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Michael C Chen, Allen R Kunselman, Christy M Stetter, Sadeer B Hannush, Benjamin W Roberts
PURPOSE: To review the graft survival rate, visual outcomes, and patient demographics of primary penetrating keratoplasty performed at Tenwek Hospital, a mission hospital in rural Kenya. METHODS: A retrospective review was performed of the clinical records of patients who underwent primary penetrating keratoplasty for optical purposes from January 2012 to October 2014. The graft survival rates were constructed using the Kaplan-Meier method, and the effect of clinical and socioeconomic characteristics on time to graft failure were examined using Cox regression models...
2017: PloS One
John K Kanyi, Timothy V Ogada, Mark J Oloo, Robert K Parker
INTRODUCTION: Chronic subdural hematoma (cSDH) is a common condition that causes significant morbidity and mortality. In rural sub-Saharan Africa, there are very few neurosurgeons. Yet, cSDH is treatable by relatively simple surgical intervention with potential for rapid clinical improvement. METHODS: We conducted a retrospective chart review of all patients with cSDH who underwent burr-hole trephination at Tenwek Hospital, Kenya, between July 2014 and July 2016...
July 24, 2017: World Journal of Surgery
Amy R L Rule, Esther Maina, David Cheruiyot, Priscilla Mueri, Jeffrey M Simmons, Beena D Kamath-Rayne
AIM: The Helping Babies Breathe (HBB) programme is known to decrease neonatal mortality in low-resource settings but gaps in care still exist. This study describes the use of quality improvement to sustain gains in birth asphyxia-related mortality after HBB. METHODS: Tenwek Hospital, a rural referral hospital in Kenya, identified high rates of birth asphyxia (BA). They developed a goal to decrease the suspected hypoxic-ischaemic encephalopathy (SHIE) rate by 50% within six months after HBB...
October 2017: Acta Paediatrica
David Kitya, Maria Punchak, Francis Bajunirwe
INTRODUCTION: Chronic back pain is a common problem, and imaging is crucial for effective diagnosis and treatment. In low-resource settings conventional myelography is a cheap alternative to magnetic resonance imaging and computed tomography. This study was conducted to reexamine the diagnostic reliability, effectiveness for surgical decision making, and safety of conventional myelography. METHODS: The study was conducted at Tenwek Mission Hospital during June 2009 and March 2010...
August 2017: World Neurosurgery
Philip Blasto Ooko, Patricia Wambua, Mark Oloo, Agneta Odera, Hillary Mariko Topazian, Russell White
INTRODUCTION: Intestinal obstruction (IO) occurs when there is impedance to the flow of intestinal contents due to a congenital or acquired pathology, and is a common paediatric surgical emergency. This study aimed to assess the pattern and outcome of paediatric IO in western Kenya. METHODS: A retrospective review of all recorded cases of mechanical IO in patients aged 15 years or below admitted at Tenwek Hospital between January 2009 and December 2013. RESULTS: The cohort included a total of 217 children (130 boys and 87 girls)...
2016: Pan African Medical Journal
Philip Blasto Ooko, Seno Saruni, Mark Oloo, Hillary Mariko Topazian, Russell White
INTRODUCTION: Ileo-sigmoid knotting (ISK) is a rare cause of bowel obstruction in which the ileum twists around the sigmoid colon. It is associated with rapid bowel gangrene and a high mortality rate. Little has been published about this condition in Kenya. The objective was to determine the presentation, management, and outcome of patients with ISK. METHODS: A seven year (January 2008-December 2014) retrospective chart review of patients managed for ISK at Tenwek Hospital in Bomet, Kenya...
2016: Pan African Medical Journal
Philip Blasto Ooko, Betty Sirera, Seno Saruni, Hillary Mariko Topazian, Russell White
INTRODUCTION: Acute mechanical intestinal obstruction (IO) is one of the leading causes of surgical admissions in most emergency departments worldwide. The causes of IO vary significantly depending on geographical location. The aim of this study was to identify the etiology, management and outcomes of patients with acute mechanical IO presenting in south-western Kenya. METHODS: A 4 year (November 2009-October 2013) retrospective review of all adult patients admitted with acute mechanical IO at Tenwek Hospital in Bomet, Kenya...
2015: Pan African Medical Journal
Kristin L Long, Carol Spears, Daniel E Kenady, John Scott Roth
BACKGROUND: Training outside the operating room has become a mainstay of surgical education. Laparoscopic training often takes place in a simulation setting. Advanced laparoscopic procedures are now commonplace, even in third-world countries with minimal hospital resources. We sought to implement a low-cost laparoscopic skills curriculum in a general surgery residency program in East Africa. STUDY DESIGN: The laparoscopic skills curriculum created and validated at the University of Kentucky was presented to the 10 general surgery residents at Tenwek Hospital...
November 2014: Journal of Surgical Education
V Duron, J Bii, R Mutai, J Ngetich, D Harrington, R Parker, R White
BACKGROUND: Esophageal cancer is the most common malignancy in Western Kenya and patients present with advanced disease. OBJECTIVE: To determine baseline level of knowledge of esophageal cancer in Bomet District in order to develop targeted and effective educational classes. METHODS: A questionnaire with twelve questions testing knowledge about esophageal cancer and eight questions aimed at determining barriers to healthcare was conducted out of Tenwek Hospital from June to July 2010...
March 2013: African Health Sciences
Craig R Otteni, Seno Ivan Saruni, Vincent P Duron, Jeremy P Hedges, Russell E White
BACKGROUND: Burn injuries are a significant source of both death and disability in developing countries. The objective of this project was to create a database of baseline inpatient burn care data to facilitate improvement of preventive measures and clinical outcomes at Tenwek Hospital, Bomet, Kenya. METHODS: Both demographic and clinical data were obtained through a retrospective chart review conducted on inpatient burn patients admitted to Tenwek Hospital between January 1, 2006 and May 31, 2010...
July 2013: World Journal of Surgery
Robert K Parker, Russell E White, Mark Topazian, Robert Chepkwony, Sonja Dawsey, Felicity Enders
BACKGROUND: Self-expandable metal stents (SEMSs) are an established palliative therapy for esophageal cancer. SEMS placement for cancers near the upper esophageal sphincter (UES) is controversial because of a perceived increased risk of complications. OBJECTIVE: To compare outcomes after patients stented for proximal esophageal cancer (PC) and distal esophageal cancer (DC). DESIGN: Matched case-control study from a prospective database. SETTING: Tertiary referral center, Tenwek Hospital, Bomet, Kenya...
June 2011: Gastrointestinal Endoscopy
Sonja P Dawsey, Stanley Tonui, Robert K Parker, John W Fitzwater, Sanford M Dawsey, Russell E White, Christian C Abnet
Certain geographically distinct areas of the world have very high rates of esophageal cancer (EC). Previous studies have identified western Kenya as a high risk area for EC with an unusual percentage of cases in subjects 30 years of age or younger. To better understand EC in these young patients, we abstracted available data on all 109 young patients diagnosed with EC at Tenwek Hospital, Bomet District, Kenya from January 1996 through June 2009, including age at diagnosis, sex, ethnicity, tumor histology, residence location, and medical interventions...
2010: PloS One
Bert Edward Park, David Kitya
The use of "stand-alone" contrast myelography (i.e., without computed tomography) has a proven track record in developing nations where few patients have access to magnetic resonance imaging, whether on the basis of prohibitive cost or the absence of such a modality altogether. To substantiate the author's 12-year experience with more than 300 myelograms performed in 16 different countries (plus some 1500 studies during 30 years of practice in the United States), a prospective pilot study was undertaken over 1 month in a community-based neurosurgical setting in western Kenya...
April 2010: World Neurosurgery
R K Parker, S M Dawsey, C C Abnet, R E White
Esophageal cancer has a strikingly uneven geographical distribution, resulting in focal endemic areas in several countries. One such endemic area is in western Kenya. We conducted a retrospective review of all pathology-confirmed malignancies diagnosed at Tenwek Hospital, Bomet District, between January 1999 and September 2007. Tumor site, histology, sex, age, ethnicity, and location of residence were recorded. Cases were analyzed within and outside a traditional catchment area defined as < or = 50 km from the hospital...
February 2010: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Daniel D Klaristenfeld, Michael Chupp, William G Cioffi, Russell E White
No abstract text is available yet for this article.
July 2008: Journal of the American College of Surgeons
Russell E White, Christian C Abnet, Caesar K Mungatana, Sanford M Dawsey
Oesophageal cancer is a common cancer with uneven geographical distribution. We reviewed all malignancies diagnosed at Tenwek Hospital (Bomet District, Kenya) between 1989 and 1998. Oesophageal cancer was the most common malignancy; 274 cases accounted for 19% of 1459 malignancies diagnosed, and for a steady rise in total cancer cases during this period. A striking feature of our study was the presence of a subset of very young patients. 26 (11%) patients were aged 30 years or less at diagnosis, and the youngest patient was 14 years old...
August 10, 2002: Lancet
John A Feagin Jr
I lived a dream. After 45 years service as an orthopaedic surgeon, a career military officer, private practice, and an appointment to the faculty at Duke University, I retired to begin another career--volunteerism. Specifically, I volunteered to serve at Tenwek Hospital in Africa. Tenwek, a World Medical Mission Hospital, is a 4-hour drive west of Nairobi, Kenya. The hospital serves 400,000 Kenyans. Tenwek is a wonderful hospital, modern by African standards, well-equipped and staffed. The average daily orthopaedic case load is five to nine cases...
March 2002: Clinical Orthopaedics and related Research
C Stanfield
No abstract text is available yet for this article.
1996: Journal of Christian Nursing: a Quarterly Publication of Nurses Christian Fellowship
M L Jacobson, M H Labbok, R L Parker, D L Stevens, S A Carter
Tenwek mission hospital, situated in the west-central highlands of Kenya, initiated a community health programme in 1984. This paper describes the major features of the programme and assesses the impact on a number of health and family planning practices after 3 years of implementation. Comparison of the results in the programme areas with the baseline survey and with control areas show significant changes in several indicators. It is concluded that Tenwek hospital demonstrated the impact a hospital can have on health of communities by effectively moving into community-based health care...
1989: Social Science & Medicine
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