Medicine and Health Sciences Commons^™

Depression And Its Associated Factors: Perceived Stress, Social Support, Substance Use And Related Sociodemographic Risk Factors In Medical School Residents In Nairobi, Kenya, Sayed Shah Nur Hussein Shah, Ahmed Laving, Violet Caroline Okech-Helu, Manasi Kumar

Brain and Mind Institute

Abstract: Background: Little data exists regarding depression and its associated factors in medical residents and doctors in Sub-Saharan Africa. Residents are at high risk of developing depression owing to the stressful nature of their medical practice and academic training. Depression in medical residents leads to decreased clinical efficiency, and poor academic performance; it can also lead to substance abuse and suicide. Our primary aim was to measure depression prevalence among medical residents in Kenya’s largest national teaching and referral hospital. Secondary aims were to describe how depression was associated with perceived stress, perceived social support, substance use, and educational environment. …

Addressing Production Gaps For Vaccines In African Countries, Anna Mia Ekström, Göran Tomson, Rhoda K. Wanyenze, Zulfiqar Ahmed Bhutta, Catherine Kyobutungi, Agnes Binagwaho, Ole Petter Ottersen

Institute for Global Health and Development

No abstract provided.

Residency Training On The Frontlines Of The Covid-19 Pandemic - A Qualitative Study From Tanzania, Mariam Noorani, Hussein Manji, Elizabeth Mmari, Samina Somji, Nahida Z. Walli, Sherin Kassamali, Shabbir Adamjee, Nancy Matillya, Hanifa Mbithe, Aliasger Nagri, Neelam Ismail

Paediatrics and Child Health, East Africa

Introduction: the Coronavirus Disease 2019 pandemic has affected residency training globally. The aim of this study was to understand how the pandemic affected teaching and learning in residency programs in low resource settings where residents and faculty were working on the front line treating patients with the disease.

Methods: this qualitative study enrolled residents and faculty from the Aga Khan University in Tanzania who were providing front line care during the pandemic. Purposeful sampling was used and data was collected using focus group discussions and in-depth interviews between August and September 2020. Analysis was done using qualitative content analysis.

Results: …

Exposure To Parasitic Infections Determines Features And Phenotypes Of Active Convulsive Epilepsy In Africa, Nelson K. Langat, Symon M. Kariuki, Gathoni Kamuyu, Angelina Kakooza-Mwesige, Seth Owusu-Agyei, Kenneth Ae-Ngibise, Anne Wang'ombe, Anthony Ngugi, Honorati Masaja, Ryan G. Wagner

Population Health, East Africa

Background: Epilepsy affects 70 million people worldwide, 80% of whom are in low-and-middle income countries (LMICs). Infections of the central nervous system (CNS) contribute considerably to the burden of epilepsy in LMICs, but the nature and presentation of epilepsy following these infections is not fully understood. We examined if epilepsy foutcomes are associated with the exposure to parasitic infections.
Methods: This was a case-comparison study nested in a cross-sectional survey of people with active convulsive epilepsy, with cases as those exposed to parasitic infections, and comparison as those unexposed. Associations of exposure to parasites with clinical and electroencephalographic …

Predicting The Environmental Suitability For Onchocerciasis In Africa As An Aid To Elimination Planning, Elizabeth A. Cromwell, Joshua C P. Osborne, Thomas R. Unnasch, Maria-Gloria Basáñez, Katherine M. Gass, Kira A. Barbre, Elex Hill, Kimberly B. Johnson, Katie M. Donkers, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where …

Systematic Review On Epidemiology, Interventions And Management Of Noncommunicable Diseases In Acute And Emergency Care Settings In Kenya, Christine Ngaruiya, Annrita Kawira, Florence Mali, Faith Kambua, Beatrice Mwangi, Mbatha Wambua, Denise Hersey, Laventa Obare, Rebecca Leff, Benjamin Wachira

Emergency Medicine, East Africa

Introduction: Mortality and morbidity from Non-Communicable Diseases (NCDs) in Africa are expected to worsen if the status quo is maintained. Emergency care settings act as a primary point of entry into the health system for a spectrum of NCD-related illnesses, however, there is a dearth of literature on this population. We conducted a systematic review assessing available evidence on epidemiology, interventions and management of NCDs in acute and emergency care settings in Kenya, the largest economy in East Africa and a medical hub for the continent.

Methods: All searches were run on July 15, 2015 and updated on December 11, …

A Review Of Toolkits And Case Definitions For Detecting Enteric Fever Outbreaks In Asian And African Countries From 1965-2019, Asif Khaliq, Mohammad Tahir Yousafzai, Salman Haq, Rahima Yaseen, Sonia Qureshi, Fahad Rind, Zahra A. Padhani, Ayub Khan, Abdul Momin Kazi, Farah Naz Qamar

Department of Paediatrics and Child Health

Background: This review assessed the case definitions, diagnostic criteria, antimicrobial resistance, and methods used for enteric fever outbreaks and utilization of any unified outbreak score or checklist for early identification and response in Asia and Africa from 1965-2019.
Methods: We searched enteric fever outbreaks using PubMed, Google Scholar, and the Cochrane library. Studies describing a single outbreak event of enteric fever in Asia and Africa from 1965-2019 were reviewed. We excluded case reports, letter to editors, studies reporting typhoid in conjunction with other diseases, the Centers for Disease Control and Prevention (CDC) trip reports, the World Health Organization (WHO) bulletins …

Needs Of Young African Neurosurgeons And Residents: A Cross-Sectional Study, Ulrick S. Kanmounye, Faith C. Robertson, Nqobile S. Thango, Alvin Nah Doe, Nourou Dine Adeniran Bankole, Pape Aicha Ginette, Solomon Ondoma, James A. Balogun, Beverly Cheserem, Mahmood Qureshi

General Surgery, East Africa

Introduction: Africa has many untreated neurosurgical cases due to limited access to safe, affordable, and timely care. In this study, we surveyed young African neurosurgeons and trainees to identify challenges to training and practice.

Methods: African trainees and residents were surveyed online by the Young Neurosurgeons Forum from April 25th to November 30th, 2018. The survey link was distributed via social media platforms and through professional society mailing lists. Univariate and bivariate data analyses were run and a P-value < 0.05 was considered to be statistically significant.

Results: 112 respondents from 20 countries participated in this study. 98 (87.5%) were male, 63 (56.3%) were from sub-Saharan Africa, …

Pediatric Rheumatology In Africa: Thriving Amidst Challenges, Angela Migowa, Djohra Hadef, Wafa Hamdi, Oscar Mwizerwa, Madeleine Ngandeu, Yassmin Taha, Faleye Ayodele, Kate Webb, Christiaan Scott

Paediatrics and Child Health, East Africa

Background: Pediatric Rheumatology is an orphan specialty in Africa which is gradually gaining importance across the continent.

Main body: This commentary discusses the current state of affairs in the sphere of Pediatric Rheumatology across Africa and offers practical strategies to navigate the challenges encountered in research, models of care, education and training. We outline the establishment, opportunities of growth and achievements of the Pediatric Society of the African League Against Rheumatism (PAFLAR).

Conclusion: This commentary lays the foundation for establishment of a formidable framework and development of partnerships for the prosperity of Pediatric Rheumatology in Africa and beyond.

High Prevalence Of Multidrug-Resistant Clostridioides Difficile Following Extensive Use Of Antimicrobials In Hospitalized Patients In Kenya, Winnie C. Mutai, Marianne W. Mureithi, Omu Anzala, Gunturu Revathi, Brian Kullin, Magdaline Burugu, Cecilia Kyany’A, Erick Odoyo, Peter Otieno, Lillian Musila

Pathology, East Africa

Introduction: Clostridioides difficile is a neglected pathogen in many African countries as it is generally not regarded as one of the major contributors toward the diarrheal disease burden in the continent. However, several studies have suggested that C. difficile infection (CDI) may be underreported in many African settings. The aim of this study was to determine the prevalence of CDI in hospitalized patients, evaluate antimicrobial exposure, and detect toxin and antimicrobial resistance profiles of the isolated C. difficile strains.

Methods: In this cross-sectional study, 333 hospitalized patients with hospital-onset diarrhoea were selected. The stool samples were collected and cultured on …

Magnetic Resonance Imaging Findings In Childhood Epilepsy At A Tertiary Hospital In Kenya, Pauline Samia, Nicholas Odero, Maureen Njoroge, Shem Ochieng, Jacqueline Mavuti, Sheila Waa, Samson Gwer

Paediatrics and Child Health, East Africa

Background: Neuroimaging is important for determining etiology and guiding care in early childhood epilepsy. However, access to appropriate imaging in sub-Saharan Africa is modest, and as a consequence, etiological descriptions of childhood epilepsy in the region have been limited. We sought to describe MRI findings in children with epilepsy presenting to a tertiary hospital in Nairobi, Kenya, over a 6-year period of routine care.

Materials and Methods: We undertook a retrospective review of MRI findings of children aged between 0 and 18 years with a diagnosis of epilepsy presenting to the pediatric neurology department of Aga Khan University Hospital in …

Covid-19 And Teleneurology In Sub-Saharan Africa: Leveraging The Current Exigency, Philip Adebayo, Olusegun John Oluwole, Funmilola Tolulope Taiwo

Faculty of Health Sciences, East Africa

tion residing in rural areas that have poor access to medical experts. Despite having a ridiculously huge, underserved population, very few African countries currently have any form of sustained and organized telemedicine practice, and even fewer have dedicated tele-neurology services. The ongoing COVID-19 pandemic has proved to be one of the most significant disruptors of vital sectors of human endeavor in modern times. In the healthcare sector, there is an increasing advocacy to deliver non-urgent care via telemedicine. This paper examined the current state of tele-neurology practice and infrastructural preparedness in sub-Saharan Africa. Currently, there is over 70% mobile phone …