Medicine and Health Sciences Commons^™

The Distribution Of Cardiovascular Risk Factors And The Association With Cadre Amongst Healthcare Workers At A Tertiary University Hospital In Nairobi City, Kenya, Emma Andrea Khabure

Theses & Dissertations

Introduction: According to the World Health Organization (WHO), non-communicable diseases such as stroke, contribute to about 70% of the top ten causes of mortality in the world. The growing burden of Cardiovascular (CVD) risk factors has also been noted to affect the health workforce. According to the Ministry of Health in Kenya employing the WHO STEPS survey, 27% of Kenyans are either overweight or obese. Few studies have been done in Kenya to highlight the prevalence and impact of cardiovascular risk factors amongst healthcare workers. The variety of findings and paucity of data bring about the need to evaluate this …

Risk Factors And Outcomes Of Acute Kidney Injury Among Covid-19 Patients At A Tertiary Hospital In Kenya, Susan Cheruiyot

Theses & Dissertations

Background: Corona Virus Disease 2019 (COVID-19), a novel infection caused by the SARS-Cov-2 virus, was declared a global pandemic on March 11, 2020. Three years later, 350,000 Kenyans had gotten the infection, with approximately 5,700 reported related deaths. Despite emerging research on the new virus, studies from the African continent on the impact of COVID-19 on the kidneys have been few. Early studies suggest that up to 75% of patients with COVID-19 have a derangement in their kidney function as evidenced by new onset proteinuria and hematuria. That said, the prevalence of acute kidney injury has varied greatly across populations, …

Burden In Family Caregivers Of Patients With Chronic Mental Illness In Aga Khan University Hospital And Mathari National Referral Hospital, Nairobi, Kenya., Norah Atieno Obungu

Theses & Dissertations

Introduction: In Africa, about 60% of patients with chronic mental health disorders live with their relatives. Family caregivers bear the responsibility of managing relatives with mental illness in the home environment, and this may result in psychopathology in the caregivers. Although extensively studied in the Western world, not much is known about the caregiver burden in Kenya.

Objectives: The primary objective of the study was to find out the prevalence of caregiver burden among family caregivers of patients with chronic mental illness attending two psychiatric care facilities in Nairobi. The secondary objective was to determine the socio-demographic characteristics and correlates …

Adequacy Of Pain Management Among Advanced Cancer Patients With Solid Tumors Attending Palliative Care Centers In Dar Es Salaam, Judith Mwijage

Theses & Dissertations

Background: Cancer pain is a universal undesirable symptom among cancer patients that if not addressed causes suffering and impedes quality of life of both the patients and their family. Observational studies available have shown increase in palliative care programs in Tanzania but there is dearth of information regarding the adequacy of pain control among patients with cancer after the initiation of these programs and improvement of the available interventions.

Objectives: This study aimed to determine adequacy of pain management among advanced cancer patients with solid tumors as well as factors affecting adequate Cancer Related Pain management.

Methods: We conducted a …

Facilitators And Barriers To Implementing A Community Rotation To The Internship Training In Kenya, Peter Mwanza Kioko

Theses & Dissertations

Background: Primary care is increasingly being prioritized all over the world more so in developing countries in an effort geared towards achieving health equity. The availability of skilled human resources at the community level has been shown to improve health outcomes. However, doctor numbers remain low in sub-Saharan countries. Kenya’s policy on universal health coverage aims to enable access to essential health services by all its citizens by 2022. The introduction of community placements among undergraduate medical students has proven beneficial in understanding community health problems, the role of primary care in health as well as increasing the likelihood of …

Knowledge, Attitude And Beliefs Towards Polypharmacy Amongst Older People Attending Family Medicine Clinic (Fmc) At The Aga Khan University Hospital, Nairobi, Kenya (Akuhn)., Maureen Wanjiru Kamau

Theses & Dissertations

Introduction: Life expectancy has increased over the last century amongst older individuals, and in particular, those 60 years and over. The World Health Organization estimates that the world's population of persons over 60 years will rise to 22 per cent by the year 2050. Ageing is associated with increasing disability, multiple chronic conditions, and an increase in the use of health services. Multiple chronic conditions associated with ageing are managed with different medications (polypharmacy) amongst the older population. Polypharmacy has numerous adverse effects including non-adherence, an increased risk of drug interactions with the various medications, reduced appetite, and risk of …

Prevalence And Social Determinants Of Alcohol Use Disorders In Patients Attending Primary Care Clinics In Nairobi Kenya, Verah Kabwayi

Theses & Dissertations

No abstract provided.

Prevalence Of Depression And Factors Associated With Depressive Symptoms Among Patients Diagnosed With Benign Prostatic Enlargement At Aga Khan University Hospital, Nairobi, Husni Abdalla

Theses & Dissertations

Background: There is a relationship between Benign Prostatic Enlargement (BPE) and Lower Urinary Tract Symptoms (LUTS). The persistence of LUTS can negatively affect the quality of living by interrupting daily activities. Depressive symptoms occur commonly in patients with BPE. Depression is a taboo subject in Africa, and Kenya is no exception. Depression at its worst can lead to suicide. Thus, it is of great importance to recognise the factors associated with depressive symptoms in patients with BPE and hence reinforce the need to assess depression in patients with BPE in our clinical practice.

Objective: This study sought to …

The Effectiveness Of Digital Health Interventions For Weight Loss In Postpartum Women: A Systematic Review And Meta-Analysis, Logan Rabuogi

Theses & Dissertations

Objectives: This systematic review and meta-analysis aimed (1) to determine the effectiveness of digital health intervention (DHI) components on weight loss in postpartum women, (2) to determine the effect of DHIs on body mass index and (3) to determine the attrition rates within DHIs.

Methods: Electronic searches were conducted on PubMed (MEDLINE), Cochrane Library, Google Scholar, and Web of Science from inception to 22nd April 2020. Studies included were; (1) randomized controlled trials (RCT), quasi-experimental trials, and controlled before-after studies (2) of weight loss interventions delivered by either website, Internet, email, computer, Apps, SMS, phone call, or video player (3) …

Knowledge Of Inhaler Use Among Medical Officers In The Management Of Asthma In Children In Dar Es Salaam, Tanzania, Hannah Moore

Theses & Dissertations

Background: The inhaled route is the preferred first line method for administration of asthma medication. It is however documented that oral and intravenous routes are the commonly adopted methods of administering asthma medication in children, and the knowledge of the use of inhalers and inhaler devices has not been well documented in middle and low-income countries. Knowledge of inhaler technique among medical personnel ensures effective education of its use to patients to provide the desired results in managing asthma in children. Studies in developing countries have demonstrated a generally low level of knowledge of inhaler use among Medical Doctors …

Validation Of Kiswahili Version Of World Health Organization Quality Of Life-Hiv Bref Questionnaire Among People Living With Hiv/Aids In Tanzania., Nuru Abdallah Kondo

Theses & Dissertations

Background: WHO has developed an HIV specific quality of life tool (WHOQOLHIV-BREF) for assessing Quality of life of HIV positive individuals. This tool takes to account the different cultural variations that exist worldwide and hence enable assessment of the quality of life across different cultures/context. This tool has been validated in different cultures and is cross-culturally a promising tool. It is simple to use in routine clinics as it is self-administered. Despite its sound validity and reliability from several studies, the developers recommend it to be validated in different cultures to fully assess its psychometric properties before its adaptation.

Objectives: …

Barriers To Timely Disclosure Of Hiv Serostatus: A Qualitative Study At Care And Treatment Centres In Dar Es Salaam, Tanzania, Neelam Akber Ismail

Theses & Dissertations

Introduction: Disclosure of HIV status is important for HIV prevention and maintenance of health for People living with HIV (PLWHIV), their spouses and the community. Despite the benefits of disclosure, there are PLWHIV who delay in disclosing their status thus increasing the risk of transmission of the disease. Objective: This study aimed at determining the barriers to timely disclosure of HIV serostatus among HIV seropositive individuals in Dar es Salaam and what motivated them to disclose.

Methods: A qualitative descriptive study using in depth individual interviews was conducted. Ten participants attending the care and treatment centres took part. Qualitative content …

Female Genital Mutilation And Its Medicalizationa Qualitative Study Among Healthcare Professionals And Community Leaders In Kisii County, Douglas Oimeke Mariita

Theses & Dissertations

Background: According to the World Health Organization (WHO), female genital mutilation (FGM) includes all procedures that involve removal of the female genitalia and / or injury to the female genital organs for cultural and / or any other nonmedical reason. The practice poses serious threats to women’s health hence violating their health and rights. FGM, also referred to as genital cutting, is deeply rooted amongst the Abagusii community of Kenya, with 84% of the girls cut as per Kenya Demographic Health Survey report of 2014 and the medicalized form slowly replacing the traditional cut. Overall in Kenya, the medicalized form …

Magnitude Of Screening For Gestational Diabetes Mellitus In An Urban Setting In Tanzania, Akampa Mukuve

Theses & Dissertations

Background: Medical screening detects risk factors for disease or presence of disease in otherwise well persons in order to intervene early and reduce morbidity and mortality. During pregnancy it is important to detect conditions which may harm the mother and fetus during antenatal care (ANC). Gestational diabetes mellitus (GDM) is one such condition which causes adverse effects during pregnancy, acutely and in the long term. There is lack of consensus on uniform screening and diagnostic guidelines for GDM both internationally and locally. Furthermore, there is evidence that recommendations in antenatal care guidelines are not routinely performed by health care providers …

Prevalence And Correlates Of Comorbid Depression In Patients With Type 2 Diabetes Attending Clinic At Aga Khan University Hospital, Nairobi, Alamin Suleiman

Theses & Dissertations

Introduction: Type 2 diabetes affects 500,000 people in Kenya and is a single cause of morbidity and mortality. It also co-exists with depression, increasing the disease severity and the likelihood of a lower quality of life.

Objectives: The primary aim of this study was to examine the depression prevalence as well as factors associated with depression among patients with Type 2 diabetes attending clinic at Aga Khan University Hospital Nairobi (AKUHN). The study also assessed the differences in depression severity with Type 2 diabetes alone and with Type 2 diabetes and other comorbid conditions.

Methodology: An analytic cross-sectional methodology was …

Patients Perspective On The Non-Urgent Use Of The Emergency Department In Kenya, Carolyne Robai Matifary

Theses & Dissertations

Background: Globally, there is an increasing demand for emergency department (ED) care in many countries accompanied by the dire need to optimize scant resources. Sub Saharan Africa (SSA) is facing a rapid surge in the prevalence of non-communicable diseases (NCDs) compounded by an already prevailing significant problem of communicable diseases and injuries. This has led to increased demand for emergency care expertise owing to acute complications of all these conditions. The impact includes ED overcrowding, increased healthcare costs, extended waiting periods and overstretched essential services. To mitigate this, it is imperative that EDs be utilized appropriately to continue providing quality …

Assessment Of Patient Satisfaction With Primary Health Care At The Family Medicine Centre Of Aga Khan University Hospital, Nairobi, Alvin M. Juma

Theses & Dissertations

Background: Patient satisfaction is one of the key indicators by which the quality of healthcare service is evaluated. The World Conference of Family Doctors African Chapter's (WONCA-Africa) encourages Family Medicine practices to regularly assess their patients' satisfaction as one of the criteria for benchmarking and auditing the quality of primary care in Africa. The Kenyan government, in a quest to improve primary care provision, has formulated policy to make family physicians essential players in coordinating and enhancing standards of primary care.

Objective: This study aimed to assess patient satisfaction with the quality of primary health care services provided by family …

Prevalence And Factors Associated With Female Sexual Dysfunction Amongst Women Using Hormonal And Non-Hormonal Contraception At The Aga Khan University Hospital Nairobi Clinics, Momin Butt

Theses & Dissertations

Background: Female sexual function is a complex phenomenon. It integrates all the body systems and is influenced by a variety of factors. Contraceptives have been shown to have variable effects on female sexual function, but there have not been adequately powered studies on this in our setting.

Justification: The prevalence of female sexual dysfunction (FSD) has been shown to vary among different population subsets globally. The associations of different factors with FSD have also shown variable conclusions that are not generalizable to our setting. In Kenya there is a high discontinuation rate of contraception and this is mainly attributed to …

A Comparison Of Caesarean Section Rates Before And After Introduction Of Free Maternity Services At Maragua Level Iv Hospital, Grace Rwamba

Theses & Dissertations

Introduction: At population level, a caesarean section (CS) rate between 10 and 15 percent is considered optimal for maternal and infant health outcomes and a useful process indicator of quality of care. However, that there has been a worldwide increase of CS rates in the past three decades. Compared to vaginal birth, questions abide of appropriateness, balance of risk versus benefit and cost implications to the health care system. Introduction of free maternity services (FMS) in June 2013has been known to increase health facility deliveries. However it may affect the quality of care offered in these facilities due to a …

Effect Of Diabetes Self-Management Education On Glycemic Control, Compared To Usual Care In Type 2 Diabetic Patients At The Family Medicine Clinic, Aga Khan University Hospital Nairobi, Catherine Wanjiku Gathu

Theses & Dissertations

Background: Globally, the magnitude of disease burden associated with diabetes is high. Poor glycemic control contributes greatly to this burden, especially in the occurrence of related complications. The value of Diabetes Self-Management Education (DSME) is evident in literature, and has been recommended as a way of optimizing glycemic and metabolic control and averting early onset of diabetes complications. Usual care involves spontaneous sharing of information during medical consultations without planned structure or defined time frame. In the African setting, the effect of DSME, and how it compares to usual care, is yet to be fully explored.

Objective: To compare the …

Primary Health Care Providers’ Knowledge And Practices On Asthma Management Within Dar Es Salaam Region Health Facilities, John C. Rwegasha

Theses & Dissertations

Background: Asthma is a common chronic health problem worldwide with considerable variation in the way it is managed. In the sub- Saharan Africa there is substantial gaps in asthma care; countries like Tanzania with inadequate health care structure are lagging far behind in both correct diagnosis and management of asthma. The increasing prevalence of asthma within populations is attributed to a number of the following factors; Patient behavior, Health service structure and access, Environmental factors and Provider's knowledge and practices. There is lack of required standard asthma care under provider's factors, hindering effective control of the disease. This could be …