Medicine and Health Sciences Commons^™

Sexual Dysfunction In Women With Endometriosis In A Low-Middle-Income Country, Edna Chacha, Charles Muteshi, Felix Oindi, Elsie Wandera

Obstetrics and Gynaecology, East Africa

Background Endometriosis affects up to 10% of reproductive-age women and significantly impairs quality of life including sexual function, intimate relationships, fertility, and psychological wellbeing. While its impact has been extensively studied in Western populations, there is limited Sub-Saharan African data exploring how the disease affects female sexual health and distress. This study aimed to assess sexual function and sexual distress among women with endometriosis at a tertiary hospital in Kenya.

Methods A cross-sectional study was conducted involving 108 women aged 18 to 49 with confirmed endometriosis from January to June 2022. The study used validated self-administered questionnaires: Female Sexual Function …

Predicting Off-Track Development In Infants Aged 0–6 Months In Low-Resource Settings Using Machine Learning, Faith Benson, Rachel Odhiambo, Anthony Ngugi, Willie Brink, Akbar Waljee, Cheryl Moyer, Ji Zhu, Felix Agoi, Amina Abubakar

Institute for Human Development, East Africa

Background This study aimed to address the critical gap in the limited application of machine learning (ML) for identifying developmental delays in low-resource settings by developing models to predict off-track development in infants aged 0 to 6 months and identify key predictors.

Methods A cross-sectional study involving 1,995 singleton infants aged 0 to 6 months was conducted in Kaloleni and Rabai sub-counties, Kilifi, Kenya, between March 2023 and March 2024. Development was assessed using the World Health Organization’s Indicators of Infant and Young Child Development tool, with Development-for-Age Z-scores used to classify infants as on- or off-track. Ridge logistic regression …

A Systematic Review Of Disparities In Alzheimer’S Diagnosis: The Overlooked Impact Of Gender And Ethnoracial Diversity On Biomarker Expression, Cynthia Smith, Olisaemeka Ogbue, Nasra Gathoni, Karen Blackmon, Tamlyn J. Watermeyer, Jasmit Shah, Chinedu Momoh

Brain and Mind Institute

Background: Biomarkers hold significant promise for the early diagnosis of dementias like Alzheimer's disease (AD). However, less than 5% of research data originates from Black African or African American populations, despite Africa's increasing dementia burden. Additionally, women are disproportionately affected by dementia globally, a trend that is expected to persist. This systematic review aims to synthesize studies on sex and gender differences in AD biomarkers, with a focus on African populations.

Method: We have conducted systematic searches across PubMed, Scopus, Web of Science, SciELO, and African journals online for articles published between 2000 and 2024. Our focus is …

One-Stop-Shop (Oss): Community Health Nursing: (For Undergraduate Nurses), Sarmad Muhammad Soomar

Books

No abstract provided.

How Effective Is Online Teaching Of Physiology Modules? Perception Of Rwandan Health Sciences Students, Abdullateef Isiaka Alagbonsi, Mojeed Akorede Gbadamosi, Mathieu Nemerimana, Makinde V. Olubiyi, Olufunke Onaadepo, Akaninyene Ubong Ime, Abdul-Rahuf Aderemi Feyitimi, Ruth Wanjiru Mungai, Florent Rutagarama, Simiat Elias

Biomedical Sciences, East Africa

Background: While blended teaching is approved in Rwandan medical education, the perceived effectiveness of online-only delivery for physiology modules remains unclear. This uncertainty limits its continued use. The present study assessed Rwandan health sciences students’ perceptions of the effectiveness of online teaching for physiology modules.

Methods: A total of 528 students from medicine and surgery (n = 300), pharmacy (n = 99), dentistry (n = 89), and clinical psychology (n = 40) programs at the University of Rwanda completed an online questionnaire. Data were analyzed using multivariable logistic regression and non-parametric tests (Mann-Whitney U, Kruskal-Wallis) with corresponding effect …

Infected Intra-Abdominal Hematoma Post-Laparoscopic One-Anastomosis Mini Gastric Bypass: Case Report And Literature Review, Musa Machibya, Hellen Mram, Jackline Gabone, Ally Mwanga, Tanseer Asghar, Authar Ali

General Surgery, East Africa

Introduction: Laparoscopic one-anastomosis gastric bypass (OAGB) is a widely performed bariatric procedure with favorable outcomes; however, it carries a risk of postoperative complications. An infected intra-abdominal hematoma is a rare but potentially serious complication, often presenting with nonspecific features that can delay diagnosis.

Case presentation: A 29-year-old female with class II obesity (BMI 36 kg/m2 ) underwent elective laparoscopic OAGB. The immediate postoperative course was uneventful, and she was discharged in stable condition. Eleven days later, she presented with fever and systemic symptoms without significant abdominal findings. Laboratory investigations suggested sepsis. Imaging revealed a large perigastric collection consistent with …

Reversible Hemi-Parkinsonism Syndrome Secondary To Bilateral Subdural Hematomas: Case Report And Literature Review, Musa Machibya, Godlove Mlay, Kelvin Sawe, Zainab Ali, Mugisha Clement, Philip Adebayo

General Surgery, East Africa

Introduction: Chronic subdural hematoma (CSDH) is a rare but reversible cause of secondary parkinsonism. Bilateral CSDH presenting with unilateral parkinsonian features is exceptionally uncommon.

Case presentation: A 61-year-old male from Comoros developed a right-hand tremor, intermittent dystonia, and mild right-sided motor deficits months after a motor vehicle accident. Medical therapy was ineffective. Imaging revealed bilateral frontoparietal subdural collections with a right hematoma causing a midline shift. Bilateral burr-hole evacuation led to marked improvement, with the UPDRS Part III score improving from approximately 7 to 1–2 points and near-complete hematoma resolution on follow-up.

Discussion: This case demonstrates the variable …

Mental Health And Art Adherence In A Multisite International Study: The Mediating Roles Of Social Support And Substance Use In People With Hiv, Joseph Awad, Wenxiu Sun, Diane Santa Maria, Rebecca Schnall, Panta Apiruknapanond, Tongyao Wang, Claudia Patricia Valencia, Christine Horvat Davey, Solymar Solis Baez, Sheila Shaibu

School of Nursing & Midwifery, East Africa

ART adherence, essential to preventing disease progression for people living with HIV (PLHIV), remains challenged by factors like poor mental health condition, insufficient social support, and substance use. This study investigates the roles of social support and substance use as mediators in the relationship between mental health and antiretroviral therapy (ART) adherence among PLHIV in a multisite, international context. Cross-sectional data from N = 1598 PLHIV across eight countries were analyzed using parallel mediation analyses in R. Results indicated that both social support and substance use independently mediated the relationship between mental health and ART adherence. Hallucinogens mediated the mental …

Formal And Informal Digital Health In Tanzania: Healthcare Workforce, Regulatory And Trust Implications Of E-Patients And Virtual Care And The Development Of The Trust Framework, Kahabi Isangula, Judith Keebisilo Leo, James Tumaini Kengia

School of Nursing & Midwifery, East Africa

Digital health and virtual care are increasingly reshaping how healthcare is organized, delivered, and experienced. In Tanzania, digital transformation is evident in national commitments to digital health governance, health information exchange, hospital information systems, digital referral and emergency transportation, telemedicine, and emerging diagnostic applications supported by artificial intelligence. At the same time, patients are increasingly using social media, mobile platforms, and other digital channels to seek health information, consultations, diagnoses, and medicines, creating new forms of digitally mediated care that often operate alongside formal healthcare systems. Using a narrative synthesis design informed by a practice-based perspective, this study reviewed policy …

Sex Differences In Clinical Characteristics, Treatment, And Outcomes Of Cardiovascular Disease: Kenya Heart Registry Analysis, Lilian Mbau, Martha Gulati, Mzee Ngunga, Jasmit Shah, Felix Barasa, Jeilan Mohamed, Anders Barasa, Bernard Gitura, Harun Otieno, Etienne Amendezo

Internal Medicine, East Africa

Background Cardiovascular disease is the leading cause of death globally, with approximately 80% of these deaths occurring in low- and middle-income countries. Sex differences in cardiovascular disease are well described in high-income countries but limited in low- and middle-income countries.

Objectives This study sought to evaluate the sex differences in clinical presentation, cardiovascular risk profile, diagnosis, treatment, and outcomes among patients in the Kenya Heart Registry.

Methods Data were prospectively collected from 3 tertiary hospitals, including patients with heart failure, acute coronary syndrome, venous thromboembolism, and atrial fibrillation. Primary outcomes were in-hospital and 6-month mortality, as well as sex-specific differences …

In Memoriam: Professor Dan J. Stein (1962-2025) — A Global Pioneer With An African Heart, Gregers Wegener, Bernard Lerer, Alan Frazer, Anthony Grace, Kazutaka Ikeda, Gabriella Gobbi, Allan Young, Joseph Zohar, Pierre Blier, Lukoye Atwoli

Internal Medicine, East Africa

With profound sadness we mark the passing of Professor Dan J. Stein—clinician, scientist, philosopher, and friend. A pioneer of International and African psychiatry, and a central figure in global neuropsychopharmacology, he devoted his life to understanding and relieving the burden of mental disorders in South Africa, across the African continent, and worldwide. In his death, we have lost a true giant.

Experience Of Using Anti-Cd 20 Therapies In Multiple Sclerosis Patients In Kenya, Eunice Nyambane, Tejal Patel, Jacqueline Mavuti, Juzar Hooker, Dilraj Sokhi

Internal Medicine, East Africa

Objective: The objective of the study was to evaluate the safety and efficacy of ocrelizumab (OCR) and rituximab (RTX) in multiple sclerosis.

Methods: This was a retrospective single-centre study. Ocrelizumab- and rituximab-treated patients were identified through the multiple sclerosis (MS) registry maintained at Aga Khan University Hospital Nairobi (AKUHN), Kenya. Adult patients aged 18–65 years old who fulfilled the McDonald 2017 diagnosis criteria and received treatment with either rituximab or ocrelizumab between January 2016 and June 2025 were retrospectively evaluated. Data collected at baseline included age, gender, first symptoms, disease duration since onset, MS phenotype, treatment duration, previous …

Surgical Interventions For Treating Vesicovaginal Fistula In Women, Yoshiyuki Okada, Tomomi Matsushita, Takeshi Hasegawa, Hisashi Noma, Erika Ota, Bob Achila, Yasukuni Yoshimura

Obstetrics and Gynaecology, East Africa

Objectives This is a protocol for a Cochrane Review (intervention). The objectives are as follows:

To assess the benefits and harms of surgical interventions for treating vesicovaginal fistula in women.

Pregnant Women’S Attitudes And Intentions Toward Tuberculosis, Malaria, Group B Streptococcus, And Respiratory Syncytial Virus Vaccines In Pregnant: Findings From A Cross-Sectional Study Of Pregnant Women Living In Brazil, Ghana, Kenya, And Pakistan, Rupali Limaye, Jessica Schue, Berhaun Fesshaye, Prachi Singh, Emily Miller, Renato Souza, Saleem Jessani, Marleen Temmerman, Caroline Dinam Badzi, Molly Sauer, Vanessa Brizuela, Ruth Karron

Centre of Excellence in Women and Child Health

There are numerous infections that can adversely impact a developing fetus, neonates, and pregnant women, and there is limited research related to how specific infections experienced during pregnancy can affect these populations. Tuberculosis (TB), malaria, Group B streptococcus (GBS) and respiratory syncytial virus (RSV) can cause negative outcomes to maternal and neonatal health. For TB and GBS, there are vaccines in various stages of clinical trial development, and malaria and RSV vaccines are available. This study aimed to examine pregnant women’s attitudes toward TB, malaria, GBS, and RSV vaccines in Brazil, Ghana, Kenya, and Pakistan. We administered a cross-sectional survey …

Predicting Dementia Risk: Progress, Pitfalls, And Priorities, Patricia Nistor, Osvaldo Espin-Garcia, Zul Merali, Shehzad Ali

Brain and Mind Institute

As populations age, identifying individuals at high risk for dementia has become a cornerstone of prevention-oriented public health policy. Accurate and scalable risk stratification could enable early intervention and resource targeting. However, existing models face methodological limitations, including constraints in available data and follow-up duration, challenges in dementia ascertainment, heterogeneity in modelling approaches, and limited external validation. This commentary discusses these challenges and identifies methodological priorities for developing dementia risk algorithms that are robust and suitable for real-world implementation.

Subfascial-Cutaneous Propeller Flap For Reconstruction Of Chronic Distal Lower-Limb Wounds With Exposed Bone: Two-Case Reports, Musa Machibya, Mike Kimambo, Irfan Rajput, Raymond Oyugi, Edwin Mrema

General Surgery, East Africa

Introduction and importance: Propeller perforator flaps provide a reliable reconstructive option for distal lower-limb soft-tissue defects, particularly in resource-limited settings where microsurgical free-flap reconstruction may not be readily available. These cases highlight the practical application of propeller perforator flaps in a low-resource setting, demonstrate key surgical decision-making processes, illustrate the management of flap-related complications, and report favorable functional outcomes following reconstruction of complex distal lower-limb wounds.

Case presentation: We present two patients with distal lower-limb wounds and exposed bone: a 33-year-old man with a post-traumatic medial malleolar defect reconstructed using a posterior tibial artery perforator propeller flap, and …

Spectrum Of Neurodevelopmental Disorders In Children Attending A Developmental Clinic In Dar Es Salaam, Tanzania, Aleya Zulfikar Remtulla, Sumayyah Nasiruddin Saudin, Orujul Hassan, Mariam Noorani

Paediatrics and Child Health, East Africa

Background: Neurodevelopmental disorders (NDDs) in children present significant challenges for healthcare systems globally. In Tanzania, children with NDDs and their families face significant challenges due to late diagnosis, lack of standardized screening tools, widespread stigma and cultural beliefs that deter health-seeking behaviours. Awareness about NDDs is low, and financial constraints further complicate access to necessary medical interventions. The country suffers from a severe shortage of specialized healthcare providers, and general healthcare providers often lack adequate training. Additionally, limited specialized facilities, high treatment costs and insufficient healthcare policies dedicated to NDDs make it difficult to manage these conditions effectively. Understanding the …

Determinants Of Awareness And Acceptability Of Hiv Pre-Exposure Prophylaxis (Prep) Among Men In Kenya, John Baptist Asiimwe, Lilian Nuwabaine, Isaac Alinda, Earnest Amwiine, Robert Kiza, Ibrahim Franklyn Kamara

School of Nursing & Midwifery, East Africa

Abstract: Background Although pre-exposure prophylaxis (PrEP) is prioritised for men at heightened risk of HIV, examining the determinants of PrEP awareness and acceptability among men in the general population is essential for informing inclusive and effective HIV prevention strategies in Kenya.

Methods: We analyzed secondary data from the 2022 Kenya Demographic and Health Survey (KDHS), which comprised 14,402 men aged 18–54 years who were selected using a two-stage stratified sampling. Data were analysed using univariable and multivariable logistic regression analyses using SPSS (version 29).

Results: Overall, 49.3% (95% CI: 47.4–51.2) of men were aware of PrEP. Among those who …

Comprehensive Analysis Platform To Understand, Remedy, And Eliminate Amyotrophic Lateral Sclerosis (Capture Als): Study Protocol For A Canadian Multicenter, Multimodal, Longitudinal Observational Study, Natalie Saunders, Claire Magnussen, Hyungmo Kang, Mathieu Blais, Harpreet Bhinder, Gerald Pfeffer, Shelagh K. Genuis, Liziane Bouvier, Tanushka Anand, Tania M. Bubela

Office of the Provost

Background: The marked heterogeneity of Amyotrophic Lateral Sclerosis (ALS) combined with a lack of biomarkers are key contributing factors to the lack of disease-modifying treatments. The Comprehensive Analysis Platform to Understand Remedy and Eliminate ALS (CAPTURE ALS) is a Canadian platform designed to create the most comprehensive picture of people living with ALS with the objective of facilitating ALS research initiatives worldwide.
Objectives: The main aims of CAPTURE ALS include: (1) to characterize ALS and healthy controls with biosamples and data in order to provide the most comprehensive picture of individuals living with ALS to date; (2) to create a …

Lived Experiences And Educational Needs Of Women With A History Of Preeclampsia: A Qualitative Phenomenological Study In Indonesia, Fitriana Fitriana, Ani Kristianingsih, Nopi Anggistaputri

Journal of Asian Midwives (JAM)

Background: preeclampsia (PE).\ is one of the leading causes of maternal morbidity and mortality worldwide Many pregnant women fail to recognize early warning signs of the condition despite attending antenatal care, for reasons such as limited understanding of PE symptoms and/ or inadequate communication of health information by healthcare providers. Women with a previous history of PE are particularly vulnerable and require targeted educational support during subsequent pregnancies.
Methods: Eight pregnant women with a documented history of PE in their second or third trimester participated in in-depth semi-structured interviews using an interpretative phenomenological technique.  To ensure credibility and reliability, the …

Too Young, Too Risky: Maternal And Neonatal Outcomes Of Teenage Pregnancy In Pakistan, A Scoping Review, Sumia Andleeb Abbasi, Noor E Marfa Shivji, Warisha Qamar, Tayyaba Riaz Abbasi, Abdullah Riaz Abbasi, Raja Adan Asif

Journal of Asian Midwives (JAM)

Introduction: Teenage pregnancy is a global concern that affects both the developed and developing regions. Adolescent pregnancy is associated with serious maternal and child health outcomes. This paper aims to identify the prevalence and patterns of maternal child health outcome of adolescent’s pregnancies.
Methods: This review utilized the PRISMA-ScR guidelines. To identify the outcomes of the adolescent pregnancies, a wide-ranging search strategy was implemented. Data were extracted from 15 eligible studies with a total population of 5692participants from Pakistan. The studies included maternal characteristics, mode of delivery, and neonatal outcomes. Only quantitative methods were included.
Results: The review of 15 …

Factors Associated With Emergency Hospitalization Of Kidney Disease Patients In A National Hospital Kenya., Dorcus Miyombe

MSc in Advanced Practice Nursing

Introduction: Emergency hospitalizations among End Stage Kidney Disease (ESKD) is a major global health burden, with low- and middle-income countries in sub-Saharan Africa (SSA), experiencing the highest rates of morbidity and mortality. Limited resource, economic burden, and insufficient health infrastructure were the main challenges. Emergency hospitalizations at Kenyatta National Hospital remains high due to systemic gaps and poor continuity of care. Prerenal, intrarenal, post-renal injuries, as well as any combination of these, are the primary causes of ESKD. There are stipulated guidelines for ESKD patients’ management however, realization of these goals has not been achieved leading to hospitalization KDIGO …

Community Health Promoters’ Experiences In Mitigation Of Cardiovascular Diseases In Lari Sub-County - Kiambu County, Kenya, Emily Njeri Muchina

MSc in Advanced Practice Nursing

Background: Cardiovascular diseases (CVDs) are a rising public health issue in low- and middle-income countries, including Kenya, where there is an escalation of their deaths and preventable risk factors. Community health promoters (CHPs) have a crucial role in the prevention of CVDs. Yet, low knowledge of CVD prevention and low detection of CVD risk factors characterise most underserved communities in Kenya. Little has been documented about CHPs' experiences in mitigating CVDs despite the presence of multilevel barriers and facilitators that can shape their experiences.

Aim: To gain an in-depth insight into the experiences of CHPs in mitigating CVD …

Predictors Of Complications Among Adult Patients Diagnosed With Type 2 Diabetis Mellitus At Thika Level Five Hospital, Kenya, Bernard Wambua Mbithi

MSc in Advanced Practice Nursing

Introduction: Despite advances in the management of Type 2 diabetes mellitus (T2DM), anecdotal reports from Thika Level Five Hospital indicate that patients still present with diabetes mellitus-associated complications. Therefore, this research aimed to determine the predictors of complications among adult patients diagnosed with T2DM in the hospital.

Methodology: Analytical cross-sectional design was utilized in this research. To select the respondents, purposive sampling was used to recruit six nurse managers and their deputies (making a total of 12 nurses), while 294 patients in the clinic were recruited using systematic sampling. Purposive sampling was also used to recruit 15 patients …

Spectrum Of Headache Disorders In Pakistan: A Multicenter Study, Amina Javed, Shafaq Saleem, Safia Awan, Saba Zaidi, Manzoor Lakhair, Fahad Saleem, Waleed Shahzad, Ahmed Wali

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective:

Headache disorders represent some of the most prevalent neurological conditions worldwide. While community-based

studies provide general prevalence, data on their diagnostic spectrum in specialized clinical settings in Pakistan remain

limited. The objective of this multicenter study was to evaluate the demographic distribution and spectrum of headache

disorders among patients presenting to neurological services across Pakistan.

Methods:

This cross-sectional observational study was carried out at 39 neurology centers across Pakistan, from August 2017

to December 2019. Diagnosis was made using International Classification of Headache Disorders, 3rd edition

(ICHD-3). Demographic details, and headache subtypes were compared across gender and …

Electrophysiological Localization And Prognostic Indicators In Radial Neuropathy Presenting As Wrist Drop: A Three-Year Retrospective Observational Study, Assad Ullah Khan, Muhammad Farooq, Saad Ali, Sadiq Ali Shah

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective:

Radial neuropathy is a common cause of wrist drop, and accurate lesion localization is essential for appropriate

management and prognostication. The objective of this study was to analyze electrophysiological localization patterns

of radial nerve lesions presenting as wrist drop and to assess whether earlier referral for electrophysiological evaluation

was associated with recovery outcomes.

Methods:

This retrospective observational study was conducted at Lady Reading Hospital Peshawar, a tertiary care setting, over

a three-year period (January 2022–December 2024). Adult patients with wrist drop and electrophysiological confirmed

radial neuropathy were included. Nerve conduction studies and needle electromyography were used to …

Visual And Brainstem Evoked Potentials: A Retrospective Cross-Sectional Audit From A Tertiary Care Hospital In Pakistan, Zuha Amin Alvi, Sundus Mehtab Shafee, Zahra Talib Shah, Dureshahwar Kanwar, Sajid Hameed

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective:

Visual and brainstem auditory evoked potentials (VEPs and BAEPs) are standard techniques for evaluating the integrity of visual and auditory pathways respectively. The objective of our audit study was to assess demographic trends,referral indications, and electrophysiological outcomes of patients undergoing VEP and BAEP testing in a tertiary care neurophysiology laboratory in Pakistan.

Methods:

A retrospective, cross-sectional audit was conducted of 952 patient records (VEP, n=219; BAEP, n=733) over a three-year period from neurophysiology laboratory of Aga Khan University Hospital. Demographic characteristics,clinical referral indications, and electrophysiological findings were collected. Standard ACNS guidelines were used for all recordings. Statistical …

Subacute Sclerosing Panencephalitis In A 24-Month-Old Child: A Rare Early Onset And Alarming Presentation, Arshad Mehmood, Javeria Raza Alvi, Sameen Qureshi, Ahmed Bilal, Shaila Ali, Tipu Sultan

Pakistan Journal of Neurological Sciences (PJNS)

Subacute sclerosing panencephalitis (SSPE) is a rare, progressive, and fatal neurodegenerative disorder caused by persistent measles virus infection. Early-onset SSPE in children under five years is uncommon but often rapidly progressive. We report a 24-month-old unvaccinated male who presented with progressive myoclonic seizures, gait difficulty, and rapid neurodevelopmental regression. Electroencephalography (EEG) showed periodic generalized discharges, and CSF measles antibody titers were elevated, fulfilling modified Dyken criteria. The child was classified as stage III SSPE. Symptomatic therapy including anti-seizure medications and supportive care, along with a planned ketogenic diet, was initiated but neurological outcome remained poor. This case emphasizes the aggressive …

Challenges Of Neurological Care In A Public Sector Hospital In Pakistan, Anila Umer

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Lack Of Multidisciplinary Collaboration In Stroke Rehabilitation In Pakistan: A Call For Integrated Care Models, Etisam Wahid, Shahzad Ahmad, Nimrah Humayoon

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.