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https://www.readbyqxmd.com/read/28334856/evaluating-the-effects-of-organizational-and-educational-interventions-on-adherence-to-clinical-practice-guidelines-in-a-low-resource-primary-care-setting-in-kenya
#1
Joseph R Egger, Kayla Stankevitz, Robert Korom, Philip Angwenyi, Brittney Sullivan, Jun Wang, Sonia Hatfield, Emma Smith, Karishma Popli, Jessica Gross
Background: Mid-level care providers serve as the backbone of primary care in many parts of sub-Saharan Africa. Despite this, research suggests that the quality and consistency of this care is uneven. This study assessed the degree to which a set of four simple, low-cost interventions could improve adherence to a set of clinical quality measures (CQMs) associated with four common health conditions seen in a resource-constrained primary care setting. Methods: A quasi-experimental, longitudinal study was carried out in three primary care clinics in Nairobi, Kenya from August 2014 to January, 2015...
March 15, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28316253/predominance-of-hepatitis-b-virus-genotype-a-among-treated-hiv-infected-patients-experiencing-high-hbv-drug-resistance-in-nairobi-kenya
#2
Sepha Nyatichi Mabeya, Caroline Wangari Ngugi, Raphael W Lihana, Samoel Ashimosi Khamadi, Anthony Kebira Nyamache
HBV/HIV coinfections are becoming common with information on HBV genetic diversity and drug resistance still remaining elusive. To evaluate the HBV genetic diversity and drug resistance associated mutations among drug experienced HIV patients, the genetic analysis of the partial HBV-pol-reverse trancriptase gene was successfully sequenced from 13 samples. Analysis of the sequences showed that all (13) the sequences belonged to genotype A. Nucleos(t)ide drug resistance mutations were found in six (6) patients...
March 19, 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/28302553/stark-regional-and-sex-differences-in-the-prevalence-and-awareness-of-hypertension-an-h3africa-awi-gen-study-across-6-sites-in-sub-saharan-africa
#3
F Xavier Gómez-Olivé, Stuart A Ali, Felix Made, Catherine Kyobutungi, Engelbert Nonterah, Lisa Micklesfield, Marianne Alberts, Romuald Boua, Scott Hazelhurst, Cornelius Debpuur, Felistas Mashinya, Sekgothe Dikotope, Hermann Sorgho, Ian Cook, Stella Muthuri, Cassandra Soo, Freedom Mukomana, Godfred Agongo, Christopher Wandabwa, Sulaimon Afolabi, Abraham Oduro, Halidou Tinto, Ryan G Wagner, Tilahun Haregu, Alisha Wade, Kathleen Kahn, Shane A Norris, Nigel J Crowther, Stephen Tollman, Osman Sankoh, Michèle Ramsay
BACKGROUND: There is a high prevalence of hypertension and related cardiovascular diseases in sub-Saharan Africa, yet few large studies exploring hypertension in Africa are available. The actual burden of disease is poorly understood and awareness and treatment to control it is often suboptimal. OBJECTIVES: The study sought to report the prevalence of measured hypertension and to assess awareness and control of blood pressure among older adults in rural and urban settings in 6 sites located in West, East, and Southern Africa...
March 13, 2017: Global Heart
https://www.readbyqxmd.com/read/28293286/who-seeks-child-and-adolescent-mental-health-care-in-kenya-a-descriptive-clinic-profile-at-a-tertiary-referral-facility
#4
Judy Wanjiru Kamau, Olayinka O Omigbodun, Tolulope Bella-Awusah, Babatunde Adedokun
BACKGROUND: The presence of psychiatric morbidity in the child and adolescent age group is demonstrable in various studies conducted in various settings in Kenya. This study set out to determine the psychiatric morbidity and socio-demographic profile of patients who eventually present for care at a tertiary specialist child and adolescent mental health clinic in Kenya. Knowledge of the patterns of presentation of disorders is crucial for planning of service scale up as well as serving as a useful training guide...
2017: Child and Adolescent Psychiatry and Mental Health
https://www.readbyqxmd.com/read/28275608/design-and-implementation-of-the-retinoblastoma-collaborative-laboratory
#5
Seemi Qaiser, Alice Limo, Josiah Gichana, Kahaki Kimani, Jessie Githanga, Wairimu Waweru, Elizabeth A O Dimba, Helen Dimaras
PURPOSE: The purpose of this work was to describe the design and implementation of a digital pathology laboratory, the Retinoblastoma Collaborative Laboratory (RbCoLab) in Kenya. METHOD: The RbCoLab is a central lab in Nairobi that receives retinoblastoma specimens from all over Kenya. Specimens were processed using evidence-based standard operating procedures. Images were produced by a digital scanner, and pathology reports were disseminated online. RESULTS: The lab implemented standard operating procedures aimed at improving the accuracy, completeness, and timeliness of pathology reports, enhancing the care of Kenyan retinoblastoma patients...
January 2017: Ocular Oncology and Pathology
https://www.readbyqxmd.com/read/28260829/mapping-of-beef-sheep-and-goat-food-systems-in-nairobi-a-framework-for-policy-making-and-the-identification-of-structural-vulnerabilities-and-deficiencies
#6
Pablo Alarcon, Eric M Fèvre, Maurice K Murungi, Patrick Muinde, James Akoko, Paula Dominguez-Salas, Stella Kiambi, Sohel Ahmed, Barbara Häsler, Jonathan Rushton
Nairobi is a large rapidly-growing city whose demand for beef, mutton and goat products is expected to double by 2030. The study aimed to map the Nairobi beef, sheep and goat systems structure and flows to identify deficiencies and vulnerabilities to shocks. Cross-sectional data were collected through focus group discussions and interviews with people operating in Nairobi ruminant livestock and meat markets and in the large processing companies. Qualitative and quantitative data were obtained about the type of people, animals, products and value adding activities in the chains, and their structural, spatial and temporal interactions...
March 2017: Agricultural Systems
https://www.readbyqxmd.com/read/28251246/the-unseeing-state-how-ideals-of-modernity-have-undermined-innovation-in-africa-s-urban-water-systems
#7
David Nilsson
In contrast to the European historical experience, Africa's urban infrastructural systems are characterised by stagnation long before demand has been saturated. Water infrastructures have been stabilised as systems predominantly providing services for elites, with millions of poor people lacking basic services in the cities. What is puzzling is that so little emphasis has been placed on innovation and the adaptation of the colonial technological paradigm to better suit the local and current socio-economic contexts...
March 1, 2017: NTM
https://www.readbyqxmd.com/read/28250964/open-source-mobile-digital-platform-for-clinical-trial-data-collection-in-low-resource-settings
#8
Joris van Dam, Kevin Omondi Onyango, Brian Midamba, Nele Groosman, Norman Hooper, Jonathan Spector, Goonaseelan Colin Pillai, Bernhards Ogutu
BACKGROUND: Governments, universities and pan-African research networks are building durable infrastructure and capabilities for biomedical research in Africa. This offers the opportunity to adopt from the outset innovative approaches and technologies that would be challenging to retrofit into fully established research infrastructures such as those regularly found in high-income countries. In this context we piloted the use of a novel mobile digital health platform, designed specifically for low-resource environments, to support high-quality data collection in a clinical research study...
February 2017: BMJ Innovations
https://www.readbyqxmd.com/read/28225338/potential-biomarkers-associated-with-discrimination-between-latent-and-active-pulmonary-tuberculosis
#9
R Kamakia, S Kiazyk, J Waruk, A Meyers, J Ochanda, T B Ball, J Oyugi
SETTING: A third of the world's population has latent tuberculous infection (LTBI). Current TB diagnostics used in developing countries are ineffective and are unable to distinguish LTBI from active TB. Identifying biomarkers that could aid in the early detection of TB and in distinguishing TB states could be a major breakthrough in global TB control. OBJECTIVE: To identify potential immune biomarkers to distinguish active TB from LTBI. DESIGN: A cross-sectional study was conducted among 19 active TB patients, 8 TB-negative individuals (controls) and 16 LTBI non-human immunodeficiency virus infected individuals in Nairobi, Kenya...
March 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28198789/sustained-responses-to-measles-revaccination-at-24-months-in-hiv-infected-children-on-antiretroviral-therapy-in-kenya
#10
Laura P Newman, Anne Njoroge, Amalia Magaret, Bhavna H Chohan, Veronicah W Gitomea, Anna Wald, Jonathan Gorstein, Julie Overbaugh, Dalton Wamalwa, Elizabeth Maleche-Obimbo, Ruth Nduati, Carey Farquhar
BACKGROUND: There are limited data on whether HIV-infected children in resource-limited countries who are receiving antiretroviral therapy (ART) are able to produce sustained, protective levels of measles antibody after multiple measles vaccinations. METHODS: We administered an additional measles vaccine to HIV-infected children 15 months to 12 years of age receiving ART in Nairobi, Kenya. Measles antibody concentrations were determined by enzyme-linked immunosorbent assay (ELISA) at enrollment, one month, 12 months, and 24 months post revaccination...
February 13, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28183341/assessing-the-feasibility-of-ehealth-and-mhealth-a-systematic-review-and-analysis-of-initiatives-implemented-in-kenya
#11
REVIEW
Martin Njoroge, Dejan Zurovac, Esther A A Ogara, Jane Chuma, Doris Kirigia
BACKGROUND: The growth of Information and Communication Technology in Kenya has facilitated implementation of a large number of eHealth projects in a bid to cost-effectively address health and health system challenges. This systematic review aims to provide a situational analysis of eHealth initiatives being implemented in Kenya, including an assessment of the areas of focus and geographic distribution of the health projects. The search strategy involved peer and non-peer reviewed sources of relevant information relating to projects under implementation in Kenya...
February 10, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28167567/environmental-and-psychosocial-barriers-to-and-benefits-of-cervical-cancer-screening-in-kenya
#12
Natasha Buchanan Lunsford, Kathleen Ragan, Judith Lee Smith, Mona Saraiya, Millicent Aketch
BACKGROUND: Cervical cancer is the second most commonly diagnosed cancer in females and is a leading cause of cancer-related mortality in Kenya; limited cervical cancer screening services may be a factor. Few studies have examined men's and women's perceptions on environmental and psychosocial barriers and benefits related to screening. MATERIALS AND METHODS: In 2014, 60 women aged 25-49 years and 40 male partners participated in 10 focus groups (6 female and 4 male), in both rural and urban settings (Nairobi and Nyanza, Kenya), to explore perceptions about barriers to and benefits of cervical cancer screening...
February 6, 2017: Oncologist
https://www.readbyqxmd.com/read/28156592/symptom-burden-and-distress-in-patients-with-cancer-in-africa
#13
(no author information available yet)
255 Background: Cancer has become a significant public health problem in Africa but still most diagnoses are made late, Sitas et al (2006). The need for palliative care is significant due to the late contact with health care providers and the many symptoms they present with. No study has been undertaken to assess symptomatology for these patients in Africa. OBJECTIVE: To study the prevalence of symptoms in patients with cancer in an African setting. METHODS: Symptom studies from records of patients with cancer referred to the Palliative Care Services at the Aga Khan University Hospital, Nairobi in 6 months...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28155289/conference-report-undergraduate-family-medicine-and-primary-care-training-in-sub-saharan-africa-reflections-of-the-primafamed-network
#14
Innocent Besigye, Robert Mash, Akye Essuman, Maaike Flinkenflögel
Internationally, there is a move towards strengthening primary healthcare systems and encouraging community-based and socially responsible education. The development of doctors with an interest in primary healthcare and family medicine in the African region should begin during undergraduate training. Over the last few years, attention has been given to the development of postgraduate training in family medicine in the African region, but little attention has been given to undergraduate training. This article reports on the 8th PRIMAFAMED (Primary Care and Family Medicine Education) network meeting held in Nairobi from 21 to 24 May 2016...
January 30, 2017: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/28154110/oxygen-saturation-ranges-for-healthy-newborns-within-24%C3%A2-hours-at-1800%C3%A2-m
#15
Melissa C Morgan, Beth Maina, Mary Waiyego, Catherine Mutinda, Jalemba Aluvaala, Michuki Maina, Mike English
There are minimal data to define normal oxygen saturation (SpO2) levels for infants within the first 24 hours of life and even fewer data generalisable to the 7% of the global population that resides at an altitude of >1500 m. The aim of this study was to establish the reference range for SpO2 in healthy term and preterm neonates within 24 hours in Nairobi, Kenya, located at 1800 m. A random sample of clinically well infants had SpO2 measured once in the first 24 hours. A total of 555 infants were enrolled...
February 2, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28139166/moving-beyond-the-household-innovations-in-data-collection-on-kinship
#16
Sangeetha Madhavan, Shelley Clark, Donatien Beguy, Caroline W Kabiru, Mark Gross
Across settings, it has been shown that the co-residential household is an insufficient measure of family structure and support. However, it continues to be the primary means of population data collection. To address this problem, we developed a new instrument, the Kinship Support Tree (KST), to collect kinship structure and support data on co-residential and non-residential kin and tested it on a sample of 462 single mothers and their children in a slum community in Nairobi, Kenya. This instrument is unique in four important ways: (1) it is not limited to the co-residential household; (2) it distinguishes potential from functional kin; (3) it incorporates multiple geospatial measures; and (4) it collects data on kin relationships specifically for children...
March 2017: Population Studies
https://www.readbyqxmd.com/read/28132519/alcohol-use-and-immune-reconstitution-among-hiv-infected-patients-on-antiretroviral-therapy-in-nairobi-kenya
#17
Anthony Cagle, Christine McGrath, Barbra A Richardson, Dennis Donovan, Sameh Sakr, Nelly Yatich, Richard Ngomoa, Agnes Chepngeno Langat, Grace John-Stewart, Michael H Chung
Studies on the effects of alcohol use on HIV disease progression have been contradictory, with at least one study finding a positive effect of low alcohol consumption on CD4 count. In addition, most such studies have taken place in the developed West. We investigated the association between alcohol use and immune reconstitution through CD4 count response among HIV-infected individuals on antiretroviral therapy (ART) at an urban sub-Saharan African clinic. This was a retrospective cohort study of treatment-naïve HIV-infected adults initiating ART in Nairobi, Kenya and followed for 12 months between January 2009 and December 2012...
January 29, 2017: AIDS Care
https://www.readbyqxmd.com/read/28118824/factors-that-influence-advance-directives-completion-amongst-terminally-ill-patients-at-a-tertiary-hospital-in-kenya
#18
Stephen Omondi, John Weru, Asim Jamal Shaikh, Gerald Yonga
BACKGROUND: An advance directive (AD) is a written or verbal document that legally stipulates a person's health care preference while they are competent to make decisions for themselves and is used to guide decisions on life-sustaining treatment in the event that they become incapacitated. AD can take the form of a living will, a limitation of care document, a do-not-resuscitate order, or an appointment of a surrogate by durable power of attorney. The completion rate of AD varies from region to region, and it is influenced by multiple factors...
January 25, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28099724/costs-of-integrating-cervical-cancer-screening-at-an-hiv-clinic-in-kenya
#19
Elisabeth L Vodicka, Joseph B Babigumira, Marita R Mann, Rose J Kosgei, Fan Lee, Nelly R Mugo, Timothy C Okech, Samah R Sakr, Louis P Garrison, Michael H Chung
OBJECTIVE: To estimate the societal-level costs of integrating cervical cancer screening into HIV clinics in Nairobi, Kenya. METHODS: A cross-sectional micro-costing study was performed at Coptic Hope Center for Infectious Diseases and Kenyatta National Hospital, Kenya, between July 1 and October 31, 2014. To estimate direct medical, non-medical, and indirect costs associated with screening, a time-and-motion study was performed, and semi-structured interviews were conducted with women aged at least 18 years attending the clinic for screening during the study period and with clinic staff who had experience relevant to cervical cancer screening...
February 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28093532/soil-ingestion-is-associated-with-child-diarrhea-in-an-urban-slum-of-nairobi-kenya
#20
Valerie Bauza, R M Ocharo, Thanh H Nguyen, Jeremy S Guest
Diarrhea is a leading cause of mortality in children under 5 years of age. We conducted a cross-sectional study of 54 children aged 3 months to 5 years old in Kibera, an urban slum in Nairobi, Kenya, to assess the relationship between caregiver-reported soil ingestion and child diarrhea. Diarrhea was significantly associated with soil ingestion (adjusted odds ratio = 9.9, 95% confidence interval = 2.1-47.5). Soil samples from locations near each household were also collected and analyzed for Escherichia coli and a human-associated Bacteroides fecal marker (HF183)...
January 16, 2017: American Journal of Tropical Medicine and Hygiene
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