Medicine and Health Sciences Commons^™

Corrigendum: Correction Of Second Author’S Name And Affiliation In “Chorea As A Rare Manifestation Of Neuropsychiatric Systemic Lupus Erythematosus: A Case Report”, Editor Pjns

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Blood- Borne Biomarkers: Exploring The Frontiers Of Minimally-Invasive Diagnosis Of Alzheimer’S Disease, Sidra Afzal, Minahil Fatima, Nimra Afzal

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Optimal Anthropometric Discharge Criteria From Treatment Of Wasting: Meta-Analysis Of Individual Patient Data From 34 Studies, Lilia Bliznashka, Sandhya Chaudhary, Susan Rattigan, Sheila Isanaka, Ruth Adah, Tahmeed Ahmed, Nur Alam, Rodrigue Alitanou, Paluku Bahwere, Helen Nabwera

Paediatrics and Child Health, East Africa

Background: Community-based treatment of acute malnutrition saves lives, but recovered children remain at risk of relapse post-discharge. Strategies to reduce this risk may include modification of anthropometric discharge criteria.

Objectives: This study aims to compare the diagnostic accuracy of anthropometric indices to reduce post-discharge relapse risk.

Methods: We searched PubMed from inception to June 2022. We included studies that enrolled children aged 0–59 mo successfully treated for severe or moderate acute malnutrition (SAM or MAM), assessed anthropometry at discharge, and had ≥1 follow-up assessment ≤6 mo post-discharge. Pooled sensitivity and specificity for anthropometric indices at discharge over multiple cutoffs were …

Power, Interests, And Maternal Health Care: A Political Economy Analysis Of Service Delivery Redesign In Kenya, Jacinta Nzinga, Easter Olwanda, Kennedy Opondo, Hillary Kimutai, Jan Cooper, Brian Arwah, Benjamin Tsofa, Edwine Barasa, Kevin Croke

Institute for Human Development, East Africa

The maternal and newborn health (MNH) service delivery redesign (SDR) in Kakamega County, Kenya, represents the country's first system-level reorganization of MNH services. The reform aimed to improve care quality and reduce mortality by centralizing delivery services at designated hubs. Using a political economy lens, we examined how ideology, political dynamics, and institutional structures shaped the agenda-setting, adoption, implementation, and sustainability of SDR. We drew on data from document reviews, stakeholder analysis, semi-structured interviews, and non-participant observation to assess the structural, contextual, and institutional factors influencing the reform. Ambiguity around SDR's purpose contributed to the community's uncertain engagement characterized by …

Assessing Neurocognitive Functioning Among Adults Ageing With And Without Hiv At The Kenyan Coast: Measurement Issues And Correlates, Patrick Nzivo Mwangala, Carophine Nasambu, Ryan Wagner, Mihaela Duta, Gaia Scerif, Charles Newton, Amina Abubakar

Institute for Human Development, East Africa

Background: Cognitive impairment is one of the most prevalent complications of HIV infection, with significant medical and functional impacts. However, valid, and reliable assessment tools are lacking for the newly emergent ageing population of people living with HIV (PLWH) in many parts of sub-Saharan Africa (SSA), including Kenya. Without these tools, critical intervention opportunities, e.g., psychoeducation, treatment and additional support, are missed. To bridge this gap in Kenya, we adapted the Oxford Cognitive Screen Plus (OCSPlus), a tablet-based cognitive assessment tool designed for low-literacy settings, with adults ageing with HIV ≥ 50 years and their uninfected peers. This study examines …

Well-Being And Quality Of Life Of Kenyan Nurses, Midwives And Community Health Volunteers: Measurement Properties And Correlates Of The Bbq And Who-5, Paul Mwangi, Sabina Odero, Rachel Odhiambo, Brenda Nzioka, Constance Shumba, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Healthcare workers’ quality of life (QoL) and well-being is directly linked to the quality of services they deliver. However, there is a shortage of validated measures to assess QoL, well-being and their predictors among healthcare workers in Kenya, as in other LMICs. This study aimed to assess the reliability and validity of the Brunnsviken Brief Quality of Life Scale (BBQ) and WHO-5 well-being index (WHO-5) among nurses, midwives and community health volunteers (CHVs) in Kenya. The BBQ and WHO-5 were selected due to their established psychometric strengths, brevity, and prior use in healthcare settings. Additionally, the sociodemographic, psychological, and health …

Integrating Evidence Synthesis Into Doctoral Research: A Guide For Family Medicine And Primary Care, Klaus B. Von Pressentin, Jacob Shabani, Taryn Young

Family Medicine, East Africa

Given the increased complexity of healthcare needs, evidence-informed practices are needed, now more than ever. Combining the best available research evidence, the perspectives of patients and communities, and the voices of healthcare workers in guiding policy and practice is essential. All of us involved in providing and strengthening family medicine and primary care need to be good consumers (users) of research, and some will be good producers (doers) of research. In both using and doing research, a helpful starting point is evidence synthesis – a form of secondary research that collates primary research on the same research question. This short …

The Frontal Assessment Battery In Older Multilingual Kenyan Adults, Anne Njoki Gitere, Anne Nyambura, Karen Blackmon, Levi Muyela, Rachel Maina, Olivera Nesic Taylor,, Jasmit Shah, Dilraj Sokhi, Sylvia Mbugua, Samuel Gitau, Sheila Waa, Juzar Hooker, Zul Merali, Chinedu Momoh, Karen Blackmon

Brain and Mind Institute

Background: The Frontal Assessment Battery (FAB) was developed as a short (6-item) bedside assessment of executive dysfunction in older adults with suspected neurodegeneration. This study describes psychometric features of the FAB in multilingual Kenyan adults with and without clinical diagnosis of dementia.

Method: The FAB consists of six items assessing verbal abstract reasoning, lexical fluency, motor learning, and inhibitory control. The score on each item ranges from 0-3, with higher scores indicating better performance. Bilingual English-Swahili study personnel translated, blind back-translated, and applied consensus-driven cultural adaptations. FAB was then administered to 95 participants [71 cognitively unimpaired (CU) controls; 24 people …

Burden Of Neurodevelopmental Disorders In Kenyan Children, Symon Kariuki, Patricia Kipkemoi, Martha Kombe, Mary Bitta, Jacqueline Phillips Owen, Amina Abubakar, Charles Newton

Institute for Human Development, East Africa

Importance: Neurodevelopmental disorders (NDDs) such as autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and intellectual disability contribute to one-tenth of the global burden of mental and neurologic disorders. The burden of NDDs is not well documented in Africa.

Objective:To assess the prevalence, risk factors, and comorbidities of NDDs in young Kenyan children.

Design, setting and participants: This cross-sectional study was conducted among children aged 6 to 9 years residing in the Kilifi Health and Demographic Surveillance System in Kenya. In stage I of the study, children were screened for NDDs from March 16, 2015, to September 14, 2016; those …

Awareness And Usability Of Community And Facility-Based Health Sector Client Feedback Mechanism In Tanzania Public Health System. A Mixed Methods Study, James Kengia, Pius Kagoma, Ally Kinyaga, Helga Mutasingwa, Simon Debere, Robert Smith, Marcos Mzeru, Rashid Mbunda, Claud Kumalija, Paschal Ruggajo

Internal Medicine, East Africa

Background Client feedback systems are increasingly becoming important in person-centered health care. The systems provide opportunities to the public to interact with the health care providers and policymakers, present their concerns related to the performance of the health care system in order to improve the quality, equity, and responsiveness in the provision of services, hence increase social accountability. This study aimed to assess the situation of client feedback systems in Tanzania, focusing on the awareness and usability of existing facility- and community-based feedback platforms from the client’s perspective.

Methods The study employed a concurrent mixed-method design using both quantitative and …

Editorial – Dec 2025, Edwin Van Teijlingen, Rafat Jan

Journal of Asian Midwives (JAM)

No abstract provided.

Effect Of Focussing On Anastatica Hierochuntica Flower On Labour Pain, Duration Of Labour And Perceived Fatigue During Labour: Randomized Controlled Study, Emine Koç, Şükran Başgöl, Sümeyye Bal, Sabire Kirtiloğlu

Journal of Asian Midwives (JAM)

Background: Maternal fatigue and pain during labour can adversely affect the health of the mother, fetus, and newborn. Anastatica hierochuntica is a plant traditionally used in some cultures during childbirth rituals. When placed in water, the dried flower gradually unfolds and symbolically represents the opening of the uterus and birth canal. This study aimed to investigate the effect of focusing on the Anastatica hierochuntica flower during labour on labour pain, duration, and perceived fatigue.
Methods: This randomized controlled trial was conducted in the delivery unit of a mother-friendly hospital with 119 participants 60 in control group and 59 in intervention …

Factors Associated With Preterm Premature Rupture Of Membranes: A Case-Control Study In A Tertiary Hospital In Kabul, Afghanistan, Atia Sharif Nadi, Freshta Sharif Tawakkuli, Zainab Sharif Ezadi, Sayed Murtaza Sadat Hofiani, Shoaib Murtaza Sadat Naeemi, Ahmad Komail Frogh

Journal of Asian Midwives (JAM)

Background: It is essential to identify preterm premature rupture of membranes (PPROM) and its associated risk factors to reduce its impact. This study aims to find the demographic, reproductive, and obstetric factors associated with PPROM among women in Kabul, Afghanistan.
Methods: This case-control study was conducted over six months in 2023 at a tertiary hospital in Kabul, Afghanistan. We included 40 cases of PPROM and 80 controls without PPROM in this study. We used structured questionnaires to collect demographic, reproductive, and obstetric characteristics of the participants. To find the factors associated with PPROM, Logistic regression was performed using IBM SPSS …

A Scoping Review Of Maternal Active Smoking During Pregnancy And Low-Birth Weight, Naomi Sondang, Nindi Oktavia, Qorinah Estiningtyas Sakilah Adnani, Lani Gumilang, Hadi Susiarno, Victor Abiola Adepoju

Journal of Asian Midwives (JAM)

Background: Low-birth weight (LBW; < 2.5 kg) infants are at increased risk of early mortality, impaired growth, neuro-developmental delay and chronic disease later in life. Maternal behavior, especially cigarette smoking, remains one of the most modifiable determinants of birth weight. We therefore synthesized recent evidence on the association between active maternal smoking during pregnancy and LBW.
Methods: Following PRISMA guidance, we systematically searched PubMed, Scopus and ScienceDirect for the period January 2020 to 31 January 2025 for English-language observational studies that quantified the relationship between active prenatal smoking and LBW. Risk of bias was appraised, and findings were summarized narratively.
Results: In total 26,650 papers were found and eight eligible studies (four cohort, three cross-sectional, one case-control) from Asia, Europe and the Middle East were included. Across all designs and exposure metrics—self-report, exhaled carbon-monoxide, urinary cotinine, and cord-blood DNA-methylation, active smoking was consistently associated with …

Neurology Residency Training In Pakistan: Current Status And Future, Bashir Soomro

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Alarming Rate Of Hemorrhagic Stroke Showing An Urgent Need For Hypertension Control: A Retrospective Study From A Major Stroke Center In Sindh, Sana Ghous, Muhammad Hashim Kalwar, Muhammad Hassan Butt, Irfan Ali Vighio, Mehfooz Ali Shah, Javed Khurshed Shaikh, Mansoor Hassan

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective:

Hemorrhagic stroke accounts for approximately 18–20% of the global stroke burden and is associated with high mortality and disability. It poses a significant challenge in low- and middle-income countries, where delayed presentation and inadequate risk factor control worsen outcomes. Hypertension remains the most important modifiable risk factor, particularly when poorly controlled. The objective of this study was to investigate the incidence of hemorrhagic stroke at a major stroke center and its association with uncontrolled hypertension.

Methods:

This retrospective study was conducted at Sindh institute of cardiovascular diseases (SICVD) Sukkur over three months, from May to July 2024. …

Factors Associated With Stillbirth In Four Selected Hospital Maternity Units: An Unmatched Case-Control Study In Eswatini, Phetsile Thwala, Abednego Ongeso, Rose Maina, Benard Mutwiri

School of Nursing & Midwifery, East Africa

Background: Stillbirth is a substantially under-recognized adverse pregnancy outcome that predominantly occurs in low-middle-income countries. In 2019, Eswatini’s stillbirth rate was 13.2 per 1,000 births, higher than global targets. However, there is limited research on stillbirths in Eswatini. This study analyzed factors associated with stillbirths among women giving birth in four selected hospitals.

Methods: A multi-center unmatched case-control study was conducted using secondary data sources from July 1 to December 31, 2021. Birth records of 268 stillbirths (cases) and 1,151 live births (controls) were selected using consecutive and systematic random sampling, respectively. A piloted data extraction tool was used to …

Exploring Factors Informing The Choice Of Caesarean Sections Among Couples, And Healthcare Workers: A Case Of The Nairobi Hospital, Kenya, Mercy Mukubwa

MSc in Advanced Practice Midwifery

Background: A caesarean section (C/S) is a lifesaving procedure to reduce maternal and newborn morbidity and mortality. It is associated with more risks compared to a vaginal birth. The rates of C/S have been on an upward trend globally and are expected to continue to rise further. C/S predisposes neonates to poor outcomes, some of which could be life-threatening compared to vaginal birth. Similarly, C/S mothers are at greater risk for serious complications.

Objective: The primary objective of this study was to investigate the factors influencing the decision to undergo a caesarean section among couples and healthcare workers …

Lived Experiences Of Chemotherapy-Induced Nausea And Vomiting Among Patients Diagnosed With Cancer At Machakos Level Five Hospital, Nancy Njeri Kamau

MSc in Advanced Practice Nursing

Background: Chemotherapy-induced nausea and vomiting (CINV) remains one of the most prevalent and distressing adverse effects of cancer treatment, affecting a substantial proportion of patients and significantly compromising their physical functioning, nutritional status, treatment adherence, and overall quality of life. However, there is a paucity of localized evidence on the magnitude and functional burden of CINV among patients diagnosed with cancer receiving chemotherapy at county referral hospitals, such as Machakos Level 5 Hospital, hence the current study.

Aim of the study: The study aimed at exploring the lived experiences of chemotherapy induced nausea and vomiting among patients diagnosed with …

Asymptomatic Cryptococcal Antigenemia: A Multi-Clinic Cross-Sectional Study On The Prevalence, Associated Factors And Predictors Of Three-Month Outcomes Among Antiretroviralnaïve And Antiretroviral-Experienced Hiv Patients In Dar Es Salaam, Tanzania, Mandela Makakala, Mukasa Mohammed, Mabula Mabelele, Kamran Hameed, Philip Adebayo

Internal Medicine, East Africa

Background: Cryptococcal meningitis remains a leading cause of HIV/AIDS-related mortality, predominantly in Sub-Saharan Africa. Current screening and prevention efforts primarily target antiretroviral therapy (ART)-naïve patients, whereas strategies for ART-experienced individuals are less well defined.

Objectives: This study primarily aimed at determining the prevalence of asymptomatic cryptococcal antigenemia (ACA) among ART-naïve and ART-experienced patients, along with associated factors and predictors of three-month outcomes among HIV patients in three HIV clinics in Dar es Salaam, Tanzania. Secondarily, factors associated with serum cryptococcal antigen positivity in the overall study population were also assessed.

Methods: This cross-sectional clinic-based study recruited 273 HIV-positive participants (ART-naïve …

Living With Dementia In Kenya: Pathways To Care, Diagnosis And Management, Edna Bosire

Institute for Human Development, East Africa

Background: Sub-Saharan Africa (SSA) is experiencing a sharp rise in the size of theolder population; consequently, the incidence and prevalence of Alzheimer’s DiseaseRelated Dementias (AD/ADRD) is also expected to rise. There is limited research onAD/ADRD lived experiences have been conducted in SSA including Kenya. Our projectaimed to explore patient’s and caregivers lived experiences with Alzheimer’s disease inKenya.

Methods: This ethnographic study was conducted at the Aga Khan University hospital(AKUH), involving in-depth interviews with 21 health care providers, 26 patientswith mild cognitive impairment and 36 caregivers. We also conducted 10 homevisits and observations. Data were transcribed verbatim and thematically analysed.In what …

Drought, Worry, And Preparing For The Future: The Ethnopsychology Of Climate Distress In Kilifi County, Kenya, Edna Bosire, Syed Wahid, Linda Khakali, Benjamin Oestericher, Felix Agoi, Anthony Ngugi, Rosebella Iseme, Jasmit Shah, Zul Merali, Lukoye Atwoli

Brain and Mind Institute

The impacts of climate change in sub-Saharan Africa (SSA) presents a chronic and intensifying disaster, with drought, flooding, and extreme heat, presenting unique challenges and profound disruptions. Growing evidence links such events to ecological grief, ecological anxiety, and solastalgia – negative affective states that reflects responses to climate change related destruction of nature, species, culturally significant or sacred spaces, and other ways of life. While this literature is expanding in the Global North, little is known about how communities in SSA perceive and respond to deteriorating or depleting natural ecosystems. This article explores the ethnopsychology of distress precipitated by environmental …

Blood-Based Clinical Markers For Early Dementia Detection: Insights From Ad-Detect-Cohort, Benard Aliwa, Jasmit Shah, Olivera Nesic Taylor,, Samuel Nguku, Juzar Hooker, Dilraj Sokhi, Sylvia Mbugua, Litha Musili, Rachel Maina, Harrison Kaleli, Levi Muyela, Anne Njoki Gitere, Anne Nyambura, Zul Merali, Karen Blackmon, Chinedu Momoh

Brain and Mind Institute

Background: Over 55 million people worldwide live with dementia, with more than60% residing in low- and middle-income countries. Alzheimer’s disease, the mostcommon form of dementia, accounts for 60–70% of cases. Early and accurate diagnosisremains a global challenge, necessitating novel approaches to mitigate the diseaseburden. Biomarkers hold significant promise in improving diagnostic accuracy andpredicting disease progression. Validated biomarkers for the preclinical stages ofdementia are crucial for advancing diagnosis and therapeutic strategies. We aimedto identify potential clinical markers for early dementia detection and assess theirpredictive accuracy in identifying high-risk individuals.

Method: We analyzed blood samples from dementia cases (n = 30) and …

Community Perspectives On Factors Contributing To Resilience For Healthy Aging In Kenya, Linda Khakali, Everline Onchari, Maureen Ondire, Catherine Onyancha, Chinedu Momoh, Edna Bosire

Brain and Mind Institute

Background: The global elderly population is increasing and expected to double in thenext decade. Aging increases the likelihood of adversities, with resilience becomingan important aspect of healthy aging. Understanding how individuals conceptualizeresilience offers an opportunity to create contextually relevant interventions forpromoting healthy aging. This study aimed to explore adults’ perspectives on factorsinfluencing resilience in Kenya.

Method: Using qualitative methods, 36 adults aged 35 years and above werepurposively recruited from various communities in Nairobi County to participate ininterviews. We asked questions about their understanding of aging, adversity andresiliency. We also provided them with case scenarios of two individuals respondingdifferently to the …

Reassessing Dementia Risk: Expanding The 2024 Lancet Commission Report For A More Accurate Global Understanding, Cyprian Mostert

Brain and Mind Institute

Background: The 2024 Lancet Commission Report analyzes 14 risk factors thataccount for 45 percent of global dementia cases. However, it overlooks four criticalrisk factors: poverty, wealth shocks, income inequality, and viral infections. This isparticularly concerning given that 57 percent of the identified risk factors in theLancet report are more prevalent in men, even though dementia predominantly affectswomen worldwide.

Method: In this policy paper, we used the recent global review studies and argue that itis essential to recalibrate and expand the 2024 Lancet Commission’s list of risk factorsto include poverty, wealth shocks, income inequality, and viral infections. Our analysissuggests that these …

Understanding And Willingness To Participate In Dementia Clinical Trials In Kenya: An Ethnographic Study, Edna Bosire, Lucy Kamau, Chinedu Momoh, Jasmit Shah, Karen Blackmon, Caroline Kiio, Irene Meier, Vaibhav Narayan, Olivera Nesic Taylor,, Zul Merali

Brain and Mind Institute

Background: Advancements in dementia research are in part contingent on participation in clinical research. Clinical trials can help researchers determine if new drugs, devices, or diagnostic procedures for dementia are safe and effective. However, little is known about clinical trials for dementia in resource constrained settings such as Kenya. The aim of our research was to explore people’s understanding of dementia clinical trials, their attitudes and perceptions towards dementia clinical trials and what can be done to enhance enrollments on such clinical trials.

Method: This was an ethnographic study involving 8 focused group discussions (FGDs; age and gender stratified; n=81) …

Perceptions And Attitudes On Biospecimen Sample Collection For Dementia Research In Kenya, Lucy Kamau, Chinedu Momoh, Karen Blackmon, Caroline Kiio, Jasmit Shah, Vaibhav Narayan, Irene Meier, Olivera Nesic Taylor,, Zul Merali, Edna Bosire

Brain and Mind Institute

Background: Biospecimen sample collection is crucial in dementia diagnosis and evaluation. Limited research exists from African Countries including Kenya on people's perception on biospecimen sample collection for dementia- a disease that is largely unknown. Our aim was to understand the public perceptions towards collection of biospecimen samples for dementia research in Kenya.

Method: We conducted 8 focused group discussions (FGDs; age and gender stratified) in Nairobi to understand people's perceptions about different biospecimens (urine, saliva, blood, tears, hair, cerebrospinal fluid (CSF) and the brain samples). An open-ended FGD guide was used for the discussions, each lasting about 90 minutes.

Result: …

Determinants Of Mental Health-Seeking Behaviour Among Upgrading Nursing Students At The Aga Khan University, Kenya, Cecilia Wanjiru Ndungu

MSc in Advanced Practice Nursing

Background: Mental health challenges are increasingly recognised, and nursing students often report higher stress and anxiety than other peers.Working nurses in upgrading programmes face additional pressure from balancing work, study and family,yet remain under-studied. At Aga Khan University in Kenya, the determinants influencing mental health-seeking behaviour among upgrading nursing students have not been documented, which is critical for addressing mental health needs. This study aimed to investigate the biological, psychological, and sociological factors influencing mental health-seeking behavior in this cohort.

Methodology: A descriptive cross-sectional study was conducted among 106 upgrading nursing students at AKU, utilizing structured questionnaires to …

Determinants Of Utilization Of Skilled Birth Attendant Among Women Of Reproductive Age In Habeswein Ward, Wajir County, Kenya, Suada Hassan

MSc in Advanced Practice Midwifery

Background: Maternal care provided by a skilled birth attendant (SBA) during pregnancy, at delivery, childbirth, and the postpartum period is vital for reducing maternal and neonatal mortality. In sub-Saharan Africa, the overall prevalence of usage of SBA in a 2021 study was 63%. Tanzania recorded the lowest rate at 13.8%, while Kenya registered 89.3% in 2023. However, disparities exist within Kenyan counties, for instance, in Wajir County only 57% of births were assisted by skilled health providers, a disparity that could be due to socio-cultural differences.

Aim: This study aimed to determine the factors influencing the utilization of skilled …

Perceived Stress And Coping Mechanisms Among Nurses Working In Oncology Inpatient Units At Kenyatta National Hospital, Bole Ado

MSc in Advanced Practice Nursing

Introduction: Cancer is the second leading cause of death globally and the third leading cause of death in Kenya. Nurses in oncology units often experience stress because of the emotionally demanding nature of providing care for patients diagnosed with cancer. Global studies show that nurses in the oncology unit reported experiencing moderate to extreme work-related stress, with a prevalence of work stress globally varying between 9.2% to 68% globally. Many nurses experience stress, and because of ineffective coping mechanisms, this affects their psychological well-being and negatively impacts the quality of their care as well as patients’ outcomes.

Objective of the …