Medicine and Health Sciences Commons^™

U.S. Cardiovascular Mortality Before And During Covid-19: Cdc Wonder Vs Gbd Comparison, Mirza Ali Baig, Muhammad Umar, Carol Becker, Salim S. Virani, Dmitry Abramov, Xiaoming Jia, Abdul Minhas

Population Health, East Africa

No abstract provided.

New-Onset Cognitive Impairment After Delirium Among Hospitalised Older Ghanaians: A Pilot Study, John-Paul Omuojine, Richard Dei-Asamoa, Caleb Otu-Ansah, Gertrude Aboah, Belinda Opoku, George Amponsah, Stella Afeti, Leah Ratner, Ruth Owusu-Antwi, Cyprian Mostert

Population Health, East Africa

Background Delirium is a potentially modifiable risk factor for dementia. However, post-delirium cognition has hardly been studied in Africa, where the burden of both disorders is rising disproportionately.

Objective We estimated the incidence of new-onset cognitive impairment (NCI) 6 months after hospitalisation with non-stroke delirium among older Ghanaians.

Methods This was a prospective observational pilot study conducted among 60 previously cognitively unimpaired (retrospective proxy assessment) adults aged ≥60 years, hospitalised with non-stroke prevalent delirium in a Tertiary Hospital. Delirium was confirmed and rated using the Confusion Assessment Method (CAM) and Severity Scale (CAM-S) within 24–72 hours of admission and reassessed …

Spatially Dissecting Drivers Of Inter- And Intra-Tumoral Heterogeneity In Kenyan Breast Cancer, Mustapha Abubakar, Shahin Sayed, Hela Koka, Scott Lawrence, Karun Mutreja, Xing Hua, Petra Lenz, Samuel Anyaso-Samuel, Rosemary Kamau, Beryl Ooro

Pathology, East Africa

Despite growing evidence on the impact of intra-tumoral heterogeneity (ITH) in breast cancer (BC), its biological drivers and clinically relevant mitigation strategies remain poorly characterized, particularly in low-resource settings where spatial profiling is rarely applied. To address this gap, we conducted a comprehensive, multiplatform spatial profiling study of BC in a Kenyan population. Using the NanoString GeoMx™ Digital Spatial Profiler, we quantified 44 protein markers across 707 spatially defined, PanCK-segmented Areas of Illumination (AOIs) from 31 tumors. All tumors exhibited measurable ITH, with one-third showing marked heterogeneity. Sixteen patients exhibited two or more intrinsic subtypes within their tumors, three of …

Formal Comment: Diagnostic Labelling Of Mental Health In Young People: Perspectives From Kenya, South Africa And Zimbabwe, Rachel Maina, Marinos Lupindo, Charmaine Nyakonda, Tara Carney, Charity Mamathuba, Christine Musyimi, Charity Somo, Eleanor Chatburn

Brain and Mind Institute

No abstract provided.

Plasma Proteomic Profiles Of Alzheimer's Disease And Neurodegeneration In African Cohorts, Ilaria Pola, Tolulope Akinyemi, Kubra Tan, Oladotun Olalusi, Wiebke Traichel, Giulia Giacomucci, Joseph Yaria, Nesrine Rahmouni, Gabriel Ogunde, Chinedu Momoh

Brain and Mind Institute

Alzheimer’s disease and related dementia (ADRD) represents a growing public health burden, especially in low- and middle-income countries. Yet, most studies focus on Non-Hispanic white (NHW) populations from high-income countries. This study investigates plasma proteomic signatures associated with amyloid pathology in African populations. Nigerian older adults from the VALIANT study and participants from a Tanzanian study, with available biomarker quantification in plasma are employed. For proteomic comparison, participants from the Canadian TRIAD cohort are included, capturing a distinct population. Here, we show that multiple proteins are differentially abundant in the plasma of p-tau217-positive individuals and in the different cognitive groups, …

A Rare Manifestation Of Mycobacterium Kansasii As A Cutaneous Infection: A Case Report, Wandera Carey, Antony Kimani, Zamanali Khakhar, Dheer Kalaiya, Alok Iyer, Sayed Karar

Internal Medicine, East Africa

Nontuberculous mycobacteria (NTM) are environmental organisms increasingly recognized as opportunistic pathogens, particularly in immunocompromised individuals. Mycobacterium kansasii, a slow-growing photochromogen (Runyon group I), is primarily associated with pulmonary disease; however, extrapulmonary and cutaneous manifestations are uncommon and often underdiagnosed. Given the rising incidence of NTM infections, cutaneous disease should be considered in the differential diagnosis of skin lesions, especially in immunocompromised patients. Early microbiological confirmation is crucial for appropriate therapy, as M. kansasii is intrinsically resistant to pyrazinamide. Herein, we present a case of pathologically confirmed cutaneous M. kansasii infection occurring in isolation, illustrating the diagnostic challenges and therapeutic outcomes.

A Blended Genome And Exome Sequencing Method Captures Genetic Variation In An Unbiased And Cost-Effective Manner, Toni Boltz, Benjamin Chu, Matthew Defelice, Calwing Liao, Julia Sealock, Robert Ye, Jacqueline Goldstein, Lerato Majara, Jack Fu, Lukoye Atwoli

Internal Medicine, East Africa

Here we developed and deployed the blended genome exome (BGE) method, a DNA library approach that generates low-pass whole-genome (1–4× mean depth) and deep whole-exome (30–40× mean depth) data in a single sequencing run. BGE is cost-effective, empowers most genomic discoveries possible with deep whole-genome sequencing and captures global common single-nucleotide polymorphism diversity. We applied BGE to sequence >53,000 samples from the PUMAS Project (Populations Underrepresented in Mental Illness Associations Studies), including African, African American and Latin American populations. Imputed genotypes showed high concordance with Illumina Global Screening Array calls (R2 ≥ 95% for minor allele frequency ≥1%; …

Why Pronatalism Fails The Planetary Health Test, Celine Delacroix, Marleen Temmerman, Nandita Bajaj, Ann Moore, Phoebe Barnard, William Ripple, William Rees, Michael Gerrard, Diana Coole, Robert Engelman

Centre of Excellence in Women and Child Health

No abstract provided.

Performance Of Road-Traffic-Based Exposure Proxies Against Personal Pm2.5 Measurements In Three Sub-Saharan African Countries, Handsome Nyoni, Terence Mushore, Laura Munthali, Sibusisiwe Makhanya, Laurine Chikoko, Stanley Luchters, Matthew Chersich, Fortunate Machingura, Liberty Makacha, Benjamin Barratt

Centre of Excellence in Women and Child Health

Particulate Matter (PM2.5) exposure contributes to the global disease burden, yet its monitoring remains sparse and uneven, with limited ground sensor infrastructure. Road-traffic proxy indicators can provide indirect estimates of PM2.5 where measurements are limited but require context-specific validation. We evaluated three PM2.5 road-traffic-related proxies: (i) population-Weighted Road Network Density (wRND), (ii) Euclidean (straight line) distance from highways (EH), and (iii) Euclidean distance from main roads (EM). We validated these proxies using high-resolution outdoor filtered PM2.5 personal exposure measurements collected over 1 year from 343 postpartum participants in The Gambia, Kenya, and Mozambique. Proxy-PM2.5 associations were assessed using Spearman correlation, …

Neonatal Admissions And Mortality: A Statistical Adjustment Approach Using Birthweight-Specific Curves To Address Bias Due To Underreporting In 65 Hospitals In Four African Countries, Lucas Malla, Siu Wong, Samuel Ngwala, Evelyn Zimba, Msandeni Chiume, Norman Lufesi, Kondwani Kawaza, Honorati Masanja, Josephine Shabani, William Macharia

Paediatrics and Child Health, East Africa

Background Underreporting of neonatal admissions and deaths – particularly among <  1000 g newborns – compromises the plausibility of in-patient neonatal mortality rate (iNMR) estimates. This limits progress tracking, since 2.3 million neonatal deaths occur annually, and 65 countries are projected to miss the Sustainable Development Goal (SDG) 3.2 target of fewer than 12 deaths per 1000 live births by 2030. Reliable iNMR estimates are essential for national and hospital-level monitoring. This study assessed birthweight-specific adjustment curves developed using simulated data, and extended the approach to routine data from 172,809 neonatal admissions across four African countries in the NEST360 network.

Methods Simulated data were generated using birthweight intervals of 500 g from 500 to 5000 g, with 1000 values per category representing 1000 hospitals. Admissions were drawn from a negative binomial distribution and mortality rates from a beta distribution based on published birthweight-specific iNMRs. Adjustment functions were developed using data from 500 hospitals without underreporting and tested on 500 with induced underreporting. This approach was then extended to real data from 65 NEST360 partnering hospitals. The adjustment functions were derived from 26 hospitals with plausible reporting (iNMR ≥ 700 per …

Unlocking The Potential Of Sub-Saharan Africa In Globalized Cancer Clinical Trials: A Perspective From The 2024 Aortic-Asco Stakeholder Meeting, Abiola Ibraheem, Adedayo Joseph, Miriam Mutebi, Mansoor Saleh, Sitna Mwanzi, Olusegun Alatise

General Surgery, East Africa

Sub-Saharan Africa (SSA) remains significantly underrepresented in global cancer clinical trials, despite having the largest population of individuals of African descent, an essential demographic for ensuring diversity in clinical research. This study, developed from the 2024 African Organization for Research and Training in Cancer (AORTIC)-ASCO stakeholder meeting, addresses the critical need to involve SSA in cancer trials to improve global trial diversity and patient outcomes. Although globalization of trials has shifted research sites to regions like Eastern Europe and Asia, < 1% occur in Africa. This report highlights emerging solutions such as regional alliances, decentralized trial models, capacity-building initiatives, and public-private partnerships. The role of AORTIC and its Clinical Trial Special Interest Group in advancing training, infrastructure development, and international collaboration is discussed, with notable clinical trial networks, such as HypoAfrica, ARETTA, African Research Group for Oncology, and regional consortia, illustrating growing momentum and capability. This study advocates for a coordinated strategy to integrate SSA into global trials, ensuring more inclusive, effective, and equitable cancer treatment outcomes.

Social Relationships, Mental Health, And Stigma: A Qualitative Study Of Social Networks And Hiv Disclosure In Western Kenya, Sarah Obatsa, Adel Mburia-Mwalili, Salvador Jauregui, Karla Wagner, Lukoye Atwoli, Francesca Odhiambo, Jayne Lewis-Kulzer, Suzanne Goodrich, Kara Wools-Kaloustian, Jennifer Syvertsen

Internal Medicine, East Africa

The disclosure of one’s HIV-positive status is a personal decision that can play an important role in engagement in HIV treatment and care. Social network approaches situate individuals within broader webs of social connections that influence health and wellbeing and thus hold the potential to elucidate key social factors shaping the process of disclosure. As part of a larger clinical study examining how substance use and mental health shape HIV outcomes, we recruited 61 individuals newly diagnosed with HIV at two clinics in Western Kenya to participate in an egocentric social networks study. We conducted a survey that generated a …

Hydroxyurea Interferes With Point-Of-Care Creatinine Testing In Children With Sickle Cell Anemia, Ruth Namazzi, Robert Opoka, Charles Ssuuna, Michael Goings, Kathryn Mcelhinney, Dibyadyuti Datta, Russell Ware, Chandy John, Andrea Conroy

Paediatrics and Child Health, East Africa

Objective To evaluate the performance of the point-of-care i-STAT device for creatinine measurement in Ugandan children with sickle cell anemia (SCA), and to determine the clinical impact of hydroxyurea-associated assay interference.

Results description This secondary analysis was nested within a randomized clinical trial involving 248 Ugandan children with SCA. The mean age at enrollment was 32 months, and 115/248 (46.2%) initiated hydroxyurea during 12 months of follow-up as part of routine clinical care. At enrollment, creatinine values measured by i-STAT and reference laboratory testing were clinically comparable. At follow-up, children receiving hydroxyurea had significantly higher creatinine values measured by iSTAT …

Paracrine Signals From Hiv-1-Infected Immune Cells Reprogram Cervical Cancer Pathways, Charles Olwal, Ujjwal Rathore, Sara Makanani, Prashant Kaushal, Immy Ashley, Manisha Ummadi, Vincent Appiah, Alexandra Lindsey Zune, Sophie Blanc, Elkanah Orang'o

Obstetrics and Gynaecology, East Africa

No abstract provided.

Ambulatory Blood Pressure Monitoring Phenotypes And Circadian Blood Pressure Patterns Among Adults Referred For Diagnostic Evaluation At Aga Khan University Hospital, Nairobi, Kenya: A Retrospective Cross-Sectional Study, Nadeem Kassam, Mzee Ngunga, James Orwa, Alisa Bhojani, Mohamed Varwani, Swaffiya Salim, Yvonne Oketch, Salim Surani, Anthony Ochola, Barbara Karau, Jeilan Mohamed, Etienne Amendezo

Internal Medicine, East Africa

Introduction: hypertension represents the primary modifiable risk factor for cardiovascular disease and poses a public health challenge in sub-Saharan regions, with Kenya experiencing particularly low detection and control rates. Traditional office-based blood pressure measurements often fail to detect key phenotypes, such as white-coat and masked hypertension. Ambulatory Blood Pressure Monitoring (ABPM) offers a comprehensive 24-hour profile that excludes white-coat hypertension and allows for the evaluation of circadian patterns, including nocturnal hypertension and non-dipping status, both of which are recognized as high-risk phenotypes strongly linked to adverse cardiovascular events. This study evaluated ABPM data from Aga Khan University Hospital, Nairobi …

Development And Validation Of The Lifetime Sense Of Safety Scale In Kenyan Adults, Karen Blackmon, Anne Nyambura, Anne Gitere, Levi Muyela, Catherine Onyancha, Kendi Muchungi, Catherine Ajalo, Litha Musili, Rachel Maina, Edna Bosire, Lukoye Atwoli, Zul Merali, Chinedu Momoh

Brain and Mind Institute

Background. Safety supports psychological wellbeing and potentially shapes brain aging yet existing scales overlook cumulative lifespan safety experiences.

Methods. To address this gap, we developed and validated the Lifetime Sense of Safety (LSS) scale in Kenyan adults. The LSS uses visual analog scaling with a red-to-green color gradient to retrospectively rate felt safety across life stages and settings. We evaluated scale psychometrics and associations with social determinants of health and indicators of brain health.

Results. The LSS shows adequate internal consistency and test-retest reliability, with two distinct but correlated factors representing childhood and adulthood safety. Women and …

Contextual Variability In Under-Diagnosed Cardiometabolic Disease And Cognitive Vulnerability Among Populations At High Risk For Alzheimer's Disease And Related Dementias, Nwanyieze Jiakponnah, Joseph Curran, Tamlyn Watermeyer, Jasmit Shah, Litha Musili, Stanely Onyango, Benard Aliwa, Zul Merali, Karen Blackmon, Chinedu Momoh

Brain and Mind Institute

Underdiagnosis of cardiometabolic risk factors (CMRFs) may represent an unrecognised biological pathway contributing to dementia risk; yet remains poorly characterised in African and African diaspora populations. We quantified the prevalence and determinants of underdiagnosed hypertension and abnormal glycaemia across four cohorts comprising up to 7000 adults aged ≥40 years from Nigeria, Kenya, and The United States: Indianapolis, and North Texas. Underdiagnosis was defined as absence of self-reported diagnosis despite elevated systolic blood pressure ( ≥130 mmHg) or fasting blood glucose ( ≥100 mg/dL). Cohort-stratified analyses examined demographic, socioeconomic, cognitive, Alzheimer’s genetic, and blood-based biomarker correlates. Underdiagnosis was pervasive in African …

Co-Designed Interventions Package For Enhancing Women's Resilience In Reproductive And Child Health Through Income-Generating Associations: A Human-Centered Design Study In Tanzania, Kahabi Isangula, Aminieli Itaeli Usiri, Eunice Pallangyo

School of Nursing & Midwifery, East Africa

Background: Maternal and under-five mortality remain major public health concerns in many low- and middle-income countries, including Tanzania. Despite their widespread use in strengthening economic resilience, income-generating associations (IGAs) have not fully utilized their potential as platforms for addressing reproductive and child health (RCH) challenges.

Objective: This study aimed to co-design an intervention package with women participating in income-generating associations to enhance their preparedness and resilience in addressing RCH challenges in Tanzania.

Methods: A qualitative descriptive study guided by a Human-Centered Design (HCD) framework was conducted in the Arusha and Shinyanga regions of Tanzania. The study followed …

Adverse Childhood Experiences Among Kenyan Adolescents: Psychometric Properties, Prevalence Rates And Correlates, Tom Osborn, Rosine Baseke, Faith Kamau, Winnan Munyasa, Christine Wasanga, Maureen Ngesa, Victoria Mutiso, Moses Nyongesa, Jasmit Shah, Zul Merali

Brain and Mind Institute

Background: Adverse Childhood Experiences (ACEs) have been consistently linked to poor mental health outcomes, yet research on their impact in low- and middle-income countries (LMICs) settings of Africa, remains relatively unexplored. In Kenya, where childhood adversity is widespread, there is a critical need to examine the validity of ACE measures and their associations with mental ill health. This study aimed to validate the Adverse Childhood Experiences questionnaire (ACE-10) in a Kenyan adolescent sample and assess its associations with symptoms of depression and anxiety, bullying, and sociodemographic factors.

Methods: Data was collected from N = 2,842 adolescents and young …

Structured Telehealth Community Health Worker-Clinician Feedback And Diabetes Outcomes: A Randomized Clinical Trial, Elizabeth Vaughan, Xiaoying Yu, Amber Amspoker, Aanand Naik, Ashok Balasubramanyam, Craig Johnston, Christi Ballantyne, Salim S. Virani, Shelton Brown, Kristina Mena

Population Health, East Africa

Importance  Community health workers (CHWs) improve chronic disease management in underserved populations, but scalable integration strategies are limited.

Objective  To evaluate whether a multidimensional intervention incorporating telementored CHWs and a structured participant-CHW-clinician feedback loop can improve diabetes outcomes.

Design, Setting, and Participants  This 12-month randomized clinical trial was conducted at 3 institutionally and geographically diverse community clinics in Texas between September 1, 2023, and April 30, 2025, and included low-income, uninsured White Hispanic adults with type 2 diabetes identified through clinic databases. Data were analyzed between May 1 and July 31, 2025.

Intervention  Individuals were randomized 1:1 to the intervention …

Family Planning Exemplar Country Selection Methodology: Time Lag And Trends Analysis, Zahid Memon, Abeer Mian, Ira Martopullo, Narjis Hussain, Zeba Sathar, Ali Mohammad Mir, Michael Mbizvo, Marleen Temmerman, Jen Drake, Zulfiqar Bhutta

Centre of Excellence in Women and Child Health

Introduction While many countries achieved notable gains in contraceptive use levels after the 1994 International Conference on Population and Development which redefined family planning (FP) as a human right, there was a long period of 15 years when contraceptive use levels did not receive due attention. It was only later that its subsequent inclusion in the Sustainable Development Goals and the 2012 London Summit on FP renewed global commitment and a focus towards FP. This paper aims to select countries that identify as ‘exemplar’ low-middle-income countries that have achieved exceptional progress in FP. Examining these outliers can uncover actionable drivers …

An Aggressive Presentation Of Anti-Melanoma Differentiation-Associated Gene 5 (Mda-5)-Positive Dermatomyositis With Rapidly Progressive Interstitial Lung Disease: A Case Report, Zamanali Khakhar, Shreedhi Patel, Rajiv Patel, Soraiya Manji, Fredrick Otieno, Sayed Karar

Internal Medicine, East Africa

Anti-melanoma differentiation-associated gene 5 (MDA-5) dermatomyositis is an uncommon condition that is frequently complicated by rapidly progressive interstitial lung disease (RP-ILD), resulting in a poor prognosis. Due to its aggressive course, management is often challenging and requires timely interventions to improve outcomes. This case of a female patient with anti-MDA-5-positive DM and RP-ILD aims to document this unique and uncommon condition, its aggressive clinical course, associated complications, diagnostic challenges, and management considerations.

Screening Tools For Maternal Mental Health In Africa: A Systematic Review, Joyce Jebet, Irene Mageto, Benard Mutwiri, Abednego Ongeso, Ruth Wagathu, Rose Maina, Denis Munene, Kawira Kithuci, Peter Gatiti

School of Nursing & Midwifery, East Africa

Background:

Maternal health during pregnancy and the postnatal period encompasses mental health, which is a key aspect in enhancing a positive outcome. Despite screening for other possible complications during pregnancy and the postnatal period, very little attention has been paid to screening for mental health. Screening is a key tool in early diagnosis and, eventually, timely diagnosis and management in cases where complications arise.

Aim:

This study aimed to assess the available maternal mental health screening tools and compare the outcome on their utilization during pregnancy and postnatal periods in the African continent.

Methodology:

This was a …

Left Bundle Branch Area Pacing Outcomes From An African Registry: Short-Term Findings From The Macop Study, Willy Mucyo, Marcus Ngantcha, Mzee Ngunga, Miriam Msunza, Justin Ragadu, Klindheer Rampersad, Jeilan Mohamed, Brian Vezi

Internal Medicine, East Africa

Background

Objective

Methods

Results

Government Health Care Worker Training Needs For Intestinal Schistosomiasis Morbidity Management, Phyllis Isaiah, Betty Nabatte, Lauren Wilburn, John Oryema, Noah Ukumu, Morris Okumu, Juma Nabhonge, Hilda Kyarisiima, Prudence Beinamaryo, Christopher Opio

Internal Medicine, East Africa

Background Schistosomiasis causes substantial chronic morbidity in sub-Saharan Africa, yet case definitions, clinical management guidance, and health worker training for schistosomiasis-related morbidity remain limited.

Methods We conducted a qualitative needs assessment for schistosomiasis morbidity management. Workshops were held over one day in each of Pakwach, Buliisa, and Mayuge Districts in Uganda in October 2024. 105 government health workers participated including clinicians, nurses, laboratory technicians, sonographers, and district health managers from health facilities at different levels of care. The workshops comprised six structured sessions: presentations on schistosomiasis burden in Uganda and the SchistoTrack cohort, a clinical case report by an expert …

Assessing Family Planning Progress In Exemplar Countries: Development Of A Conceptual Framework And Case Study Methodology, Zahid Memon, Hina Najmi, Abeer Mian, Sacha Ahmad, Muhammad Islam, Kevin Samuel, Marleen Temmerman, Ali Mohammad Mir, Zeba Sathar

Centre of Excellence in Women and Child Health

Family planning (FP) is a critical component of reproductive health, enabling individuals to plan the number and timing of children through various contraceptive methods.

We outline the conceptual framework and country case study methodology used by the Exemplars in Family Planning (EFP) project. This was based on the wider Exemplars in Global Health programme, which uses mixed-methods to examine determinants of FP progress in countries that exceed expectations for health outcomes. The EFP project integrates findings from case studies on six such countries, including quantitative analyses of trends and drivers of modern contraceptive prevalence, systematic reviews, policy, programme and financing …

Assessing Aflatoxin Knowledge, Perceptions, And Related Practices, In A Rural Coastal Community: A Population-Based Cross-Sectional Survey, Rosebella Iseme, Joseph Abuodha, Anthony Ngugi, Innocent Abayo, Mansoor Saleh

Population Health, East Africa

Background

Aflatoxin contamination is a significant yet under-addressed food safety challenge in low-resource settings, driven by a complex interplay of environmental, agricultural, and socio-economic factors. Limited access to agricultural inputs, inadequate post-harvest handling and storage, and weak regulatory enforcement alongside food scarcity and climate change heighten the risk of contamination and exposure. Human exposure is associated with serious health consequences, including hepatocellular carcinoma, immune suppression, and childhood stunting. Although aflatoxin is increasingly recognized as a global food safety concern, little is known about community-level knowledge, risk perceptions, and preventive practices. This study examined household heads’ awareness, perceptions, and behaviours related …

Satellite-Derived Longitudinal Evidence Of Flood Effects On Community Water And Sanitation Resilience In Coastal Kenya, Felix Oluoch, Rosebella Iseme, Fredrick Gudda, Alfred Keter, Rachel Odhiambo, Jai Das, Zulfiqar Bhutta, Anthony Ngugi

Population Health, East Africa

Background Flooding can disrupt water, sanitation and hygiene services in low-income rural and peri-urban settings, yet there is limited quantitative evidence on how repeated flood exposure affects safe water and sanitation over time at the level of Community Health Units (CHUs), which are the operational units for primary health care in Kenya.

Methods We analysed repeated CHU-level data from ten Community Health Units in Kilifi County, Kenya, across eleven surveillance rounds from 2017 to 2024. For each round, we calculated the percentage of households with safe drinking water and with access to a functional latrine, and linked these outcomes to …

Feasibility And Acceptability Of A Mobile App And Wearable Device For Collecting Mental Health Survey And Passively Sensed Data Among Health Care Workers In Kenya: Mixed Methods Pilot Study, Linda Khakali, Andrew Aballa, Dorcas G. Mwigereri, Willie Njoroge, Rachel Maina, Amos Bunde, Peris Musitia, Moses Nyongesa, James Orwa, Jasmit Shah, Anthony Ngugi, Lukoye Atwoli, Amina Abubakar, Zul Merali

Brain and Mind Institute

Background: Mobile apps and wearable devices may help to facilitate early detection of mental health conditions by providing objective, real-time data to supplement other forms of feedback and diagnoses. Few studies have investigated the acceptability and feasibility of using a mobile app to track survey- and wearable-based data in mental health research in Sub-Saharan Africa.

Objective: This pilot study evaluated the feasibility and acceptability of using a mobile app and wearables to capture mental health–based survey data and passively sensed data among Kenyan health care workers.

Methods: A mixed methods study was conducted among health care workers …

Recurrent Upper Gastrointestinal Bleeding Due To Gastric Arteriovenous Malformation, Lavender Otom, Priyanka Panwar, Gerald Odong, Christopher Opio, Saleem Abdulkarim

Internal Medicine, East Africa

We present the case of a 45-year-old male with repeated episodes of upper gastrointestinal bleeding due to a gastric arteriovenous malformation (AVM). The case underscores the diagnostic challenges, multidisciplinary decision-making, and management considerations associated with gastrointestinal vascular malformations. Given the rarity of gastric AVMs and their potential for serious complications, this report highlights the importance of an integrated approach to diagnosis and treatment, including advanced imaging and endovascular interventions.