Medicine and Health Sciences Commons^™

Lymphoma Imaging In Hiv And Non-Hiv Patients: A Retrospective Cross-Sectional Study With Clinical And Pathological Correlation, Poonamjeet Loyal, Edward Chege, Jasmit Shah, Anne Mwirigi, Samuel Gitau

Imaging & Diagnostic Radiology, East Africa

Background: Patients with Human Immunodeficiency Virus (HIV)have an atypical imaging pattern of lymphoma. There is paucity of literature on differences in tumor volume or burden of disease amongst HIV positive patients compared with HIV negative patients and how this correlates with clinicopathological parameters of aggressiveness and prognosis.

Methods: This was a retrospective cross-sectional study of patients with non-Hodgkin lymphoma which were categorized into HIV positive and HIV negative. The tumor burden, disease sites, international prognostic score and Ki-67 index were recorded. Continuous variables were analyzed using the Kruskal Wallis test and categorical variables with Fisher’s Exact test.

Results …

Not All That Hurts Is Malignant: A Painful Case Of Focal Nodular Hyperplasia, Zamanali Khakhar, Abdullahi Abdigafar Yunis, Dayib Buthul, Khadija Warfa, Soraiya Manji, Rajiv Patel, Sayed Ali Raza Bukhari

Imaging & Diagnostic Radiology, East Africa

Focal nodular hyperplasia (FNH) is a benign hepatic lesion most often detected incidentally during imaging studies. While typically asymptomatic, a small subset of patients may present with abdominal pain or discomfort. Clinically and radiologically, FNH can mimic malignant liver tumors, occasionally resulting in unnecessary invasive procedures. This case report describes a 45-year-old woman with symptomatic FNH who was placed on routine imaging surveillance and managed conservatively. This case underscores the importance of accurately distinguishing this benign condition from hepatic malignancies. It further highlights the diagnostic challenges associated with achieving a definitive diagnosis.

Challenges And Opportunities With Providing Genetic Testing And Counseling For Mucopolysaccharidosis Type Ii In Kenya, Lucy Mungai, Charles Njeru, Allan Njoroge, Michuki Maina, Syokau Ilovi, Dalton Wamalwa, Ruth Nduati, Beatrice Odongkara, Danny Miller

Pathology, East Africa

Background Limited or absent genetic counseling and testing resources in low- and medium-income countries lead to missed or late diagnoses for treatable metabolic conditions with irreversible complications. In some communities, misunderstanding about the etiology of a genetic condition may lead women whose children are affected to be viewed as a bad omen and become stigmatized or ostracized from their community. Mucopolysaccharidosis type II (MPS II), or Hunter syndrome, is a lysosomal storage disorder in which deficiency or inactivity of the enzyme iduronate-2-sulfatase leads to accumulation of glycosaminoglycans throughout the body. The diagnosis can be made through clinical assessment, enzyme activity …

Female Genital Mutilation And Its Effects Among Women Of Reproductive Age In Kenya: Insights From Kenya Demographic And Health Survey 2022, Jovinary Adam, Joyce Jebet

School of Nursing & Midwifery, East Africa

Introduction Female genital mutilation (FGM) is a significant public health issue rooted in cultural traditions, affecting millions of women and girls. In Kenya, the practice is prevalent in various ethnic groups and is often associated with social and economic pressures.

Objective To determine the prevalence of FGM, the factors associated with FGM, and its effects among women of reproductive age in Kenya.

Methods This study used secondary data of a total 16,716 weighted women of reproductive age drawn from the 2022 Kenya Demographic and Health Survey. The study used the “svy” command in Stata to assign the sample weight. Multivariable …

Stakeholders’ Perceptions Of The Roles And Regulations Of Advanced Practice Nursing And Advanced Practice Midwifery, Constance Shumba, Benard Mutwiri, Denis Munene, Rachel Kimani, Beatrice May, Isabel Kambo, Colette Henderson, Irene Mageto, Daniela Lehwaldt, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Background Advanced practice nursing (APN) and advanced practice midwifery (APM) in Kenya are critical in healthcare system strengthening by expanding access to quality care, particularly in underserved regions. Globally, the International Council of Nurses (ICN) defines APN as a level of nursing practice that requires a minimum of a master’s degree, along with advanced clinical training and competency. Similarly, APM involves midwives with advanced training to provide specialized maternal and neonatal care. In Kenya, the APN and APM concepts were launched in 2020 and are still nascent, and their practice is determined by the context as provided by the country …

Uptake Of Covid-19 Vaccination And Associated Factors Among Patients Attending Oncology Services At The Ocean Road Cancer Institute In Dar Es Salaam, Tanzania: Insights From Mixed Design Methods’ Trajectory, David Makoko, Anthony Kapesa, Micheal Mugerwa, Mamsau Ngoma, Mark Mseti, Mary Lyimo, Lucy Kisaka, Ntuli Kapologwe, Jeremiah Seni

School of Nursing & Midwifery, East Africa

Background

COVID-19 vaccination campaigns have reduced disease severity and fatalities around the globe. Global data shows that 67.7% of the general population are vaccinated, and Tanzania has reported appealing findings of over 70% coverage among individuals over 18 years of age. However, a group-specific assessment of vaccination coverage is needed in sub-Saharan Africa. This study aimed at assessing the COVID-19 vaccination uptake and associated factors among cancer patients owing to their vulnerability.

Methods

A cross-sectional analytical study design was conducted in September 2022 at Ocean Road Cancer Institute (ORCI) in Dar es Salaam, Tanzania. A multistage sampling approach was employed …

Single-Cell-Driven Design Of Logic-Gated Car Circuits For Enhanced Solid Tumor Immunotherapy, Sanna Madan, Tian-Gen Chang, Alexandra Harris, Huaitian Liu, Andrew Martinez, Saugato Dhruba, Binbin Wang, Padma Rajagopal, Sanju Sinha, Shahin Sayed

Pathology, East Africa

Background Chimeric antigen receptor (CAR) T-cell therapy has revolutionized cancer immunotherapy for hematological malignancies but faces critical barriers in solid tumors due to tumor antigen heterogeneity and on-target, off-tumor toxicities. Logic-gated multi-antigen targeting using Boolean operators (AND, OR, NOT) represents an emerging precision immunotherapy engineering approach to overcome these challenges.

Methods We developed LogiCAR designer, a genetic algorithm-based computational framework that systematically identifies optimal logic-gated antigen combinations (i.e., ‘circuits’) from single-cell transcriptomics data. The algorithm identifies CAR circuits consisting of 1-5 antigens from 2,758 cell surface proteins, optimizing tumor-targeting efficacy while maintaining stringent safety requirements in normal tissues. …

Who Classification Of Skin Tumours: Key Updates In The Fifth Edition, Gabrielle Goldman-Lévy, Raymond Barnhill, Boris Bastian, Werner Kempf, David Elder, Pedram Gerami, Wayne Grayson, Dmitry Kazakov, Daniela Massi, Shahin Sayed

Pathology, East Africa

The 5th edition of the World Health Organization Classification of Tumours (WCT) serves as a foundation for global diagnostic standards in tumour pathology. Similar to other volumes in this series, the Skin Tumours (Skin5) edition follows a standardized approach. This edition introduces two new chapters: ‘Tumours of the nail unit’ and ‘Metastases to skin’, along with new entities across relevant chapters. This review article provides an overview of the updates in Skin5 based on currently published evidence, with emphasis on newly introduced chapters and newly described entities that involve the skin, in particular, epidermal, melanocytic and appendageal tumours.

Factors Associated With Cervical Cancer Screening Among Women Attending Maternal Child Health Clinics In Kenya, Loise Nthambi, Marleen Temmerman, William Macharia, Joshua Nyagol, Sophia Mogere, Jillian Neary, Edward Nyabs, Janet Itindi, Agnes Langat, Evelyn Wangari

Centre of Excellence in Women and Child Health

Background Cervical cancer is the second leading malignancy in incidence among women in sub-Saharan Africa. Early detection through screening and treatment of pre-cancerous cervical lesions is paramount in preventing cervical cancer. We sought to examine factors associated with ever being screened for cervical cancer among women attending infant immunization clinics in Kenya.

Methods We conducted secondary data analysis from a cross-sectional survey that enrolled mother-infant pairs attending 55 infant immunization clinics in Kenya between 2018 and 2019. Clinics were selected from high and medium/low HIV-burden counties using probability-proportionate-to-size sampling. The primary outcome was self-reported cervical cancer screening. To align with …

Women’S Unique Health Needs And The Sustainable Development Goals: A Meeting Report From The 79th United Nations General Assembly Science Summit, Irene Aninye, Sarah Chew, Nicole Althaus, Michele Barry, Ru-Fong Cheng, Carolyn Harris, Eleanor Nwadinobi, Beth Battaglino, Aisha Brooks, Marleen Temmerman

Centre of Excellence in Women and Child Health

Biological sex, hormones, and gender uniquely affect health and disease, often resulting in disparities for women across the lifespan and from different racial and ethnic groups, geographical locations, and socioeconomic backgrounds. Without intentional investment and infrastructure to support good health and wellbeing for women, half of the world’s population remains vulnerable to preventable morbidity and mortality. The Society for Women’s Health Research and ECHAlliance–The Global Health Connector convened a women’s health program as part of the 10th Annual Science Summit during the United Nations 79th General Assembly. This hybrid event was held in New York, NY, (USA) and virtually in …

Palliative Care Conditions Managed At Home And Self-Reported Challenges Experienced By Informal Home-Based Caregivers In Rwanda: A Qualitative Study, Jean Claude Twahirwa, Madeleine Mukeshimana, Margaret Fitch, Godfrey Katende

School of Nursing & Midwifery, East Africa

Introduction: A greater dependency on informal home-based caregivers to assist patients in their homes stems from Rwanda’s rising palliative care needs and the burden of terminal illnesses. These caregivers play a critical role in addressing patients’ physical and emotional needs and assisting with daily activities. However, in low-resource settings like Rwanda, limited attention has been given to understanding their lived experiences and the challenges they face. This study primarily aimed to explore the lived experiences and caregiving challenges of informal home-based caregivers providing palliative care. A secondary aim was to describe the range of life-threatening conditions being managed at home …

Economic Factors Influencing Utilization Of World Health Organisation-Recommended Anc Visits Among Women In Jordan: An Analysis Of Jordan Population And Family Health Survey 2023, Lilian Nuwabaine, Joseph Kawuki, John Baptist Asiimwe, Benjamin Betunga, Mathius Amperiize, Angella Namulema, Imelda Namatovu, Shamim Nabidda, Patience Annet Nakalega, Quraish Sserwanja

School of Nursing & Midwifery, East Africa

Background: Antenatal care (ANC) is crucial for reducing maternal and neonatal mortality by identifying and managing complications early during pregnancy. In 2016, the World Health Organization (WHO) updated its guidelines, recommending a minimum of eight ANC visits to improve maternal health outcomes. Despite Jordan’s efforts to enhance maternal healthcare, disparities in ANC utilization persist, particularly among vulnerable populations such as refugees. This study aimed to assess the economic factors influencing utilization of the WHO-recommended eight ANC visits among women in Jordan.

Methods: The study used data from the 2023 Jordan Population and Family Health Survey (JPFHS). A two-stage sampling technique …

Peer Education Programme To Improve Adolescent Sexual And Reproductive Health In Rwanda, Aimable Nkurunziza, Michael Habtu, Germaine Tuyisenge, Nadja Van Endert, Godfrey Katende, Assumpta Yamuragiye, Justine Bagirisano, B.H. Jean Hitayezu, Olive Tengera, Edward Rwagasore

School of Nursing & Midwifery, East Africa

Background: A peer education programme was developed in response to the tendency of high school students in Rwanda to seek sexual and reproductive health information from peers who are often inadequately informed.

Aim: To assess the effect of Sexual and Reproductive Health Peer Education Programme (SRH PEP) on knowledge and the attitudes of SRH among high school adolescents in Rwanda. Setting: The study was conducted at selected high schools in Rwanda.

Methods: This pre-test and post-test design study was conducted in two selected high schools. The pre-test data were collected in February 2020, followed by the post-test data in May …

The Rise Of E-Patients In Tanzania: Reflections On The Unregulated Growth Of Digital Health Consultations, Kahabi Isangula

School of Nursing & Midwifery, East Africa

Background: Digital technologies have significantly transformed healthcare delivery globally, enabling patients to access healthcare services through electronic and mobile platforms. In Tanzania, this transformation has manifested in the rise of “e-patients” — individuals who actively seek health advice, consultation, or treatment through unregulated digital platforms. This paper examines the drivers, patterns, and implications of this trend in Tanzania.

Methods: A descriptive approach was employed, synthesising peer-reviewed and grey literature from global and sub-Saharan African sources, with a particular focus on Tanzania. Insights were also drawn from expert discussions, public digital platforms, and the author’s experiential reflections to contextualize …

Impact Of Covid-19 Pandemic On Quality Of Life, Anxiety, Connections To Friends, And Access To Resources Among People With Hiv: Using The Social Ecological Model, Carol Dawson-Rose, Christine Davey, Emily Huang, Laura Cox, Phillips Craig, Motshedisi Sabone, Lufuno Makhado, Emilia Iwu, Kathleen Fitch, Sheila Shaibu

School of Nursing & Midwifery, East Africa

The purpose of this study was to understand the impact of the coronavirus disease 2019 (COVID-19) pandemic and mitigation efforts on health and social outcomes for people with HIV at the individual, social, and structural levels of the Social Ecological Model. The International Nursing Network for HIV collected data for a cross-sectional survey of people with HIV in Botswana, Canada, Colombia, Hong Kong, Kenya, Nigeria, South Africa, Thailand, and the United States from August 2021 through June 2023. Among 1,400 participants, 47.5% experienced decreased quality of life, 40.9% experienced increased anxiety, 33.0% had reduced connection with friends, and 38.8% had …

Broadening Dementia Risk Models: Building On The 2024 Lancet Commission Report For A More Inclusive Global Framework, Cyprian Mostert, Chinedu Momoh, Andrea Winkler, Connor Mclaughlin, Harris Eyre, Mohamed Salama, Levi Muyela, Karen Blackmon, Zul Merali, Kirti Ranchod

Brain and Mind Institute

No abstract provided.

Weight Loss Remains A Challenge For Idiopathic Intracranial Hypertension Patients: A Retrospective Case Series From Kenya, Zian Muikamba, Jaskirat Sokhi, Jasmit Shah, Sheila Marco, Juzar Hooker, Dilraj Sokhi

Internal Medicine, East Africa

Background Idiopathic intracranial hypertension (IIH) is a neurological condition characterized by elevated intracranial CSF pressure without demonstratable evident causes. The mechanisms leading to a particular predilection for women of childbearing age who are overweight and obese or who have recent rapid weight changes remain imprecisely described. If undiagnosed, it can progress to disabling irreversible visual loss. Weight loss is useful in addition to medical therapy in treating the condition. There is a rise of obesity in sub-Saharan Africa (SSA) but there is little published on IIH.

Methods We conducted a retrospective cross-sectional study at our tertiary regional referral neurology centre …

Unnoticed Early Pregnancy During Myomectomy With Favorable Outcome: Case Report, Ronak Mulji, Lusajo Mwagobele, Farhat Seif, Zainab Fidaali, Munawar Kaguta

Obstetrics and Gynaecology, East Africa

Introduction

Uterine fibroids are a common cause of infertility, and myomectomy remains a key surgical intervention to improve reproductive outcomes. However, the occurrence of an undetected pregnancy during myomectomy is rare and poses significant clinical risks.

Case Presentation

We report a 34-year-old woman, nulliparous with a history of secondary infertility and three first-trimester miscarriages. She had multiple fibroids and was managed for polycystic ovarian syndrome and hyperprolactinemia. Scheduled for abdominal myomectomy, the surgery proceeded uneventfully, with six fibroids removed and no breach of the endometrial cavity. Five weeks postoperatively, she presented with symptoms suggestive of early pregnancy. Ultrasound confirmed a …

Cervical Hpv 18 Detection Is Associated With High-Grade Cervical Dysplasia In Kenyan And Ugandan Women Living With Hiv, Miriam Nakalembe, Collins Mpamani, Jane Namugga, Carolyn Nakisige, Grace Banturaki, Phillip Tonui, Peter Itsura, Omenge Orango, Kapten Muthoka, Anthony Ngeresa

Obstetrics and Gynaecology, East Africa

Objectives Cervical cancer, caused by “high-risk” (HR) HPV, is the most common malignancy and the leading cause of cancer deaths among women living in Kenya and Uganda. Women living with HIV (WLWH) are at a high risk for HR-HPV infection. This longitudinal, observational cohort analysis was conducted to identify factors that are important among WLWH in prediction of cervical intraepithelial neoplasia grades 2 or 3 (CIN2/3).

Methods Data of this analysis was based on a study of HPV natural history and cervical cancer among Kenyan and Ugandan WLWH. Demographic, behavioral and biological data were collected; HR-HPV DNA testing of cervical …

Cervical Hpv 18 Detection Is Associated With High-Grade Cervical Dysplasia In Kenyan And Ugandan Women Living With Hiv, Miriam Nakalembe, Collins Mpamani, Jane Namugga, Carolyn Nakisige, Grace Banturaki, Phillip Tonui, Peter Itsura, Elkanah Orang'o, Kapten Muthoka, Anthony Ngeresa

Obstetrics and Gynaecology, East Africa

Objectives Cervical cancer, caused by “high-risk” (HR) HPV, is the most common malignancy and the leading cause of cancer deaths among women living in Kenya and Uganda. Women living with HIV (WLWH) are at a high risk for HR-HPV infection. This longitudinal, observational cohort analysis was conducted to identify factors that are important among WLWH in prediction of cervical intraepithelial neoplasia grades 2 or 3 (CIN2/3).

Methods Data of this analysis was based on a study of HPV natural history and cervical cancer among Kenyan and Ugandan WLWH. Demographic, behavioral and biological data were collected; HR-HPV DNA testing of cervical …

Growth Measurements In Ugandan Children With Sickle Cell Anaemia From A Hydroxyurea (Hydroxycarbamide) Treatment Trial Relative To Unaffected Sibling Controls, Dennis Kalibbala, Vincent Mboizi, Grace Nambatya, Susan Murungi, Joan Ashaba, Catherine Nabaggala, Lynnth Turyagyenda, Deogratias Munube, Phillip Kasirye, Robert Opoka

Paediatrics and Child Health, East Africa

No abstract provided.

Scalable Long-Read Nanopore Hpv16 Amplicon-Based Whole-Genome Sequencing, Maina Titus, David Giesbrecht, Cliff Oduor, Kapten Muthoka, Karamoko Niaré, Rebecca Crudale, Abebe Fola, Sin Hui, Isaac Kim Jr., Elkanah Orang'o

Obstetrics and Gynaecology, East Africa

Human papillomavirus 16 (HPV16) drives precursor cervical lesions that often progress to cervical cancer (CC). Variation within the HPV16 genome has been associated with CC risk. Here, we developed an affordable and portable amplicon-based long-read whole genome sequencing (WGS) approach using Oxford Nanopore Technologies to investigate HPV16 genetic diversity among women in sub-Saharan African countries. Applied to a control CaSki cell line and clinical samples (n = 12), our method generated complete HPV16 genomes at high coverage (median read coverage: 5,899–15,279 ×). Benchmarking our HPV16 controls showed high accuracy for two variant calling pipelines (Clair3 and PEPPER-Margin DeepVariant). Phylogenetic analysis …

Determinants Of Uptake Of Breast Cancer Screening Among Women Of Reproductive Age In Makueni County, Lola Ndirangu

MSc in Advanced Practice Nursing

Background: Breast cancer is the most diagnosed cancer in all women worldwide, with women in low and middle-income countries dying of the disease in disproportionate numbers because of late diagnosis and access to screening services. Sub-Saharan Africa is an under-researched area, and the level of screening uptake in Kenya, especially in rural and semi-arid areas, including Makueni County, is low. This research assessed the factors that determine the reproductive age women's screening uptake of breast cancer in Makueni County.

Methodology: The cross-sectional design was analytical and was conducted in Makueni County Referral Hospital, where 301 randomly chosen women …

Positive Depression Screen Among Pregnant Women Attending Antenatal Clinic At Aga Khan University Hospital, Michael Maina Muriithi

Master of Medicine in Obstetrics and Gynecology

Introduction: One in seven women experience peripartum depression, a common disorder that can occur during pregnancy or in the postpartum phase. Women are particularly vulnerable to depressive symptoms during pregnancy and the immediate postpartum period due to physiological changes during pregnancy as well as other sociocultural stressors. Peripartum depression is associated with significant maternal and perinatal adverse outcomes, including self-neglect, substance use, preterm birth, low birth weight and poor neurocognitive development, in offspring. There is a need to understand the prevalence and factors associated with depressive symptoms during pregnancy to improve maternal and neonatal outcomes. To our knowledge, this …

Global Transfusion Practices In Septic Patients In The Intensive Care Unit: Insights From The Input-Study Sub-Analysis, Vincent Kurucz, Andrew Flint, Alexis Poole, Merijn Reuland, Claudia Oord, Caroline Schaap, Jan Bakker, Maurizio Cecconi, Aarne Feldheiser, Marcus Lance

Anaesthesiology, East Africa

Background Transfusion practices among intensive care unit (ICU) patients with sepsis vary widely. While restrictive hemoglobin thresholds for red blood cell (RBC) transfusion are well studied, the indications and thresholds for platelet and plasma transfusions remain uncertain.

Methods We performed a sepsis-specific sub-analysis of the International Point Prevalence Study of Intensive Care Unit Transfusion Practices, a prospective, multicenter, observational study capturing all adult ICU admissions during four pre-scheduled weeks between March 2019 and October 2022. Patients admitted with sepsis or septic shock, or who developed sepsis during their ICU stay, were included. We recorded demographics, daily laboratory values, and transfusion …

The Current State Of Diagnostics For Neuroimmunological Disorders In Africa, Malya Sahu, Mashina Chomba, Fiifi Duodu, Monica Diaz, Dilraj Sokhi, Deanna Saylor

Internal Medicine, East Africa

The epidemiology of neuroimmunological disorders in Africa remains poorly understood. Regional variation in diagnostics and provider knowledge has led to challenges in real-world application of diagnostic criteria. We conducted a cross-sectional survey of clinicians practicing in Africa to characterize the current state of clinical diagnostic resources and developed a clinician-driven prioritized action plan. 130 respondents from 24 out of 54 countries in Africa participated (44% national response rate). Most respondents specialized in neurology (n = 86, 66%) and practiced in an urban setting (n = 84, 65%). While all participating countries had access to a neurologist and ophthalmologist, only half …

Artificial Intelligence And Medical Education (2013-2024): A Scopus-Based Bibliometric Analysis, Festus Mulakoli, Edward Misava

School of Nursing & Midwifery, East Africa

Background: Artificial Intelligence (AI) is transforming medical education by enabling personalised learning, adaptive feedback, simulation-based training, and automated assessments. While AI offers significant benefits, including curriculum optimisation and virtual tutoring, concerns around data privacy, access, and ethical implementation persist. Although bibliometric studies have explored AI in healthcare, comprehensive analyses of global collaboration and publication trends in AI-focused medical education remain limited. Aim: This study aims to analyse global research trends, key contributors, and thematic developments in the application of AI within medical education. Methods: A bibliometric analysis was conducted using the Scopus database. The search strategy included terms …

Genome Wide Association Study Of Psychosis Identifies African Enriched Variants In Ptprd And Tmem150c, Lerato Majara, Toni Boltz, Dickens Akena, Solomon Teferra, Symon Kariuki, Charles Newton, Dan Stein, Lukoye Atwoli, Zukiswa Zingela, Bizu Gelaye

Internal Medicine, East Africa

No abstract provided.

Prevalence And Risk Factors Of Hypertension Among Clients Seeking Care At Selected Healthcare Facilities In Kenya, Jasmit Shah, Soraiya Manji, Jamila Nambafu, Cynthia Smith, Anthony Ochola, Linda Barasa, Faraj Amir, Husni Abdalla, Rajiv Patel, Sayed Karar

Internal Medicine, East Africa

Background Hypertension remains one of the primary risk factors for cardiovascular disease and the leading cause of mortality worldwide. According to the World Health Organization (WHO), as estimated 1.28 billion adults suffer from hypertension worldwide and approximately half are unaware of the problem. This study aimed to explore the prevalence of hypertension, and the association of sociodemographic, behavioral, and physiological factors related to hypertension in patients seeking care at the different healthcare facilities in Kenya.

Methodology We carried out a cross-sectional survey study between April 2023 and July 2023. The general adult public visiting the outpatient clinics were recruited from …

Healthcare Informatics October 2025, Aga Khan University

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