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Primary Health Care And The Tanzania Comprehensive Cancer Project, Gijs Walraven, Harrison Chuwa, Alain Fourquet, Paschal Ruggajo Apr 2024

Primary Health Care And The Tanzania Comprehensive Cancer Project, Gijs Walraven, Harrison Chuwa, Alain Fourquet, Paschal Ruggajo

Internal Medicine, East Africa

No abstract provided.


An Exploration Of The Genetics Of The Mutant Huntingtin (Mhtt) Gene In A Cohort Of Patients With Chorea From Different Ethnic Groups In Sub-Saharan Africa, Mendi J. Muthinja, Carlos Othon Guelngar, Maouly Fall, Fatumah Jama, Huda Aldeen Shuja, Jamila Nambafu, Daniel Gams Massi, Oluwadamilola Ojo, Juzar Hooker, Dilraj Sokhi Apr 2024

An Exploration Of The Genetics Of The Mutant Huntingtin (Mhtt) Gene In A Cohort Of Patients With Chorea From Different Ethnic Groups In Sub-Saharan Africa, Mendi J. Muthinja, Carlos Othon Guelngar, Maouly Fall, Fatumah Jama, Huda Aldeen Shuja, Jamila Nambafu, Daniel Gams Massi, Oluwadamilola Ojo, Juzar Hooker, Dilraj Sokhi

Internal Medicine, East Africa

Background: Africans are underrepresented in Huntington's disease (HD) research. A European ancestor was postulated to have introduced the mutant Huntingtin (mHtt) gene to the continent; however, recent work has shown the existence of a unique Htt haplotype in South-Africa specific to indigenous Africans.

Objective: We aimed to investigate the CAG trinucleotide repeats expansion in the Htt gene in a geographically diverse cohort of patients with chorea and unaffected controls from sub-Saharan Africa.

Methods: We evaluated 99 participants: 43 patients with chorea, 21 asymptomatic first-degree relatives of subjects with chorea, and 35 healthy controls for the presence of the mHtt. Participants …


Cross-Cultural Equivalence Of The Kessler Psychological Distress Scale (K10) Across Four African Countries In A Multi-National Study Of Adults, Amantia Ametaj, Christy Denckla, Anne Stevenson, Rocky Stroud, Jasmine Hall, Linnet Ongeri, Barkot Milkias, Jacob Hoffman, Lukoye Atwoli, Stella Gichuru Apr 2024

Cross-Cultural Equivalence Of The Kessler Psychological Distress Scale (K10) Across Four African Countries In A Multi-National Study Of Adults, Amantia Ametaj, Christy Denckla, Anne Stevenson, Rocky Stroud, Jasmine Hall, Linnet Ongeri, Barkot Milkias, Jacob Hoffman, Lukoye Atwoli, Stella Gichuru

Internal Medicine, East Africa

The Kessler Psychological Distress Scale (K10) has been widely used to screen psychological distress across many countries. However, its performance has not been extensively studied in Africa. The present study sought to evaluate and compare measurement properties of the K10 across four African countries: Ethiopia, Kenya, Uganda, and South Africa. Our hypothesis is that the measure will show equivalence across all. Data are drawn from a neuropsychiatric genetic study among adult participants (N = 9179) from general medical settings in Ethiopia (n = 1928), Kenya (n = 2556), Uganda (n = 2104), and South Africa (n = 2591). A unidimensional …


Incidental Actinomycosis In A 44-Year-Old Female During Total Abdominal Hysterectomy For Abnormal Uterine Bleeding: A Case Report, Willbroad Kyejo, Allyzain Ismail, Abduel Kitua, Brenda Moshi, Gregory Ntiyakunze, Munawar Kaguta, Ally Mwanga Apr 2024

Incidental Actinomycosis In A 44-Year-Old Female During Total Abdominal Hysterectomy For Abnormal Uterine Bleeding: A Case Report, Willbroad Kyejo, Allyzain Ismail, Abduel Kitua, Brenda Moshi, Gregory Ntiyakunze, Munawar Kaguta, Ally Mwanga

Internal Medicine, East Africa

Actinomycosis, a rare chronic bacterial infection caused by Actinomyces species, presents diagnostic challenges due to diverse clinical presentations. This report presents a case of peritoneal actinomycosis incidentally discovered during a total abdominal hysterectomy in a 44-year-old female with refractory abnormal uterine bleeding and a history of long-term intrauterine contraceptive device use. The patient presented with persistent abnormal uterine bleeding despite conservative management. Intraoperative findings during total abdominal hysterectomy revealed peritoneal involvement, prompting histopathological evaluation confirming actinomycosis. This case highlights diagnostic complexities associated with actinomycosis, emphasizing the significance of histopathological confirmation. Postoperative management with antibiotics demonstrated favorable outcomes, supporting their efficacy …


Acute Coronary Syndrome Patterns In The Young: Risk Factor Profile And In-Hospital Outcomes In A Tertiary Referral Hospital In Kenya, Nadeem Kassam, Mzee Ngunga, Mohamed Varwani, Miriam Msunza, Jeilan Mohamed Apr 2024

Acute Coronary Syndrome Patterns In The Young: Risk Factor Profile And In-Hospital Outcomes In A Tertiary Referral Hospital In Kenya, Nadeem Kassam, Mzee Ngunga, Mohamed Varwani, Miriam Msunza, Jeilan Mohamed

Internal Medicine, East Africa

Introduction: Acute coronary syndrome (ACS) accounts for coronary artery disease (CAD) –related morbidity and mortality. There has been growing concern about the rising incidence of ACS among young individuals globally both in developed and developing countries, including Sub-Saharan Africa. This group’s phenotypic characteristics; risk factors and clinical outcomes are not well described. contextual and regional studies are necessary to understand the magnitude of ACS among young Individuals and help highlight challenges and opportunities for improved ACS outcomes in the region. The study aimed to describe the demographic and clinical characteristics of young individuals hospitalized with ACS and report on in-hospital …


Dental Caries In Children With Sickle Cell Disease And Its Association With The Use Of Hydroxyurea And Penicillin Prophylaxis In Dar Es Salaam, Irene Kida Minja, Evarist Mulyahela Wilson, Ferdinand M. Machibya, Agnes Jonathan, Fortunata Cornel, Paschal Ruggajo, Julie Makani, Ferdinand M. Machibya Mar 2024

Dental Caries In Children With Sickle Cell Disease And Its Association With The Use Of Hydroxyurea And Penicillin Prophylaxis In Dar Es Salaam, Irene Kida Minja, Evarist Mulyahela Wilson, Ferdinand M. Machibya, Agnes Jonathan, Fortunata Cornel, Paschal Ruggajo, Julie Makani, Ferdinand M. Machibya

Internal Medicine, East Africa

Purpose.

This comparative study sets out to report dental caries status among individuals with Sickle Cell Disease (HbSS) against those with sickle cell trait (HbSA) and those without the disease (HbAA) as controls. The study further assessed the impact of penicillin chemoprophylaxis and hydroxyurea use on dental caries among Sickle Cell Disease participants.

Methods.

This was a comparative cross-sectional study in which 93 children aged 30 to 60 months were recruited. There were 60 participating children who had SCD (HbSS), 17 with SCD trait (HbAS) and 16 were without SCD or SC trait (HbAA). A questionnaire was used to record …


National Non-Communicable Diseases Conferences- A Platform To Inform Policies And Practices In Tanzania, Davis E. Amani, Harrieth P. Ndumwa, Jackline E. Ngowi, Belinda J. Njiro, Castory Munishi, Erick A. Mboya, Doreen Mloka, Amani I. Kikula, Emmanuel Balandya, Paschal Ruggajo Mar 2024

National Non-Communicable Diseases Conferences- A Platform To Inform Policies And Practices In Tanzania, Davis E. Amani, Harrieth P. Ndumwa, Jackline E. Ngowi, Belinda J. Njiro, Castory Munishi, Erick A. Mboya, Doreen Mloka, Amani I. Kikula, Emmanuel Balandya, Paschal Ruggajo

Internal Medicine, East Africa

Background:

Non-communicable diseases (NCDs) arise from diverse risk factors with differences in the contexts and variabilities in regions and countries. Addressing such a complex challenge requires local evidence. Tanzania has been convening stakeholders every year to disseminate and discuss scientific evidence, policies, and implementation gaps, to inform policy makers in NCDs responses. This paper documents these dissemination efforts and how they have influenced NCDs response and landscape in Tanzania and the region.

Methods:

Desk review was conducted through available MOH and conference organizers’ documents. It had both quantitative and qualitative data. The review included reports of the four NCDs conferences, …


A Case Of Parkinsonian Symptoms Secondary To Chronic Subdural Hematoma, Willbroad Kyejo, Frank Swai, Clement Mugisha, Philip Adebayo Mar 2024

A Case Of Parkinsonian Symptoms Secondary To Chronic Subdural Hematoma, Willbroad Kyejo, Frank Swai, Clement Mugisha, Philip Adebayo

Internal Medicine, East Africa

Chronic subdural hematoma is a known neurosurgical entity often associated with a spectrum of neurological manifestations. While primarily recognized for its characteristic accumulation of blood between the dura mater and arachnoid membrane, emerging literature suggests a rare association between chronic subdural hematoma and Parkinsonian symptoms. This report aims to underscore this unique neurological relationship by presenting a case of a 70-year-old male who developed Parkinsonism following chronic subdural hematoma post-head trauma. This case underscores the rare association between chronic subdural hematoma and Parkinsonian symptoms, emphasizing the importance of timely diagnosis and intervention in managing such cases.


Resilience And Associated Factors In Orphaned And Separated Adolescents In Kenya: Understanding The Relationship With Care Environment And Hiv Risks., Sarah Sutherland, Harry Shannon, David Ayuku, David Kleiner, Olli Saarela, Lukoye Atwoli, Joseph Hogan, Paula Braitstein Jan 2024

Resilience And Associated Factors In Orphaned And Separated Adolescents In Kenya: Understanding The Relationship With Care Environment And Hiv Risks., Sarah Sutherland, Harry Shannon, David Ayuku, David Kleiner, Olli Saarela, Lukoye Atwoli, Joseph Hogan, Paula Braitstein

Internal Medicine, East Africa

Orphans are at higher risk of HIV infection and several important HIV risk factors than non-orphans; however, this may be due to a combination of related social, psychological, and economic factors, as well as care environment, rather than orphan status alone. Understanding these complex relationships may aid policy makers in supporting evidence-based, cost-effective programming for this vulnerable population. This longitudinal study uses a causal effect model to examine, through decomposition, the relationship between care environment and HIV risk factors in orphaned and separated adolescents and youths (OSAY) in Uasin Gishu County, Kenya; considering resilience, social, peer, or family support, volunteering, …


Exploring User Experiences Of A Text Message-Delivered Intervention Among Individuals On Opioid Use Disorder Treatment In Kenya: A Qualitative Study, Sarah Kiburi, Saeeda Paruk, Edith Kamaru Kwobah, Bonginkosi Chiliza Dec 2023

Exploring User Experiences Of A Text Message-Delivered Intervention Among Individuals On Opioid Use Disorder Treatment In Kenya: A Qualitative Study, Sarah Kiburi, Saeeda Paruk, Edith Kamaru Kwobah, Bonginkosi Chiliza

Internal Medicine, East Africa

Opioid use disorder causes significant burden of disease and treatment comprises pharmacotherapy and psychosocial treatment. Cognitive behavioral therapy is an effective psychosocial intervention used in substance use disorders treatment and can be delivered using digital approach. There is limited use of digital treatment among individuals with opioid use disorder in Kenya. This study aimed to describe the experiences and feedback from participants with opioid use disorder enrolled in a text-message intervention in Kenya. Qualitative data was collected from participants in the intervention arm of a feasibility trial testing a text-message intervention based on cognitive behavioral therapy. Data was collected using …


Burden Of Bradycardia And Barriers To Accessing Bradycardia Therapy In Underserved Countries, Diego Egas, Francisco Rodriguez, Aparna Jaswal, Jeilan Mohamed, Goran Milasinovic, Ahmed Al Fagih Dec 2023

Burden Of Bradycardia And Barriers To Accessing Bradycardia Therapy In Underserved Countries, Diego Egas, Francisco Rodriguez, Aparna Jaswal, Jeilan Mohamed, Goran Milasinovic, Ahmed Al Fagih

Internal Medicine, East Africa

Bradycardia, a condition characterized by an abnormally slow heart rate, poses significant challenges in terms of diagnosis and treatment. While it is a concern world-wide, low- and middle-income countries (LMICs) face substantial barriers in accessing appropriate bradycardia therapy. This article aims to explore the global aetiology and incidence of bradycardia, compare the prevalence and management of the condition in high-income countries versus LMICs, identify the key reasons behind the disparities in access to bradycardia therapy in LMICs, and emphasize the urgent need to address these disparities to ensure equitable healthcare on a global scale


Surgical Site Infections Post Cesarean Section And Associated Risk Factors: A Retrospective Case-Control Study At A Tertiary Hospital In Kenya, David Odada, Jasmit Shah, Annastacia Mbithi, Reena Shah Dec 2023

Surgical Site Infections Post Cesarean Section And Associated Risk Factors: A Retrospective Case-Control Study At A Tertiary Hospital In Kenya, David Odada, Jasmit Shah, Annastacia Mbithi, Reena Shah

Internal Medicine, East Africa

Background: Surgical site infection is a common healthcare-associated infection that affects maternal health, yet it can be prevented or controlled. Caesarian sections are most likely to develop surgical site infections. The rates of delivery by caesarian section in reported to be higher that the acceptable rates in some healthcare facilities. Risk factors for surgical site infections can be identified and modified to reduce the occurrence of surgical site infections. This study aims to determine the risk factors that contribute to surgical site infections post caesarian section in a tertiary teaching hospital in Kenya.

Methods: This was a retrospective …


Improving Implant Training For Physicians And Their Teams In Under-Represented Regions, Jeilan Mohamed, Mohamed Varwani, Abdul Raqib, Emin Evren Ozcan Dec 2023

Improving Implant Training For Physicians And Their Teams In Under-Represented Regions, Jeilan Mohamed, Mohamed Varwani, Abdul Raqib, Emin Evren Ozcan

Internal Medicine, East Africa

The burden of cardiovascular disease is increasing globally, with low- and middle-income countries (LMICs) absorbing most of the burden while lacking the necessary healthcare infrastructure to combat the increase. In particular, the disparity in pacemaker implants between high-income countries and LMICs is glaring, partially spurned by reduced numbers of physicians and supporting staff who are trained in pacemaker implant technique. Herein, we will discuss current pacemaker implant training models, outline training frameworks that can be applied to underserved regions, and review adjunctive training techniques that can help supplement traditional training models in LMICs.


High Acceptability, Convenience And Reduced Carbon Emissions Of Tele-Neurology Outpatient Services At A Regional Referral Centre In Kenya, Fazal Yakub, Jasmit Shah, Dilraj Sokhi Nov 2023

High Acceptability, Convenience And Reduced Carbon Emissions Of Tele-Neurology Outpatient Services At A Regional Referral Centre In Kenya, Fazal Yakub, Jasmit Shah, Dilraj Sokhi

Internal Medicine, East Africa

Background: There is severe shortage of neurologists in sub-Saharan Africa. Tele-neurology consultations (TNC) can bridge this service gap, but there is very little published evidence on TNC in our setting, which we addressed through our study.

Methods: We prospectively enrolled patients at our neurology outpatients from October 2020 to October 2021. We administered a post-TNC questionnaire which captured satisfaction/acceptability using Likert scales. A sub-group of participants who also did in-person consultations (IPC) were additionally administered post-IPC questionnaires. Statistical comparisons were made using the paired student t-test, and descriptive data expressed as median (inter-quartile range).

Results: From 219 enrolled patients, 66.7% …


Gendered Lives, Gendered Vulnerabilities: An Intersectional Gender Analysis Of Exposure To And Treatment Of Schistosomiasis In Pakwach District, Uganda, Sarah N. Ssali, Rosemary Morgan, Salama Nakiranda, Christopher Opio, Mariam Otmani Del Barrio Nov 2023

Gendered Lives, Gendered Vulnerabilities: An Intersectional Gender Analysis Of Exposure To And Treatment Of Schistosomiasis In Pakwach District, Uganda, Sarah N. Ssali, Rosemary Morgan, Salama Nakiranda, Christopher Opio, Mariam Otmani Del Barrio

Internal Medicine, East Africa

Introduction: Schistosomiasis is a neglected tropical disease (NTD) that is endemic in Uganda, despite several interventions to eliminate it. It is transmitted when people infected with it pass on their waste matter into fresh water bodies used by others, consequently infecting them. Several studies have demonstrated gender and age differences in prevalence of schistosomiasis and NTDs such as lymphatic filariasis and soil transmitted helminths. However, few intersectional gender analysis studies of schistosomiasis have been undertaken. Using the World Health Organisation (WHO)’s intersectional gender analysis toolkit, this study was undertaken to identify which social stratifiers most intersected with gender to influence …


The Pattern Of Admission, Clinical Characteristics, And Outcomes Among Patients Admitted To The Intensive Care Unit Of A Tertiary Hospital In Tanzania: A 5-Year Retrospective Review, Nadeem Kassam, Philip Adebayo, Iris Martin Matei, Eric Aghan, Samina Somji, Samwel Paul Kadelya, Yasson Abha, Frank Elton Swai, Mangaro Mabusi, Kamran Hamid Nov 2023

The Pattern Of Admission, Clinical Characteristics, And Outcomes Among Patients Admitted To The Intensive Care Unit Of A Tertiary Hospital In Tanzania: A 5-Year Retrospective Review, Nadeem Kassam, Philip Adebayo, Iris Martin Matei, Eric Aghan, Samina Somji, Samwel Paul Kadelya, Yasson Abha, Frank Elton Swai, Mangaro Mabusi, Kamran Hamid

Internal Medicine, East Africa

Introduction: Despite the implementation of complex interventions, ICU mortality remains high and more so in developing countries. The demand for critical care in Sub-Saharan Africa is more than ever before as the region experiences a double burden of rising rates of non-communicable diseases (NCD) in the background battle of combating infectious diseases. Limited studies in Tanzania have reported varying factors associated with markedly high rates of ICU mortality. Investigating the burden of ICU care remains crucial in providing insights into the effectiveness and challenges of critical care delivery.

Material and Methods: A single-center retrospective study that reviewed records of all …


Predictors Of Coronary Artery Disease In Heart Failure With Reduced Ejection Fraction At The Aga Khan University Hospital In Nairobi, Redemptar Kimeu, Jeilan Mohamed, Mzee Ngunga Oct 2023

Predictors Of Coronary Artery Disease In Heart Failure With Reduced Ejection Fraction At The Aga Khan University Hospital In Nairobi, Redemptar Kimeu, Jeilan Mohamed, Mzee Ngunga

Internal Medicine, East Africa

There appears to be an epidemiological transition in the etiology of heart failure in sub-Saharan Africa (SSA) in parallel with a steady increase in risk factors for coronary artery disease (CAD). SSA has limited access to heart failure and CAD diagnostics, limiting the number of patients who receive optimal care. Our objectives were to study the predictors of coronary artery disease among patients with heart failure with reduced ejection fraction (HFrEF) and develop a model to assist clinicians in determining the likelihood of CAD before cardiac catheterization.

Methodology: This was a retrospective study at the Aga Khan University Hospital, …


Reducing The Rate Of Central Line-Associated Bloodstream Infections; A Quality Improvement Project, David Odada, Hellen Munyi, Japhet Gatuiku, Ruth Thuku, Jared Nyandigisi, Anne Wangui, Emilie Ashihundu, Beatrice Nyakiringa, Jemimah Kimeu, Martin Musumbi, Rodney Adam Oct 2023

Reducing The Rate Of Central Line-Associated Bloodstream Infections; A Quality Improvement Project, David Odada, Hellen Munyi, Japhet Gatuiku, Ruth Thuku, Jared Nyandigisi, Anne Wangui, Emilie Ashihundu, Beatrice Nyakiringa, Jemimah Kimeu, Martin Musumbi, Rodney Adam

Internal Medicine, East Africa

Background The burden of central line-associated bloodstream infections is significant and has negative implications for healthcare, increasing morbidity and mortality risks, increasing inpatient hospital stays, and increasing the cost of hospitalization. Efforts to reduce the incidence of central line-associated bloodstream infections have utilized quality improvement projects that implement, measure, and monitor outcomes. However, variations in location, healthcare organization, patient risks, and practice gaps are key to the success of interventions and approaches. This study aims to evaluate interventions of a quality improvement project on the reduction of central line-associated bloodstream infection rates at a university teaching hospital.

Methods This was …


Stop-Bang Questionnaire For Screening Obstructive Sleep Apnea Syndrome Among Hypertensive Patients In Kenya, Salim Abdallah Salim, Jasmit Shah, Jumaa Bwika, Sayed Karar Sep 2023

Stop-Bang Questionnaire For Screening Obstructive Sleep Apnea Syndrome Among Hypertensive Patients In Kenya, Salim Abdallah Salim, Jasmit Shah, Jumaa Bwika, Sayed Karar

Internal Medicine, East Africa

Introduction: Obstructive sleep apnea (OSA) is a type of breathing problem during sleep caused by the blockage of the upper airway, which can cause cessation of airflow. There is limited research on the prevalence of OSA in hypertensive patients in sub-Saharan Africa (SSA). The study aimed to describe the prevalence and clinical characteristics of OSA among hypertensive patients at a tertiary hospital in Nairobi, Kenya.

Methods: This cross-sectional study was conducted at the Aga Khan University Hospital in Nairobi, Kenya. Two hundred and fifty-one hypertensive patients were screened for OSA risk using the STOP-Bang questionnaire (SBQ). Patients with a SBQ …


Stop-Bang Questionnaire For Screening Obstructive Sleep Apnea Syndrome Among Hypertensive Patients In Kenya, Salim Abdallah, Jasmit Shah, Jumaa Bwika, Sayed Karar Sep 2023

Stop-Bang Questionnaire For Screening Obstructive Sleep Apnea Syndrome Among Hypertensive Patients In Kenya, Salim Abdallah, Jasmit Shah, Jumaa Bwika, Sayed Karar

Internal Medicine, East Africa

Introduction: Obstructive sleep apnea (OSA) is a type of breathing problem during sleep caused by the blockage of the upper airway, which can cause cessation of airflow. There is limited research on the prevalence of OSA in hypertensive patients in sub-Saharan Africa (SSA). The study aimed to describe the prevalence and clinical characteristics of OSA among hypertensive patients at a tertiary hospital in Nairobi, Kenya.

Methods: This cross-sectional study was conducted at the Aga Khan University Hospital in Nairobi, Kenya. Two hundred and fifty-one hypertensive patients were screened for OSA risk using the STOP-Bang questionnaire (SBQ). Patients with a SBQ …


An Electronic Health Record System Implementation In A Resource Limited Country—Lessons Learned, Sayed Karar, Muhammad Haroon Khan, Jasmit Shah, Nadeem Ahmed Sep 2023

An Electronic Health Record System Implementation In A Resource Limited Country—Lessons Learned, Sayed Karar, Muhammad Haroon Khan, Jasmit Shah, Nadeem Ahmed

Internal Medicine, East Africa

Electronic health records have revolutionized the medical world by improving medical care, refining provider documentation, standardizing care, and minimizing sentinel events. Successful implementation of electronic health records remains a daunting task and requires careful strategic planning and buy-in from key stakeholders. Much has been published in resource-rich settings and high-income countries about implementations of electronic health records. However, little is known about the experience in resource-limited settings where challenges remain unique and distinct from other parts of the world. Our intention is to share lessons learned during implementation of a web-based electronic health record at a tertiary care center in …


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 Sep 2023

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 …


Gall Bladder Schistosomiasis Diagnosed Incidentally Post Laparoscopic Cholecystectomy: A Case Report, Willbroad Kyejo, Sajida Panjwani, Ally Zain Ismail, Blessing Mathew, Caroline Ngimba, Ally Mwanga Sep 2023

Gall Bladder Schistosomiasis Diagnosed Incidentally Post Laparoscopic Cholecystectomy: A Case Report, Willbroad Kyejo, Sajida Panjwani, Ally Zain Ismail, Blessing Mathew, Caroline Ngimba, Ally Mwanga

Internal Medicine, East Africa

Introduction and importance: Schistosomiasis is a neglected tropical disease caused by parasitic worms of the genus Schistosoma. It primarily affects the intestines, liver, and urinary tract however, rare cases have been reported where the parasite invades other organs. This case report presents an incidental finding of schistosomiasis, upon histopathology evaluation, in a patient who underwent laparoscopic cholecystectomy for symptomatic gallstone disease with recurrent attacks of cholecystitis.

Case presentation: We present the case of a 42-year-old female patient who presented to the emergency department with symptoms and signs suggestive of acute cholecystitis. She underwent conservative management with interval laparoscopic cholecystectomy …


“Association Between Traumatic Life Events And Psychosis: A Case-Control Study In Western Kenya", Mohamed Aden Hillow, Lukoye Atwoli, Edith Kamaru Kwobah Aug 2023

“Association Between Traumatic Life Events And Psychosis: A Case-Control Study In Western Kenya", Mohamed Aden Hillow, Lukoye Atwoli, Edith Kamaru Kwobah

Internal Medicine, East Africa

Globally close to 70% of the general population has experienced at least one traumatic life event (TLE). Although child and adulthood exposure to TLEs is considered a risk factor for the subsequent development of psychosis, few studies have examined the association between trauma and psychosis in the African population.

We sought to explore the association between TLEs and psychosis in patients with psychotic disorders (N = 254) and individuals without (N = 254). The participants were matched by age and sex. The study was conducted at a national referral hospital, the Life Events Checklist for DSM-5 (LEC-5) was used to …


Determinants Of First‐Ever Stroke Severity In West Africans: Evidence From The Siren Study, Oladimeji Adebayo, Onoja Akpa, Osahon J. Asowata, Adekunle Fakunle, Fred S. Sarfo, Albert Akpalu, Kolawole Wahab, Reginald Obiako, Morenikeji Komolafe, Philip Adebayo Jun 2023

Determinants Of First‐Ever Stroke Severity In West Africans: Evidence From The Siren Study, Oladimeji Adebayo, Onoja Akpa, Osahon J. Asowata, Adekunle Fakunle, Fred S. Sarfo, Albert Akpalu, Kolawole Wahab, Reginald Obiako, Morenikeji Komolafe, Philip Adebayo

Internal Medicine, East Africa

Background: Baseline stroke severity is probably partly responsible for poor stroke outcomes in sub-Saharan Africa. However, there is a paucity of information on determinants of stroke severity among indigenous Africans. We sought to identify the factors associated with stroke severity among West Africans in the SIREN (Stroke Investigative Research and Educational Networks) study.

Methods and Results: Stroke was diagnosed clinically and confirmed with brain neuroimaging. Severe stroke was defined as a Stroke Levity Scale score of ≤5. A multivariate logistic regression model was constructed to identify factors associated with stroke severity at 95% CI and a nominal cutoff of 5% …


Microbiome Diversity In African American, European American, And Egyptian Colorectal Cancer Patients, Amr Elkholy, Nagavardhini Avuthu, Mohammed Abdalla, Michael Behring, Prachi Bajpai, Hyung-Gyoon Kim, Doaa Header, Reham Ah. Elwafa, Hesham Saed, Mansoor Saleh Jun 2023

Microbiome Diversity In African American, European American, And Egyptian Colorectal Cancer Patients, Amr Elkholy, Nagavardhini Avuthu, Mohammed Abdalla, Michael Behring, Prachi Bajpai, Hyung-Gyoon Kim, Doaa Header, Reham Ah. Elwafa, Hesham Saed, Mansoor Saleh

Internal Medicine, East Africa

Purpose: Although there is an established role for microbiome dysbiosis in the pathobiology of colorectal cancer (CRC), CRC patients of various race/ethnicities demonstrate distinct clinical behaviors. Thus, we investigated microbiome dysbiosis in Egyptian, African American (AA), and European American (EA) CRC patients.

Patients and methods: CRCs and their corresponding normal tissues from Egyptian (n = 17) patients of the Alexandria University Hospital, Egypt, and tissues from AA (n = 18) and EA (n = 19) patients at the University of Alabama at Birmingham were collected. DNA was isolated from frozen tissues, and the microbiome composition was analyzed by 16S rRNA …


Highlights From The Second Choosing Wisely Africa Conference: A Roadmap To Value-Based Cancer Care In East Africa (9–10 February 2023, Dar Es Salaam, Tanzania), Rugengamanzi Eulade, Godwin Abdiel Nnko, Jerry Ndumbalo, Nazima Dharsee, Larry O. Akoko, Christian Ntizimira, Beda Likonda, Harrison Chuwa, Salum Lidenge, Verna Vanderpuye, Nazik Hammad, Sikudhani Muya, Rubagumya Rubagumya May 2023

Highlights From The Second Choosing Wisely Africa Conference: A Roadmap To Value-Based Cancer Care In East Africa (9–10 February 2023, Dar Es Salaam, Tanzania), Rugengamanzi Eulade, Godwin Abdiel Nnko, Jerry Ndumbalo, Nazima Dharsee, Larry O. Akoko, Christian Ntizimira, Beda Likonda, Harrison Chuwa, Salum Lidenge, Verna Vanderpuye, Nazik Hammad, Sikudhani Muya, Rubagumya Rubagumya

Internal Medicine, East Africa

The ecancer Choosing Wisely conference was held for the second time in Africa in Dar es Salaam, Tanzania, from the 9th to 10th of February 2023. ecancer in collaboration with the Tanzania Oncology Society organised this conference which was attended by more than 150 local and international delegates. During the 2 days of the conference, more than ten speakers from different specialties in the field of oncology gave insights into Choosing Wisely in oncology. Topics from all fields linked to cancer care such as radiation oncology, medical oncology, prevention, oncological surgery, palliative care, patient advocacy, pathology, radiology, clinical trials, research …


Prevalence Of Antimicrobial Resistance And Association With Patient Outcomes In A Rural Kenyan Hospital, Ian C. Drobish, Immaculate K. Barasa, George Otieno, Moses Odhiambo Osoo, Solomon K. Thuo, Kaya S. Belknap, Arianna Mclain Shirk, S. Taylor Mcclanahan, Elizabeth Irungu, Felix Riunga May 2023

Prevalence Of Antimicrobial Resistance And Association With Patient Outcomes In A Rural Kenyan Hospital, Ian C. Drobish, Immaculate K. Barasa, George Otieno, Moses Odhiambo Osoo, Solomon K. Thuo, Kaya S. Belknap, Arianna Mclain Shirk, S. Taylor Mcclanahan, Elizabeth Irungu, Felix Riunga

Internal Medicine, East Africa

Data on antimicrobial resistance (AMR) and association with outcomes in resource-variable intensive care units (ICU) are lacking. Data currently available are limited to large, urban centers. We attempted to understand this locally through a dual-purpose, retrospective study. Cohort A consisted of adult and pediatric patients who had blood, urine, or cerebrospinal fluid cultures obtained from 2016 to 2020. A total of 3,013 isolates were used to create the Kijabe Hospital’s first antibiogram. Gram-negative organisms were found to be less than 50% susceptible to third- and fourth-generation cephalosporins, 67% susceptible to piperacillin–tazobactam, 87% susceptible to amikacin, and 93% susceptible to meropenem. …


Prevalence, Incidence And Chronicity Of Child Abuse Among Orphaned, Separated, And Street-Connected Children And Adolescents In Western Kenya: What Is The Impact Of Care Environment?, Samuel Ayaya, Allison Delong, Lonnie Embleton, David Ayuku, Edwin Sang, Joseph Hogan, Allan Kamanda, Lukoye Atwoli, Dominic Makori, Mary A. Ott, Caroline Ombok, Paula Braitstein May 2023

Prevalence, Incidence And Chronicity Of Child Abuse Among Orphaned, Separated, And Street-Connected Children And Adolescents In Western Kenya: What Is The Impact Of Care Environment?, Samuel Ayaya, Allison Delong, Lonnie Embleton, David Ayuku, Edwin Sang, Joseph Hogan, Allan Kamanda, Lukoye Atwoli, Dominic Makori, Mary A. Ott, Caroline Ombok, Paula Braitstein

Internal Medicine, East Africa

Background: The effect of different types of care environment on orphaned and separated children and adolescents’ (OSCA) experiences of abuse in sub-Saharan Africa is uncertain.

Objective: Our two primary objectives were 1) to compare recent child abuse (physical, emotional, and sexual) between OSCA living in institutional environments and those in family-based care; and 2) to understand how recent child abuse among street-connected children and youth compared to these other vulnerable youth populations.

Participants and setting: This project followed a cohort of OSCA in Uasin Gishu County, Kenya (2009–2019). This analysis includes 2393 participants aged 18 years and below, 1017 from …


Hiv Prevalence And Characteristics Among Patients With Aids-Defining And Non–Aids-Defining Cancers In A Tertiary Hospital In Kenya, Diana Muturi, Sitna Mwanzi, Felix Riunga, Jasmit Shah, Reena Shah Apr 2023

Hiv Prevalence And Characteristics Among Patients With Aids-Defining And Non–Aids-Defining Cancers In A Tertiary Hospital In Kenya, Diana Muturi, Sitna Mwanzi, Felix Riunga, Jasmit Shah, Reena Shah

Internal Medicine, East Africa

Purpose: Antiretroviral therapy (ART) has resulted in a higher life expectancy of persons living with HIV. This has led to an aging population at risk for both non–AIDS-defining cancers (NADCs) and AIDS-defining cancers (ADCs). HIV testing among patients with cancer in Kenya is not routinely performed, making its prevalence undefined. The aim of our study was to determine the prevalence of HIV and the spectrum of malignancies among HIV-positive and HIV-negative patients with cancer attending a tertiary hospital in Nairobi, Kenya.

Materials and Methods: We conducted a cross-sectional study between February 2021 and September 2021. Patients with a …