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Kenya Medical Research Institute (KEMRI))
© 2024 The authors. This work is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0).
Determinants of Optimal Antenatal Care Services Uptake among Adolescent Mothers in Bomachoge Borabu Subcounty, Kisii County
Background: Pregnancy and childbirth complications are leading causes of death among adolescent girls. Due to the high number of teenage pregnancies in Bomachoge Borabu Sub-County, this study aimed to determine adherence levels and factors associated with the uptake of antenatal care services among adolescent mothers in Bomachoge Borabu Sub-County, Kisii County, Kenya. Methods: This study employed a quantitative cross-sectional design. Five government health facilities were purposively selected, and 293 adolescent mothers aged between 15 and 19 years randomly sampled. Structured questionnaires were used in the study. Fisher’s exact test of association and multivariable analysis were carried out to determine the association between adherence and various variables. Results: A majority of the sampled adolescent mothers (88.3 %) had access to at least one Antenatal Care (ANC) visit during their pregnancy. Their mean age was 17.4 (STD± 1.38) years. The majority (96.1 %) did not adhere to optimal ANC uptake, with 25.2 % and 48.8% adhering to the scheduled visits in the 1st and 2nd trimester, respectively. None came for the 3rd trimester. Gestational age at 1st ANC, knowledge of recommended number of ANC visits and mode of reminders to attend scheduled ANC visits were significantly associated in univariable analysis (p <.001). Mothers who sought ANC between 8-12 weeks and 16 weeks, respectively, were 24.5% (p<.00425) and 18.75 % (p<.0228) times more likely to adhere, respectively, compared to those who sought ANC at 4 weeks. Similarly, mothers without knowledge of the recommended number of ANC visits were 89% (p<.006) more likely to adhere compared to those who had the knowledge. Conclusion: Most adolescent women were at risk of maternal morbidity and mortality due to high levels of non-adherence to optimal ANC uptake, despite having knowledge of the ANC recommendations. Early ANC contact initiation and use of ANC reminders boost adherence to optimal ANC uptake among adolescent mothers.
Copyright (c) 2025 Jacinta Omariba, Joseph Mutai, George Alliwa Makalliwa, Charles K. Syengo (Author) https://creativecommons.org/licenses/by/4.0
Determinants of Underweight among Children of Adolescent Mothers in Western Kenya
Background: Underweight among adolescent mothers' children remains a significant public health issue, especially in Low and middle-income countries [LMICs]. Understanding context-based determinants of underweight is important in the formulation of specific interventions necessary for addressing it. Therefore, this study investigated the determinants of underweight among children of adolescent mothers in Vihiga County, Western Kenya. Methodology: This hospital-based cross-sectional study was carried out across 25 health facilities in Vihiga County. A total of 121 adolescent mothers were interviewed using a semi-structured questionnaire to obtain their children's health status data. Additional information was obtained from the antenatal, postnatal and maternity records. Data was analysed using descriptive statistics, bivariate analyses, and multivariable logistic regression models in STATA version 18. Results: Overall, 15.3% of children born to adolescent mothers were undernourished, with 4.7% underweight and 10.6% severely underweight. Maternal primary-level education was associated with higher odds of child underweight [aOR = 6.66, 95% CI: 2.02–21.96, p = 0.002]. Preterm delivery emerged as the strongest predictor [aOR = 17.6, 95% CI: 3.24–96.44, p = 0.001]. Additional determinants included lack of parental support and guidance [aOR = 7.31, 95% CI: 1.89–28.38, p = 0.004] and limited access to healthcare [aOR = 4.86, 95% CI: 1.26–18.71, p = 0.021]. Conclusion: Maternal education, parental support, preterm delivery and challenges in accessing health services are key determinants of underweight in children of adolescent mothers in Vihiga. There is an urgent need for programmatic interventions to address these determinants to promote these vulnerable children's health outcomes.
Copyright (c) 2025 Martin Osotsi, Winnie Majanga, Dorothy Okemo, Antony Ochung', Daniel Onguru, George Ayodo (Author) https://creativecommons.org/licenses/by/4.0
The Impact of COVID-19 on HIV Services in Kajiado County, Kenya: An interrupted time series analysis
Background: Globally, approximately forty million people are living with HIV, indicating HIV/AIDS is a major global public health issue. The World Health Organisation (WHO) projected that disruptions to HIV treatment caused by the COVID-19 pandemic could result in over 500,000 additional AIDS-related deaths in sub-Saharan Africa between 2020 and 2021. In recent decades, Kenya has made significant progress in HIV/AIDS care, leading to notable declines in incidence, morbidity, and mortality. However, limited data exist on the impact of the COVID-19 pandemic on HIV/AIDS care in sub-Saharan Africa. Methodology: This was an interrupted time series study design, where aggregate monthly HIV care services data were collected from the health information systems of Loitoktok, Ongata Rongai, Kitengela sub-County Hospitals and Entasopia Health Centre in Kajiado County. The pre-COVID-19 period (June 2018 to February 2020) and the COVID-19 period (March 2020 to November 2021) were analysed. Results: ART continuation remained stable at the beginning of COVID-19 pandemic (p = 0.200) and significantly increased over time (p = 0.048). New HIV care enrolments sharply declined at the pandemic's onset (p < 0.001), and HIV testing services showed a sustained decrease (p = 0.009). In contrast, PrEP use rose steadily throughout (p < 0.001). Conclusions: In Kajiado, COVID-19 negatively impacted HIV treatment and prevention services. Decreasing trends indicated COVID-19 disruption, while increasing trends indicated that healthcare systems have successfully evolved to continue delivering HIV care despite COVID-19 disruptions.
Copyright (c) 2025 Regina Malit, Kenneth Ngure, Moses Kinayia, Benjamin Ngugi (Author) https://creativecommons.org/licenses/by/4.0
Seroprevalence of Anti-Sars-Cov-2 Antibodies among Patients Visiting Hospital-Based Sentinel Sites in the Rift Valley Region, Kenya
Background: Accurate estimation of the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is crucial for guiding public health prevention strategies. Underreporting from polymerase chain reaction (PCR) based testing, especially in low- and middle-income countries, often obscures the true extent of exposure and immunity to coronavirus disease 2019 (COVID-19). This study aimed to determine the seroprevalence and antibody levels against SARS-CoV-2 among patients visiting hospital-based sentinel sites in Kenya’s Rift Valley region. Method: A cross-sectional study was conducted at four hospital-based sentinel sites among patients with symptoms of acute respiratory infection. Patients aged six months or older visiting the sites between January 2022 and December 2022, presenting with symptoms of acute respiratory infection, were enrolled. Clinical and sociodemographic data were collected using a structured questionnaire. A quantitative enzyme-linked immunosorbent assay (ELISA) kit detected IgG antibodies against SARS-CoV-2 S protein in serum samples. Results: Among 557 individuals enrolled in the study, the seroprevalence of SARS-CoV-2 antibodies was 97.8% (n=545). Vaccinated individuals demonstrated significantly higher odds of seropositivity compared to unvaccinated counterparts, with an odds ratio of 3.33 (95% CI: (0.4, 27.87). While seropositivity remained consistent across age groups, older adults exhibited the highest odds. Site-specific differences in enrolment and vaccination rates highlight potential access-related disparities. Conclusion: Our findings indicate prior exposure to SARS-CoV-2 within the study region, underscoring the significant impact of natural infection and vaccination efforts in driving SARS-CoV-2 seroprevalence within the Rift Valley region. Despite the underestimation of infections and disparities in vaccination access, this study demonstrates the effectiveness of vaccination for conferring SARS-CoV-2 immunity. To ensure equitable vaccination coverage, targeted interventions should focus on increasing vaccine accessibility through mobile clinics and community-based vaccination campaigns while addressing vaccine hesitancy through targeted public health messaging and community engagement.
Copyright (c) 2025 Vincent Kiplangat Ruttoh, Brian Kipkoech, Ronald Tonui, Ruth Omoti John, Ibrahim Mwangi, Ruth Wambui Gicho, Sally Wambui Kamau, Maureen Njihia, Samwel Symekher, Timothy Mwanzia, James Gikunda, Matthew Munyao, Caroline Njoroge, Samson Nzou (Author) https://creativecommons.org/licenses/by/4.0
Assessment of Bacteriological Quality and Physicochemical Properties of Borehole Water Supplies in Eastleigh, Nairobi County, Kenya
BACKGROUND A borehole is a valuable source of fresh, potable water that globally feeds around 1.5 billion people daily. It is, however, vulnerable to both microbial and chemical pollution, which poses health risks to the population if consumed without proper treatment. It is from this perspective that this study aimed to assess the quality of borehole water supplies in Eastleigh, considering their implications for human health. METHODOLOGY A repeated cross-sectional design was employed to study physicochemical and microbiological parameters of the boreholes. A proportionate stratified sampling method was used to sample 25 boreholes. Water samples from the storage tanks of the boreholes were collected in sterilised 250 ml glass bottles and transported to Kenyatta University microbiology laboratories for analysis. Temperature, pH, Turbidity and Fluoride levels were measured by their respective meters. Lead, cadmium and Arsenic levels were determined by the Atomic Absorption Spectrophotometer. The Most Probable Number technique quantified the coliform and Microbial culturing for bacterial detection. A 12-month retrospective case-control design determined the prevalence of waterborne illnesses from the Eastleigh Community Wellness Centre, Eastleigh Health Centre and Biafra Health Facility hospitals. Mean values obtained for physicochemical and microbiological parameters during the wet and dry seasons (April-May, 2024 and July, 2024, respectively) and across the road streets were analysed using one-way analysis of variance, with p ≤0.05 being significant. RESULTS All physicochemical parameters were generally within Kenya Bureau of Standards (KEBS) permissible standards for drinking water, except for cadmium, fluoride and pH. The total coliform exceeded the KEBS permissible requirements. At least one of the pathogenic bacteria of interest (Escherichia coli, Vibrio cholerae, Salmonella spp and Shigella spp) was detected in every borehole. Review of the patient’s clinical data showed an overall prevalence rate of 8.5%, with patients <5 years and >5 years recording 11.06% and 7.33%, respectively. CONCLUSION Borehole water in Eastleigh is contaminated, and with the prevalence rate of 8.5%, it concludes waterborne diseases in the region as a public health concern. Consumption of water from questionable sources like these boreholes should be limited.
Victor Onyango School of Pure and Applied Sciences, Kenyatta University, Nairobi, Kenya
Copyright (c) 2025 Victor Onyango Otieno, Anncarol Karanja, John Maingi (Author) https://creativecommons.org/licenses/by/4.0
Time to Sputum Smear Conversion in Patients with Bacteriologically Confirmed Pulmonary Tuberculosis in Kiambu County, Kenya
Introduction: Tuberculosis (TB) remains a significant global health burden, with 8.3 million new cases and 1.25 million deaths reported in 2023. Africa accounted for 24% of these cases, with Kenya ranking among the top 30 high-burden countries, reporting 97,126 TB cases. Kiambu County is among Kenya's top 12 high-burden counties, with a case notification rate of 189 per 100,000. Consequently, this study aimed to assess the time to sputum smear conversion and identify demographic, clinical, and socio-economic factors associated with delayed conversion among TB patients in Kiambu County. Methods: A prospective longitudinal study was conducted among 316 newly diagnosed TB patients, who were followed from treatment initiation with weekly sputum smear assessments and monthly measurements of blood sugar and weight until smear conversion. Data were analysed using R Version 4.3.4 employing descriptive statistics, Cox Proportional Hazards Models, and survival analysis. Results: Delayed sputum conversion was significantly associated with a high initial bacillary load (hazard ratio, HR = 1.52, p < 0.001), diabetes (HR = 1.20, p = 0.036), and poor socioeconomic status (HR = 1.16, p = 0.007). Conversely, older age groups 35–44 years (HR = 0.61, p = 0.037) and 55+ years (HR = 0.73, p = 0.032) demonstrated faster conversion rates. Conclusion: This study underscores the importance of addressing demographic, socioeconomic, and clinical factors, such as area of residence, employment status, baseline bacillary load, diagnosis delays, and diabetes, to optimise sputum smear conversion. The findings highlight the need for targeted interventions and tailored strategies to enhance treatment success across diverse populations.
Copyright (c) 2025 Annfreshia Wangari Maina, Jane Rahedi Ong’ang’o, Magoma Kwasa , Richard Kiplimo, Simon Njuguna Ndungu, Moses Ndiritu, Moses Mucugi Njire (Author) https://creativecommons.org/licenses/by/4.0
Endoscopic Retrograde Cholangiopancreatography Utilisation and Outcomes in Mater Misericordiae Hospital, Nairobi: A retrospective cohort study
INTRODUCTION Endoscopic management of hepatobiliary conditions is becoming increasingly important. This includes the use of endoscopic retrograde pancreatography (ERCP) and endoscopic ultrasound. The objective of this retrospective review was to report on the utilisation and outcomes of Endoscopic Retrograde Cholangiopancreatography. These include the success rate, incidence and risk factors for procedure-related complications and outcomes in Mater Misericordiae Hospital, Nairobi, for the first 122 cases since the introduction of ERCP, from August 2023 to January 2025. METHODOLOGY This is a retrospective review of records made before, during and after ERCP procedures between October 2023 and January 2025. Data on the clinical status of patients before the procedure, the procedure conducted, complications and patient treatment outcomes after 48 hours and at two weeks following the procedure were abstracted using a standardised tool. Statistical significance was set at p<0.05 and confidence interval at 95%. RESULTS Records for 122 patients were recovered. There was a male-to-female ratio of 1:1.39, where males were 51 and females 71. The mean age was 51.38 years, with the mean age for males as 54.67 years and 49.01 years for females. The procedure success rate was 95%, while reported complications were less than 5%. Biliary duct strictures were the most common condition observed, and most patients with this condition were older than 50 years. The average time taken for the procedures was 64.79 minutes (SD±37.11), with a minimum of 25 minutes and a maximum of 220 minutes. CONCLUSIONS These findings report early outcomes from the first 122 Endoscopic Retrograde Cholangiopancreatography (ERCP) procedures conducted at the Mater Misericordiae Hospital in Nairobi, Kenya. A procedural success rate of 95% was achieved, with complication rates reported at under 5%. Biliary duct strictures were the most common indication, particularly among patients over 50 years. The findings reflect safe and effective service initiation at the facility, within the study period.
Endoscopic Retrograde Cholangiopancreatography
Copyright (c) 2025 Hudson Lodenyo, Imelda Leitich (Author) https://creativecommons.org/licenses/by/4.0
Adherence to Self-Care Practices and Associated Factors among Patients Diagnosed with Hypertension Visiting the Medical Outpatient Clinic at Kenyatta National Hospital
Background: Self-care practices in hypertension describe proactive behaviours undertaken by patients to manage their condition and prevent complications. These include medication adherence, dietary changes, such as low-sodium intake and adherence to the Dietary Approaches to Stop Hypertension (DASH) diet, regular physical activity, weight control, alcohol moderation, and smoking cessation. This study assessed adherence to self-care practices and associated factors among hypertensive patients attending the medical outpatient clinic at Kenyatta National Hospital (KNH), Kenya's largest national referral hospital. Methodology: A hospital-based analytical cross-sectional study was conducted among 167 adult patients receiving antihypertensive treatment at KNH. Systematic random sampling was used, where every third eligible patient was selected after the first was chosen via lottery. Data were collected using an interviewer-administered structured questionnaire incorporating the validated Hypertension Self-Care Activity Level Effect (H-SCALE) and Hypertension Evaluation of Lifestyle and Management (HELM) scale. Data analysis was done using SPSS version 26. Descriptive statistics and binary logistic regression were used to determine associations between independent variables and self-care adherence. Results: The mean age of participants was 43.4 years (SD±6.1). Only 34.7% demonstrated good adherence to self-care practices, while 65.3% had poor adherence. Among individual behaviours, smoking cessation had the highest adherence (92.7%), followed by medication adherence (86.5%) and alcohol moderation (57.8%). Lower adherence was observed for weight management (30.9%), physical activity (27.3%), and low-salt diet (15.1%). Sociodemographic characteristics were not significantly associated with self-care adherence. However, participants with good knowledge of hypertension were significantly more likely to adhere to self-care practices (OR = 3.20, 95% CI: 1.64–6.24, p = 0.001), indicating that knowledge is a key independent predictor. Conclusion and Recommendations: Adherence to self-care among hypertensive patients remains low, especially in dietary salt reduction and physical activity. While sociodemographic factors were not significant, adequate knowledge of hypertension markedly improved self-care adherence. This underscores the importance of structured, culturally sensitive health education in outpatient settings. Programmes should focus on diet and physical activity, use interactive approaches, and involve family support to sustain long-term behavioural change.
Copyright (c) 2025 Anne Adhiambo Opiyo, Grace Mbuthia, Joan Shisoka (Author) https://creativecommons.org/licenses/by/4.0
Prevalence, Distribution, and Antifungal Susceptibility Patterns of Yeast Isolates at the Nairobi South Hospital
BACKGROUND Yeast infections significantly impact global morbidity and mortality but remain underdiagnosed and underreported. Treatment failure due to antifungal resistance, particularly in critically ill patients, limits treatment options. The aim of this study was to retrospectively describe the proportion and distribution of yeast isolates recovered from inpatient records at The Nairobi South Hospital over five years and to describe the isolates' antifungal drug susceptibility patterns. METHODOLOGY We reviewed inpatient records from 2018 to 2022, focusing on 308 fungal culture records that met the inclusion criteria. Clinical data included age, sex, ward, and year of admission. Laboratory data included sample type, yeast species, and antifungal susceptibility. Identification and antifungal susceptibility testing were performed using VITEK-2, and interpreted as per the Clinical and Laboratory Standards Institute guidelines (CLSI). RESULTS Out of 2006 records, 308 (15%) yielded yeast isolates. Distribution was: Candida albicans (38%), non-albicans Candida (NAC) species (50%), Cryptococcus species (10%), and Trichosporon species (2%). The yeasts demonstrated reduced susceptibility to all tested antifungal agents. Based on Minimum Inhibitory Concentration (MIC) data and CLSI breakpoints, 90% of the isolates exhibited high MICs and were classified as resistant to amphotericin B, 70% to itraconazole, and 61% to fluconazole. In contrast, 74% and 44% of the isolates had low MICs and were susceptible to flucytosine and voriconazole, respectively. CONCLUSION AND RECOMMENDATIONS Candida albicans remained the most common yeast species, although non-albicans Candida species are on the rise. Widespread antifungal resistance necessitates tracking yeast profiles and susceptibility patterns for effective patient management.
Copyright (c) 2025 Charity Lyavuli Akweya, Winnie C. Mutai, Kenneth Omollo, Gloria Omosa-Manyonyi, Florence Mutua (Author) https://creativecommons.org/licenses/by/4.0
Assessment of the Particle Filtration Efficiency of N95 Masks Protecting Quarry Workers in Erongo, Otjozondjupa, and Kunene Regions of Namibia
Background: Quarry workers use different types of N95 masks to protect themselves from occupational respirable dust. However, little is known about the filtration efficiency of N95 masks among Namibian quarry workers. Hence, this study measured the filtration efficiency of the different N95 masks used in quarry mines following respirable dust exposure. Methodology: The study employed a quantitative experimental design in a controlled environment with a sample of seven (7) N95 masks labelled A, B, C, D, E, F, and G from seven (7) quarry mining sites, with one mask from each site. Samples were selected using purposive sampling, focusing on the availability of masks FFP1 and FFP2, which are considered standard respiratory protection masks used in quarry mines. Masks' particle filtration efficiency and effectiveness were assessed by an experiment that included gravimetric weighing, mask testing, and particle size analysis techniques. Results: The seven N95 masks collected insignificant dust compared to the amount of dust that passed through them, through gravimetric weighing. Site G recorded the highest dust exposure at 0.015mg, above the technique's standard uncertainty of ±0.010mg. Sites A and B had lower filtered dust weights, whereas Sites C, D, F, and G had higher values. The mass on filters increased significantly with a 5-minute sample period. The particle size analyser method showed that Sites A, B, and C showed smaller particles with 100% of the PM10 range, while sample Site D showed the highest particle size, with at least 60% below the PM10 range. Conclusions: The N95 mask efficiently filters respirable dust particles at the initial stages. However, their filtration efficiency diminishes following prolonged use. Accordingly, Efficacy decreases as respirable dust exposure increases. Recommendations: Based on the study findings, all the N95 masks met the filtration efficiency standards that attain the ideal respiratory protection; therefore, quarry workers should just increase the frequency of changing the masks. Additionally, masks should be tested upon fitting, properly fitted when used, and frequently replaced to complement the desired filtration efficiency.
Copyright (c) 2025 Saima Shihepo, Roswitha Mahalie, Omotayo Awofolu (Author) https://creativecommons.org/licenses/by/4.0
Knowledge, Attitude and Practices on Bed Net Usage among Communities in Cherangany Sub-County, Kitale, Kenya
BACKGROUND Globally, vector-based malaria control programs, such as insecticide-treated nets (ITNs) play an essential role in reducing malaria infections. Despite evidence of their effectiveness when properly and consistently used, usage still lags. The study investigated knowledge, attitudes, and practices towards insecticide-treated nets utilisation among communities in Cherangany Sub County, Trans-Nzoia County. METHODS This cross-sectional study was conducted in the Charangany sub-county, and 326 respondents were recruited for the study. Quantitative data were collected by interviewer-administered questionnaires, and data were analysed using STATA version 15. Data were presented using frequencies and percentages. Linear correlations were used to determine associations between the dependent variable and independent variables, and Regression analysis was carried out to test whether the independent variables were predictors of net usage. RESULTS Academic achievement and educational resources showed a strong correlation with net usage (r = 0.746, p < 0.01). Knowledge, attitudes, and practices (β = 0.41, p = 0.021) and socio-economic factors (β = 0.296, p = 0.010) were also significant predictors. Individual characteristics had the strongest correlation (r = 0.872). Marital status and urban residence (β = 0.372, p = 0.000) were key predictors. Standardised results ranked knowledge (β = 0.421) highest, followed by education (β = 0.308) and socio-demographics (β = 0.291). These findings highlight education and socio-economic factors as critical for ITN adoption. Low-income households, lower education levels, and employment status were associated with lower bed net usage. CONCLUSIONS The study highlighted education and socioeconomic status as major influences on insecticide-treated net use. We also noted the important roles of individual factors like marital status and urban residence. These findings indicate that improving bed net utilisation may require both broad public education and targeted interventions for specific groups.
Copyright (c) 2025 Titus Kibet Kiprono (Author); Alexander Mbeke, Dominic Mogere https://creativecommons.org/licenses/by/4.0
Child Oral Health: Practices among Parents Attending Child Welfare Clinics in Murang’a County, Kenya
BACKGROUND Early childhood caries affects half of Kenya's under-five-year-old children. This high disease burden suggests possible gaps in child oral healthcare practices among their parents. To facilitate change in practice towards reducing early childhood caries, there was a need to identify current practice gaps. This study thus aimed at assessing child oral healthcare practices among parents attending child welfare clinics in Murang’a County, Kenya. METHODOLOGY This was a baseline cross-sectional study targeting 357 parents of children aged 6-18 months attending the child welfare clinics in Murang’a County, Kenya. An interviewer-administered questionnaire was used to collect data on child oral healthcare practices. The chi-square test and logistic regressions were used to determine the association between predictor variables and practices. RESULTS Fifty-one (14.3%) of the parents cleaned their children's teeth, majority brushed occasionally. Brushing was significantly (p<0.001) influenced by the child's age. Parents' age, sex or level of education did not influence teeth cleaning. Only 2.0% used toothbrush and toothpaste, while a piece of cloth was the preferred cleaning tool (10.9%) and only 1.1% used toothbrush only. Additionally, only 14.3% of participating parents referred to dental health notes in the mother-child booklet, none had filled the baby's teeth development chart. Notably, no parent had taken their child for an index dental visit, consumption of a cariogenic diet was prevalent (32.8%), and uvulectomy (6.7%) was practised among the study population. CONCLUSION AND RECOMMENDATIONS Parents visiting the child welfare clinics had poor child oral health practices, consequently, they should be educated on child oral health practices and how to utilize the mother-child booklet for oral health.
Copyright (c) 2025 Kaguru George, Mutave Regina James, Ayah Richard, Karimi Peter, Mugambi Cosmas https://creativecommons.org/licenses/by/4.0
Level of Awareness of PrEP among the General Population and HealthCare Providers in Kisumu County
BACKGROUND Even though the Human Immune Deficiency Virus (HIV) prevalence has stabilized, the disease continues to pose challenges, with about 1.3 million cases reported globally and over 22,000 reported in Kenya, making it necessary to use Pre-Exposure Prophylaxis (PrEP) as one of the effective ways used to prevent infection among individual at risk. The study aimed to assess the awareness level of PrEP among the general population in Kisumu County, Kenya. METHODOLOGY The study used a cross-sectional mixed-methods design where data were collected in January 2024 using a questionnaire and key informant interviews with health care providers (HCPs). We used random systematic sampling to select 435 participants from the outpatient departments of selected facilities in Kisumu. Purposive sampling was used in the selection of eight health care providers in these facilities. Descriptive statistics were used to analyse the quantitative data, while narrative analysis was used to analyse the qualitative data. RESULTS Out of the total number of participants, a majority was female (73.79%) and married (63.91%). In addition, 8 health care providers (HCPS) were purposively sampled for in-depth interviews. Most of the participants (97.24%) had ever heard of Prep, with more than half (58.85%) first hearing about it from a healthcare provider. However, this knowledge varied with some participants having poor or scanty knowledge (28.74%), average knowledge (32.64%) and good knowledge (35.86%). Most of the participants (88.97%) would recommend PrEP to others. There was a low proportion of participants (9.89%) who said that their associates had myths concerning PrEP, with some believing that it lowers libido, causes infertility and continual use can make one acquire HIV. Healthcare providers revealed a high level of knowledge and understanding of PrEP and suggested the creation of awareness not only to the PrEP clients but also to the larger community. CONCLUSION There was a general high level of PrEP awareness among participants. However, the varying knowledge levels among participants, as well as the existence of myths and misconceptions, emphasise the need for targeted educational campaigns among the general population on this subject.
Copyright (c) 2025 Munala Anangwe Samson, Odongo Alfred Owino, Mungai Samuel, Muhinji Arnold, Odhiambo Fredrick Oluoch (Author) https://creativecommons.org/licenses/by/4.0
Factors Associated with Mental Health Illness among Construction Workers in Nakuru East Sub-County, Nakuru County, Kenya
Background: According to the World Health Organisation (WHO), mental health is a state of well-being enabling individuals to cope with daily life and contribute to society. In Nakuru Town East Sub-County, construction workers face unique mental health challenges due to short deadlines, long hours, financial stress, and stigma. This study explored the factors influencing their mental health. Methodology: A cross-sectional study was conducted with 275 participants to determine the factors impacting the mental health of workers in construction sites. Data was collected using questionnaires and IBM SPSS Statistics version 28.0.1.0 was used for analysis. Results: This study examined factors influencing mental health among construction workers in Nakuru East Sub-County. Findings revealed that 60.4% lacked safety training, and trained workers were 0.29 times less likely to report mental health issues (95% CI: 0.11–0.72). Awareness of mental health conditions was moderate (41.7%), with knowledgeable individuals being 0.64 times less likely to experience mental health problems (95% CI: 0.52–0.88). Stigma was prevalent, with 34.2% of participants holding negative views about mental health. Workers who experienced stigma, such as ridicule or discrimination, were 2.21 times more likely to face mental health issues (95% CI: 1.85–3.24). Only 32.9% were aware of mental health resources, which was associated with reduced risk (OR=0.29; 95% CI: 0.07–0.87). Additionally, 52.9% reported inadequate workplace support, which doubled the likelihood of mental health challenges (OR=2.08; 95% CI: 1.23–3.55). Short deadlines were reported by 68.8%, 67.5% lacked sufficient rest, 50.4% experienced job stress, and 29.2% were dissatisfied with their jobs. Conclusion: The safety training and awareness of mental health conditions act as protective factors against mental health issues in the construction industry in Nakuru East Sub-County. However, the likelihood of mental health issues is increased by the existence of stigma around mental health, a lack of safety training and knowledge about the resources that are accessible. Recommendation: Implementation of safety training, stigma-reduction campaigns, anti-stigma policies, anonymous assessments, and improved access to care through mobile clinics and workplace support systems should be enhanced. Structured workplace support systems and employee assistance programs will provide ongoing support. Further research will be necessary to assess the long-term impact and inform future policy development.
Depression and Anxiety in Construction workers
Copyright (c) 2025 Patrick Kiplelgo, Alexander Mbeke, Joseph Muchiri (Author) https://creativecommons.org/licenses/by/4.0
Determinants of Nurses' Ethical Decision-Making in Acute Care: A case study of Thika level V hospital
BACKGROUND Nurses in acute care settings often face complex ethical challenges, requiring them to make rapid and skilled decisions despite having limited clinical support. Moreover, novice nurses with limited experience frequently adopt linear decision-making approaches, which focus on single tasks and problems. However, in critical care environments, these decisions could significantly affect patient outcomes. Therefore, this study aimed to identify determinants influencing ethical decision-making among nurses working in the intensive care unit, renal unit, and emergency unit of Thika level V hospital, in Kiambu County, Kenya. METHODOLOGY Adopting an analytical cross-sectional design with quantitative and qualitative methods through a census approach, we recruited 36 registered nurses working in critical care settings of Thika Level V hospital. A self-administered questionnaire and a key informant interview guide were instruments used to collect quantitative and qualitative data, respectively. We analysed the quantitative data using SPSS version 26.0 for descriptive and inferential statistics and thematically analysed qualitative data using NVivo version 21.2. The Mantel-Haenszel chi-square test was used in the inferential analysis with P<0.05 considered statistically significant. The confidence interval was set at 95%. RESULTS The majority of nurses (75%) demonstrated low adherence to the ethical decision-making process. Work-related factors did not significantly influence adherence levels. Emerging thematic areas of ethical issues were three namely, resource allocation, paediatric care, and challenges affecting patient care in acute settings. CONCLUSION AND RECOMMENDATIONS Most nurses in Thika Level V Hospital’s acute care settings exhibited low adherence to ethical decision-making processes and work-related factors did not significantly affect their adherence. The ethical dilemmas the nurses faced were: the allocation of resources, handling of paediatric patients and ethical issues affecting care. To address these gaps, healthcare institutions should provide targeted support to nurses for navigating ethical challenges. We also recommend further research, inter-institutional collaborations, and dissemination of best practices to enhance ethical decision-making in critical care environments.
Copyright (c) 2025 Rachael Nyarangi Simeka, Sherry Oluchina, Jostine Mutinda https://creativecommons.org/licenses/by/4.0
Clinical and Hospital Level Predictors of Quality of Healthcare for Clients with Epilepsy attending Treatment at Selected Hospitals in Kenya
BACKGROUND Quality of Healthcare is the degree to which health services increase the likelihood of desired health outcomes of individuals and populations in the context of prevailing professional knowledge. Despite accounting for 1% of the global disease burden, epilepsy care faces significant challenges, and treatment remains inadequate. This study aimed to determine predictors of quality of care for clients at the selected hospitals in the Nairobi metropolis. METHODS A mixed methods cross-sectional approach was adopted and quantitative data were collected from 373 sampled epilepsy patients from Mama Lucy, Kiambu, Gatundu, Thika and Machakos Level 5 Hospitals using semi-structured questionnaires. Qualitative data were collected from key informant interviews and focus group discussions in the study sites. Using (SPSS) version 26, quantitative data were analysed using chi-square to determine the distribution of observation between groups, and logistic and multiple linear regression analyses to test for association quality of care and various variables. Qualitative data were analysed into themes using NVIVO. RESULTS Predictors of high quality included formal employment with 3.372 OR CI (1.423-7.625) P=0.005, similarly, those who did not experience stigma were 1.98 CI (1.123-3.497) P= 0.018 likely to rate care as high quality. Less than one seizure after beginning treatment was another predictor of high-quality rating OR=2.405 CI (1.017-5.684), P= 0.045. Additionally, a shorter waiting time was a predictor of a good rating with OR= 2.692 CI (0.353-0.756) P=0.028. Patients who could afford treatment were also likely to rate care as high-quality OR=1.79 CI (2.427-3.642) P=0.045. CONCLUSION Key clinical predictors of quality-of-care rating included the time to treatment initiation, type of anti-seizure medication, seizure frequency after treatment onset, and stigma experience. Hospital-related factors influencing care quality included waiting time, service availability, and affordability. Additionally, individuals with formal employment, seizure control, shorter waiting times, and the ability to afford medication were more likely to rate healthcare quality highly.
Copyright (c) 2025 Tiberry D.O. Nyakwana, Simon Karanja, John Gachohi (Author) https://creativecommons.org/licenses/by/4.0
Impact of Point-of-Care Ultrasound in Triage on Diagnosis and Treatment of Trauma Patients in a Resource-Limited Setting in East Africa
BACKGROUND Emergency Department Point-of-Care Ultrasound (ED-POCUS) has shown promise in expediting the management of patients in resource-limited settings. This study aimed to evaluate the clinical impact of triage-based ED-POCUS using the Extended Focused Assessment with Sonography for Trauma (E-FAST) exam for the evaluation of blunt trauma patients in the Accident & Emergency Department (A&E) of a large tertiary public hospital in East Africa. METHODS This was a non-randomized, prospective, quasi-experimental study of adult patients presenting with blunt torso trauma to the A&E of Kenyatta National Hospital in Nairobi, Kenya. The before group received usual care, and the intervention group underwent an E-FAST exam immediately after triage in addition to usual care. The primary outcome was defined as the occurrence of and time to intervention, such as transfusion of blood products, chest tube insertion, or transfer to the operating theatre. Secondary outcomes included time to intravenous fluids (IVF), first speciality consultation, time from consult to specialist evaluation, disposition, length of hospital stay, and in-hospital mortality. RESULTS The usual care group (before ultrasound) included 149 patients, and 99 patients were enrolled in the E-FAST (after ultrasound) cohort. The occurrence of and time to the composite primary outcome did not differ significantly between the two groups (p=0.61 and p=0.56, respectively). Of the secondary outcomes, time to IVF was significantly shorter in the E-FAST compared with the usual care group (median 5.5 minutes (IQR 16.0) vs 32.8 (117.5). CONCLUSION The use of the E-FAST exam at triage in blunt trauma victims did not significantly improve the time to surgical intervention or transfusion of blood products. However, there was improved time to IVF resuscitation.
Copyright (c) 2025 Justin Myers , Janet Sugut, Sarah Ashley, Betty Ngila, Alice Maingi , Travis Wieland, Patricia Othieno , Timothy Platts-Mills, Rayad Shams (Author); Ali Wangara; Stephen Dunlop, Castro Jasper, Paul Mbuvi, Katherine M. Hunold , Adam Aluisio, Mark Hoppens, Philemon Kimathi, Daniel Ojuka , Grace Wanjiku (Author) https://creativecommons.org/licenses/by/4.0
Awareness and Knowledge of Ocular Allergy among Undergraduate Students in Public Universities in Zimbabwe: An online survey
BACKGROUND Despite the increasing prevalence of ocular allergies globally, there is a lack of literature regarding the awareness and knowledge levels of ocular allergies in Zimbabwe. This study aimed to assess the awareness and knowledge of ocular allergy among undergraduate students in public universities in Zimbabwe. MATERIALS AND METHODS A descriptive cross-sectional study was conducted across eleven public universities in Zimbabwe, and questionnaires were sent via WhatsApp and other social media platforms. The study was carried out between April 2022 and November 2022. A three-section self-administered online questionnaires created electronically on Google Forms were used to collect the data. RESULTS The study included 1000 undergraduate students, comprising 54.1% males and 45.9% females. Their age ranged between 18 and 42 years. Most students (29.3%) were from the science faculties and were in their third year (34.0%). Almost all the participants (96.1%) were enrolled in the conventional study type. A significant association was found between sex and place of origin, the year of study, and the course of study (p<0.001). Most of the students had a fair knowledge of ocular allergies, and there was a significant association with the programme of study (p<0.05). More than half of the participants (55.3%) reported that ocular allergies are eye inflammation in response to a harmless foreign substance. Most of the participants had poor knowledge of the forms of ocular allergy. Sources of information on ocular allergy, as reported by the participants, included friends or relatives, the internet, media, eye specialists, training programs, books, and schools. CONCLUSION AND RECOMMENDATION Awareness and knowledge of ocular allergies among University undergraduate students in Zimbabwe is good, whilst significant gaps exist in their knowledge of the forms of ocular allergies. However, students enrolled in science-related programmes had a better understanding of ocular allergies compared to their counterparts. There is a need for health education on ocular allergy.
Copyright (c) 2025 Michael Agyemang Kwarteng, Mitchel Goto, Samuel Kyei, Ngozika Esther Ezinne, Selassie Tagoh, Eugene Buah Enimah (Author) https://creativecommons.org/licenses/by/4.0
Knowledge and Practice of Relapse Prevention among Family Caregivers of Patients with Schizophrenia in Kano State, Nigeria
Background: Schizophrenia is a severe mental disorder which causes significant disability and burden. Primary caregivers, who are often family members, are responsible for relapse prevention by monitoring medication, detecting early warning signs, and facilitating hospital follow-ups. Caregiver knowledge and practices significantly influence the success of this role. Poor knowledge and practices can lead to high relapse rates. The study aimed to assess caregivers' knowledge and practices regarding relapse prevention and management among patients with schizophrenia. Materials and Methods: Using a cross-sectional design, this study investigated the knowledge and practices of relapse prevention among 166 family caregivers of patients with schizophrenia in Kano State, Nigeria. Data was collected using a socio-demographic questionnaire and an adapted Knowledge, Attitude and Practice (KAP) questionnaire. Analysis was carried out using chi-square tests and logistic regression. Results: Caregivers demonstrated good understanding of relapse, signs and preventive measures, with most utilising medication (93.4%) and regular clinic follow-up (94.6%) as relapse prevention strategies. The highest attributions as cause of relapse were poor compliance with medication (75.9%) and poor social support (74.7%), while positive symptoms (4.7%) were more readily identified as signs of relapse. Caregiver practices regarding relapse prevention independently predicted the number of admissions in the past year (OR=0.110, 95% CI= 0.014 – 0.832). Harmful practices such as physical restraints, confinement and visiting prayer houses during a relapse highlight a need for intervention. Conclusion: Study findings emphasise the importance of enhanced family interventions, family psychoeducation and tailored relapse prevention education in the management of schizophrenia. While caregivers demonstrate good knowledge and practices regarding relapse prevention, gaps remain. To enhance schizophrenia care, we recommend individualised psychoeducation to family caregivers, while policymakers should establish supportive frameworks and ongoing evaluations to foster caregiver empowerment and early interventions.
Copyright (c) 2025 Salman Mamman Shata, Aishatu Abubakar-Abdullateef, Hayat Gommaa, Fatima Balarabe, Hadiza Danjuma Mohammed (Author) https://creativecommons.org/licenses/by/4.0
Menstrual Cycle Patterns among Adult Females Attending a Neuropsychiatric Facility in Kaduna, Northwestern Nigeria
INTRODUCTION Menstruation is a very important aspect of any woman’s life. Changing levels of reproductive hormones during the menstrual cycle can impact the incidence and pattern of neuropsychiatric illnesses. However, little is known about the impact of neuropsychiatric illness on the menstrual cycle. Abnormal patterns of menstruation may cause difficulties in this set of patients, from issues related to hygiene, to missed comorbidities. This study aimed to study menstrual patterns and characteristics among patients with neuropsychiatric illness. METHODOLOGY A cross-sectional study was conducted between November 1st 2022 to January 31st 2023. Participants were adult female patients diagnosed with neuropsychiatric illness. Data were collected using the Mini International Neuropsychiatric Interview, and a questionnaire with information on general socio-demographic characteristics, menstrual characteristics and possible confounding variables which may affect cycle regularity. Data were analysed using SPSS version 22, presented in frequency tables for descriptive purposes, and the relationship between categorical variables was analysed using chi-square or Likelihood ratio. A p-value of <0.05 was considered statistically significant. RESULTS All 285 participants were aged 18 – 40 years. Majority were Hausa (179, 62.8%), Muslims (192, 67.4%), married (149, 52.3%), had secondary/post-secondary education (200, 70.2%) and unemployed (174, 61.1%). Most participants were parous (175, 61.4%), attained menarche normally between the ages of 10 and 16 (215, 75.4%). Eighty -one participants (28.4%) had normal cycle lengths, duration of menstrual flow was abnormal in majority (193, 67.7%), most had normal volume of menstrual flow (188, 66.0%), and dysmenorrhea (212, 74.4%) which was mostly mild. The commonest diagnosis was schizophrenia (131,46%), depressive disorders (55, 19.3%) and seizure disorders (40, 14.0%). Most participants’ duration of illness was 1 -5 years (132, 46.3%), and stable (129, 45.3%). There was no significant association between diagnosis and cycle length, duration of menstrual flow and menstrual pain (p-value >0.05). Volume of menstrual flow was associated with diagnosis (p-value <0.05). CONCLUSION The duration of menstrual flow was abnormal in majority of participants. Those with seizure disorders appeared to have more abnormal volumes of menstrual flow, as compared to depressive disorders or schizophrenia. Carers should routinely screen for menstrual abnormalities.
Copyright (c) 2025 Mohammed-Durosinlorun Amina, Lasisi Marufa Dupe, Umar Abubakar, Taiwo Oduguwa (Author) https://creativecommons.org/licenses/by/4.0
A Comparative Study of Sexual and Reproductive Health Knowledge among Adolescents in Rural and Urban Secondary Schools of Ekiti-State, Nigeria
BACKGROUND Adolescents without adequate knowledge of sexual reproductive health are predisposed to high-risk sexual behaviours. Knowledge of sexual and reproductive health among adolescents is generally low, especially in rural areas. This study aimed to compare sexual and reproductive health knowledge and likely disparities among adolescents in rural and urban secondary schools. METHODOLOGY The study was a comparative cross-sectional design. Pre-tested, semi-structured, adapted questionnaires were administered to 669 students selected through a multistage sampling technique. Univariate, bivariate and multivariate analyses were conducted after entering data using SPSS version 25. Descriptive statistics (percentages, the sample mean, and frequency tables) were computed. Chi-square was used to determine the association between socio-demographic characteristics and knowledge. Multivariate analyses were conducted using binary regression, considering a p-value threshold of < 0.05. RESULTS Overall knowledge was 257 (65.2%) and 207 (75.3%) in the urban and rural, respectively. In the urban area 72.5% (n=150) of the females had good knowledge compared to only 57.2% (n=107) of the boys (p=0.006). Sex of participant was associated with knowledge of sexual reproductive health (p < 0.05). CONCLUSIONS The knowledge of sexuality, reproductive anatomy, and physiology among adolescents in rural schools was better than in urban schools. Knowledge of female adolescents was better than that of male adolescents, and the differences were statistically significant. RECOMMENDATIONS Culturally gender-sensitive educational intervention should be employed by the government, teachers, and parents.
Knowledge of Reproductive Anatomy and Physiology
Copyright (c) 2025 Oluremi Olayinka Solomon , Olusoji Abidemi Solomon , Victor Mayowa Adeleye , Eyitope Oluseyi Amu https://creativecommons.org/licenses/by/4.0
Molecular Detection of Multidrug-Resistant Klebsiella pneumoniae and Screening of Antimicrobial Resistance Genes from Chicken Samples: A comparison study between Kunshan, China, and Nairobi,
Background: Resistance to antimicrobial (AMR) agents has been recognised as one of the global public health threats and a significant development concern. Misuse of antimicrobial agents in veterinary and human medicine has been reported as one of the factors accelerating the AMR threat. Klebsiella pneumoniae, a member of the Bacteriaceae, is mostly used as a community indicator due to its ability to acquire and transfer genes including potential AMR-genes including Extended-Spectrum-Beta-Lactamases (ESBLs), Carbapenemases, and colistin, across species, which may result in a public health concern. This study aimed to provide prevalence data for K. pneumoniae in poultry, assess antimicrobial resistance patterns, and determine resistance genes harboured. Materials and Methods: We carried out a cross-sectional study in Kunshan City, China, and Nairobi, Kenya. A total of 385 cloacal swabs were collected from live chickens, 192 from Kunshan, and 193 from Nairobi. Samples were cultured, isolated, and identified using standard media, and their identity was confirmed by Polymerase Chain Reaction and gel electrophoresis. Susceptibility of K. pneumoniae isolates towards antimicrobial agents was determined through the Disk diffusion technique, and results were determined according to the Clinical and Laboratory Standards Institute (CLSI-M100-2022). The prevalence of resistance genes was also determined by PCR amplification alongside gene-specific primers. Results: The prevalence of K. pneumoniae was higher in Kunshan (46.1%) compared to the prevalence recorded in Nairobi (35.9%). Resistance was reportedly high against Ampicillin,81.7%, Ciprofloxacin,60.8%, and Aztreonam,48.7%. BlaOXA-1 was the predominant resistance gene in both sites, while blaCTX-M and blaNDM-1 were highly noted in Nairobi isolates, with a significant difference of p=0.037, showing an existing variation in resistance genes based on region. Conclusion: There was a high prevalence and resistance of isolates towards antimicrobial agents from both sites; however, the presence of resistant genes was predominant in isolates from Nairobi. The study highlights the need to invest in programs that will promote best practices, improve awareness, and establish surveillance programs exploring a One Health framework.
Copyright (c) 2025 Sophia Atingo Kuve, Sajid Umar, Chenkai Wu, Yiu-Wing Kam, Lucy Ochola (Author) https://creativecommons.org/licenses/by/4.0
Prevalence and Factors Associated with Depression among Prisoners in a Rural Setting in Kisii County, Kenya
BACKGROUND Compared to the general population, mental disorders, particularly depression, are prevalent among prisoners. Depression among prisoners has been linked to individual factors such as marital status, trauma history, age, history of mental illness, gender, and education, as well as environmental factors like violence, bullying, overcrowding, duration of incarceration, and social support. Despite high depression rates, there is limited data from Kenyan prisoners, particularly in medium-security prisons. This study assessed the prevalence and factors associated with depression among prisoners at Kisii Main and Women's Prison, addressing this gap in medium-security settings. METHODOLOGY A cross-sectional approach was utilised at Kisii Main and Women's Prisons, with 289 prisoners selected through systematic random sampling. Depression prevalence and severity were evaluated using the Patient Health Questionnaire. Bivariate and multiple logistic regression analyses were performed in STATA 15.1. RESULTS Depression prevalence among inmates was high at 51.4%, with 51.8% in males and 50.6% in females. Among males, having chronic illness (AOR = 26.951), being bullied (AOR = 4.176), being physically violated (AOR = 22.056), and experiencing more than ten traumatic events (AOR = 15.804) increased depression risk, whereas receiving moderate (AOR = 0.238) or high (AOR = 0.043) social support decreased the risk. Among females, past drug use (AOR = 45.502) and experiencing more than ten traumatic events (AOR = 22.308) increased depression risk, while a history of alcohol use (AOR = 0.044), and receiving high social support (AOR = 0.035) decreased the risk. CONCLUSION AND RECOMMENDATIONS There was a high burden of depression among the prisoners, for the males, physical violence, chronic illness, trauma history, social support, and bullying were significant predictors of depression, while for females, trauma history, social support, and a history of substance abuse were important factors. The high depression prevalence highlights the urgency for enacting effective prevention and intervention strategies.
Copyright (c) 2025 Elvin Kemunto, Linnet Ongeri, Dennis Magu, Merab Odero, Tele Kapkirwork, Christine Njambi (Author) https://creativecommons.org/licenses/by/4.0
Hepatitis B and C Virus: Current status among health professional students in Mwanza, Tanzania - A cross-sectional study
BACKGROUND Hepatitis B and C viruses are recognized as major public health concerns, particularly among high-risk groups such as healthcare workers and students in related medical fields. Hepatitis infection can progress to serious liver diseases such as hepatocellular carcinoma and cirrhosis. However, there is a paucity of data on the magnitude of Hepatitis B and C among undergraduate students in clinical years in Mwanza hindering its control interventions. This study aimed to assess the current status of Hepatitis B and C infections and their associated factors among clinical students in Mwanza, Tanzania. METHODOLOGY This cross-sectional study involving 300 medical students was conducted between June and August 2023 in Mwanza city. Socio-demographic information and other relevant information of the study participants were collected using a structured pretested data collection tool. About 5 ml of blood for serum analysis was collected from each participant. Detection of HbsAg was by a one-step HbsAg rapid Test kit, and HCV SD Bio line was used for detection of HCV Antibodies finally data analysis was done using STATA version 15 software. RESULTS The median age for the study participants was 23 [interquartile range 18-46] years. The prevalence of HBV and HCV in this study was 2.7% (8/300) 95%CI [1.16 -5.19] and 1% (3/300)95%CI [0.21 -2.89], respectively and unprotected sex was significantly associated with HBV positivity with a p-value of 0.004. CONCLUSION In this study, we report a low intermediate prevalence of HBsAg (HBV infection) and moderate endemicity of HCV among clinical students in Mwanza, Tanzania. Moreover, unprotected sex was found to be significantly associated with HBV infection, while no factors showed a significant association with HCV infection.
Copyright (c) 2025 Betrand Msemwa, Martha James, Simon Kavishe, Hawa Mzee, Samson Onesmo, Mwita Marwa, Mashaka G. Kaji, Mholya Zabron, Johaness Joshua, Helmut Nyawale, Stephen E. Mshana, Mariam M Mirambo https://creativecommons.org/licenses/by/4.0
Nurses' Knowledge of Evidence-Based Preventive Measures for Catheter-Associated Urinary Tract Infections in Kiambu County Referral Hospitals, Kenya
BACKGROUND Catheter-associated urinary tract infections (CAUTIs) remain one of the most common healthcare-associated infections (HAIs) despite established preventive guidelines. Nurses play a key role in implementing prevention strategies, educating patients, and ensuring evidence-based practices. However, many lack sufficient expertise in this area. This study evaluated nurses' knowledge of evidence-based CAUTI prevention measures. MATERIALS AND METHODS This descriptive cross-sectional study was part of a larger quasi-experimental research. The setting was adult medical and surgical wards in Kiambu and Thika County Referral Hospitals in Kiambu County in Kenya. The census method was used to recruit 83 nurses from these wards based on pre-defined inclusion criteria. Data were collected using a pretested researcher-developed knowledge questionnaire. Data analysis was done using SPSS version 26. Descriptive and inferential statistics were used to summarize and compare the results. RESULTS Nurses in Kiambu and Thika county referral hospitals demonstrated poor knowledge of evidence-based measures to prevent CAUTIs. The mean knowledge scores were 57.52% (SD = 11.48) and 56.98% (SD = 10.80), respectively, with no significant difference between the two groups (χ²=0.002, p=0.968). Overall, 87.95% (73/83) of participants scored below the 70% pass mark, highlighting gaps across all four key areas of CAUTI prevention: appropriate catheter use, proper insertion techniques, catheter maintenance, and timely removal. Only 12.05% (10/83) met the recommended benchmark, as set by the Commission on Collegiate Nursing Education. CONCLUSION AND RECOMMENDATION Nurses’ knowledge was poor as it was below the pass mark recommended for high-risk skills such as indwelling urinary catheter maintenance. Medical-surgical nurses should be educated on current CAUTI evidence-based prevention measures to improve their knowledge and skills and ultimately reduce these infections.
Catheter-associated urinary tract infections
Copyright (c) 2025 Jocyline Mukiri, Albanus Mutisya Kyalo, Justus Maingi Simba, Irene Gacheri Mageto https://creativecommons.org/licenses/by/4.0
Influence of Smartphone Application Reminder Service on Postpartum Contraception among Postpartum Women in Kitui County, Kenya
Background: Low uptake of postpartum contraception remains a significant public health concern, contributing to the rising incidence of unintended pregnancies among postpartum women. This study aimed to establish the influence of smartphone application reminder service on postpartum contraception uptake among postpartum women in Kitui County, Kenya. Methodology: A quasi-experimental study was conducted among 228 eligible participants drawn from two major referral health facilities (Kitui County Referral and Mwingi Central Sub-County Hospitals), which were purposively sampled. Trained interviewers conducted baseline and six-week postpartum interviews with eligible participants, who were recruited through systematic random sampling. The groups were dichotomised into an intervention group, which received the smartphone application (app) reminder and the control group, which did not receive the app reminder. The intervention was a smartphone application with an audio alert in the background, accompanied by a message three days a week. Informed consent and approvals were obtained before the commencement of the data collection process, which was achieved by the use of semi-structured questionnaires. Data were analysed using SPSS version 29. Inferential statistics included chi-square tests and logistic regression, while the Difference-in-Differences (DiD) method was employed to assess the impact of the intervention. Results: Postpartum women with the smartphone app reminder utilised postpartum contraception more (49.1%) compared to those who did not have the reminder (6.1%). Smartphone app reminders increased the likelihood of using postpartum family planning by 8.23 times (OR: 8.23; P=0.000; CI: 14.22-102.41). Conclusion and Recommendations: Smartphone app reminders significantly enhanced the uptake of postpartum contraception among postpartum women. We recommend that smartphone reminders be incorporated into the postpartum care package. The County government should strengthen postpartum contraception and boost capacity at the grassroots to enhance postpartum contraception through smartphone reminder services.
Copyright (c) 2025 Judith Nzilani Mwanza, Eliphas Gitonga, Judy Mugo (Author) https://creativecommons.org/licenses/by/4.0
Effectiveness of Community Health Clubs Intervention on Selected Hygiene and Health Outcomes in Kajiado County, Kenya: A Quasi-Experimental Study of a Pastoral Community
INTRODUCTION: Maintaining optimal hygiene and health is a fundamental human right that cannot be compromised. The United Nations General Assembly has acknowledged the significance of achieving "health and well-being" and providing "safe water and sanitation for all" by 2030. However, diseases associated with water, sanitation and hygiene remain a significant concern worldwide, with diarrheal diseases being a leading cause of morbidity and mortality among children under five. This study evaluated the effectiveness of community health clubs on selected hygiene and health outcomes in children under five years old. METHODOLOGY: A quasi-experimental design was conducted among households in the intervention group where community health clubs (CHCs) and community-led total sanitation (CLTS) were utilized and in the control group where only community-led total sanitation was utilized. Researchers conducted a baseline survey, facilitated discussions on open defecation, and created action plans. Community health clubs were formed for health education, with two community health extension workers and two community Health Assistants providing training on hygiene and latrine ownership. This study recruited a representative sample of 514 households, 256 in the intervention group, and 258 in the control group. Trained interviewers conducted interviews at baseline and after six months with household heads. Twenty focus group discussions were conducted, and 162 water samples were collected for bacteriological analysis to determine the presence and quantity of microbes. RESULTS: The study revealed diarrheal cases reduction at the end of the study in the intervention group from 50.8% to 37.4%. A significant decrease in risk of 32.1% in female-headed households was also observed. Additionally, families headed by a person who had attained tertiary education showed a 100% decrease in risk from both study arms. CONCLUSION: Incorporating health strategies such as community health clubs into sanitation programs leads to improved water safety and hygiene. Our findings indicate that the combined approach of community health clubs and community-led total sanitation significantly reduced the incidence of diarrhoea among children under five years old and positively influenced other selected hygiene and health outcomes.
Copyright (c) 2024 James Otieno Okumu, Violet Wanjihia, John Gachohi https://creativecommons.org/licenses/by/4.0
Factors Associated with HIV Self-Testing among Long-Distance Truck Drivers Along Uganda Road in Uasin Gishu County, Kenya
INTRODUCTION HIV self-testing was introduced to increase the number of HIV testing rates among hard-to-reach populations such as long-distance truck drivers. However, little is known about its uptake in Kenya, where it has been available since 2017, or the factors influencing its utilisation. Therefore, this study aimed to assess the uptake and establish the sociodemographic and behavioural factors associated with HIV self-testing among truck drivers along Uganda Road in Uasin Gishu County, Kenya. METHODOLOGY This cross-sectional study recruited 287 participants using proportionate stratified and simple random sampling. Data were collected through a pretested, interviewer-administered questionnaire uploaded to KoboToolbox. Necessary research licences and permits were obtained. Data were analysed using SPSS version 28 for descriptive statistics including means, frequencies, and percentages. Bivariate analysis was used to determine associations between variables, while multivariate logistic regression using a generalised linear model identified true predictors of HIV self-testing at a 95% confidence interval (CI) at p < 0.05. RESULTS The majority (98.6%) of the 287 participants were male averaging 38.66 years and HIV self-testing uptake was 35.5%. Factors associated with HIV self-testing included the duration of driving specifically 6-10 years (Odds Ratio(OR)=3.0, 95% CI =1.3-6.9, p=0.008); moderate and high perceived risk of HIV infection (OR=4.1, 95% CI=1.9-9.1, p=<0.001 and OR=3.7, 95% CI=1.3-10.8, p=0.012); average and excellent HIV knowledge (OR=11.7, 95% CI =2.2-217.4, p=0.021 and OR=28.3, 95% CI =5.1-536, p=0.002). CONCLUSION HIV self-testing uptake remains low, highlighting the need for targeted educational campaigns. Peer-led programs and workplace sensitisation can help reinforce HIV risk perception and knowledge, while interventions should be tailored to meet the needs of drivers of varying degrees of experience.
Copyright (c) 2025 Dennis Kipkosgei Rotich, Alfred Owino Odongo, Joseph Muchiri https://creativecommons.org/licenses/by/4.0
Socio-Demographic Predictors of Healthcare Quality for Epilepsy Patients in Selected Hospitals in Nairobi, Kiambu, and Machakos, Kenya
BACKGROUND: Epilepsy is a neurologic condition that accounts for 1% of the global disease burden. If diagnosed and treated early, 70% of the cases can achieve seizure remission. Mass sensitization around the Nairobi metropolis since 2010 has increased the number of patients seeking treatment in local facilities. Nevertheless, those on treatment still suffer epilepsy-led injuries. There is a paucity of data on quality of care, and studies have not documented its socio-demographic predictors. This study aimed to determine predictors of quality of care for clients at the selected hospitals in the Nairobi metropolis and its environs (Kiambu and Machakos counties). METHODOLOGY: This was a cross-sectional study conducted between May and September 2021 in selected level-five hospitals in three counties in Kenya, namely Nairobi, Kiambu and Machakos. Quantitative data were collected from 373 sampled epilepsy patients using semi-structured questionnaires. Data were analyzed using chi-square, logistic and multiple linear regression analyses. The statistical significance of the relationship between the variables was tested using 2 with a level of significance fixed at 0.05. RESULTS: Quality of care ratings varied by age, with the 0–5 age group rating care highest, and the 19–28 and 50+ age groups rating it lower. Gender did not significantly influence care ratings, while occupation was significantly associated with higher ratings (χ²=22, df=2, P=0.000). CONCLUSION AND RECOMMENDATIONS: Different views on care quality suggest that a single approach may not work well for all epilepsy patients. Occupation was identified as the primary sociodemographic predictor in how people rated the quality of their healthcare. Training healthcare staff to consistently show courtesy and respect to all epilepsy patients is essential. Further longitudinal studies are required to monitor fluctuations across different age groups
Copyright (c) 2024 Tiberry D.O. Nyakwana, Simon Karanja, John Gachohi https://creativecommons.org/licenses/by/4.0
Determinants of Influenza, Pneumococcal and Varicella-Zoster Vaccine Hesitancy in Older Adults Attending a Geriatric Clinic in Nigeria
BACKGROUND Influenza, pneumococcal disease, and shingles are vaccine-preventable diseases with high morbidity and mortality in older adults. Nigeria lacks a national immunisation program for older adults as well as empirical evidence on the uptake and hesitancy to the vaccines for these diseases. This study determined the level and factors associated with the uptake and hesitancy to influenza, pneumococcal, and varicella zoster vaccines among older adults at the Geriatric Centre, University College Hospital, Ibadan, Nigeria. METHODOLOGY This was a cross-sectional hospital-based study of older adults (≥60 years). Data were obtained from 332 patients in the outpatient clinic of the Chief Tony Anenih Geriatric Centre (CTAGC) of the University College Hospital (UCH), Ibadan, Nigeria. Participants were selected using a systematic sampling method, collecting data from January to March of 2023. Univariate and multivariate analyses were carried out at 5% significance. RESULTS Out of the 332 participants recruited, mean age was 71.8±7.3 years and female-to-male ratio 1.24. Vaccination rates were low for influenza (2.7%), pneumococcal (2.4%), and varicella zoster (0.9%). Vaccine hesitancy rates were 79.2% (influenza), 78.6% (pneumococcal), and 81.6% (varicella zoster). Bivariate analysis revealed significant associations with vaccine hesitancy, including low education, low income, living with family, financial and social support, concerns over side effects, commercial profiteering, reliance on natural immunity, risk calculation, collective responsibility, and negative perceptions of vaccine safety and effectiveness. Multivariate logistic regression identified a preference for natural immunity, greater calculation of disease and vaccination risk, and vaccine safety concerns as predictors of hesitancy to influenza, pneumococcal, and varicella zoster vaccines. CONCLUSION AND RECOMMENDATIONS The uptake of influenza, pneumococcal, and varicella zoster vaccines was poor among older adults in our setting,while vaccine hesitancy was high indicating that a high proportion of older adults were unwilling and undecided to take the vaccines. Investigating and addressing vaccination concerns such as preference for natural immunity, greater calculation of disease and vaccination risk, and concerns about vaccine safety may improve vaccination coverage among older adults.
Copyright (c) 2025 Adebusoye Lawrence Adekunle, Obadare Abiola, Oyinlola Oluwagbemiga, Cadmus Eniola Olubukola https://creativecommons.org/licenses/by/4.0