Bottomley, Steven White, Josemir W. Sander, Brian G. R. Neville, Charles R. J. C. Newton
Internal Medicine, East Africa
Purpose: Epilepsy is common in sub-Saharan Africa (SSA), but the clinical features and consequences are poorly characterized. Most studies are hospital-based, and few studies have compared different ecological sites in SSA. We described active convulsive epilepsy (ACE) identified in cross-sectional community-based surveys in SSA, to understand the proximate causes, features, and consequences.
Methods: We performed a detailed clinical and neurophysiologic description of ACE cases identified from a community survey of 584,586 people using medical history, neurologic examination, and electroencephalography (EEG) data from five sites in Africa: South Africa; Tanzania; Uganda; Kenya; and Ghana. The cases were examined by clinicians to …
Comparing Papanicolau Smear, Visual Inspection With Acetic Acid And Human Papillomavirus Cervical Cancer Screening Methods Among Hiv-Positive Women By Immune Status And Antiretroviral Therapy, Michael Chung, K. P. Mckenzie, H. D. Vuyst, B. A. Richardson, Farzana Rana, R. Pamnani, J. W. Njoroge, E. Nyongesa-Malava, S. R. Sakr, G. C. John-Stewart, N. R. Mugo
Comparing Papanicolau Smear, Visual Inspection With Acetic Acid And Human Papillomavirus Cervical Cancer Screening Methods Among Hiv-Positive Women By Immune Status And Antiretroviral Therapy, Michael Chung, K. P. Mckenzie, H. D. Vuyst, B. A. Richardson, Farzana Rana, R. Pamnani, J. W. Njoroge, E. Nyongesa-Malava, S. R. Sakr, G. C. John-Stewart, N. R. Mugo
Internal Medicine, East Africa
Background: A rigorous comparison of cervical cancer screening methods utilizing data on immune status, antiretroviral therapy (ART) and colposcopy-directed biopsy has not been performed among HIV-positive women.
Methods: Between June and November 2009, 500 HIV-positive women were enrolled at an HIV treatment clinic in Nairobi, Kenya, and underwent Papanicolau (Pap) smear, visual inspection with acetic acid (VIA), human papillomavirus (HPV) and colposcopydirected biopsy (gold standard). Positive Pap smear (ASCUS, LSIL, HSIL), VIA, HPV and their combinations were compared with CIN2/3+. Sensitivity, specificity and AUC (sensitivity and 1-specificity) were compared using pairwise tests and multivariate logistic regression models that included age, …
Harnessing The Power Of The Grassroots To Conduct Public Health Research In Sub-Saharan Africa: A Case Study From Western Kenya In The Adaptation Of Community-Based Participatory Research (Cbpr) Approaches, Allan Kamanda, Lonnie Embleton, David Ayuku, Lukoye Atwoli, Peter Gisore, Samuel Ayaya, Rachel Vreeman, Paula Braitstein
Harnessing The Power Of The Grassroots To Conduct Public Health Research In Sub-Saharan Africa: A Case Study From Western Kenya In The Adaptation Of Community-Based Participatory Research (Cbpr) Approaches, Allan Kamanda, Lonnie Embleton, David Ayuku, Lukoye Atwoli, Peter Gisore, Samuel Ayaya, Rachel Vreeman, Paula Braitstein
Internal Medicine, East Africa
Background: Community-based participatory research (CBPR) is a collaborative approach to research that involves the equitable participation of those affected by an issue. As the field of global public health grows, the potential of CBPR to build capacity and to engage communities in identification of problems and development and implementation of solutions in sub-Saharan Africa has yet to be fully tapped. The Orphaned and Separated Children’s Assessments Related to their Health and Well-Being (OSCAR) project is a longitudinal cohort of orphaned and non-orphaned children in Kenya. This paper will describe how CBPR approaches and principles can be incorporated and adapted into …