School of Health and Biomedical Sciences

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Anti-Schistosomal activity of five plant extracts on Swiss white mice infected with Schistosoma mansoni
(2016-04-13) Waiganjo, Naomi; Yole, Dorcas; Ochanda, Horace
Abstract : Schistosomiasis in humans is a major public health problem worldwide. Schistosomiasis occurs in 76 tropical countries and it is estimated that 85% of the infections are in Africa. In Kenya, it is estimated that 3 million people are infected. The Conventional drugs are effective in the treatment of the disease but very little progress has been achieved on treatment of Schistosomiasis in Kenya. Any effort towards developing alternative drugs for the disease is worthwhile. Praziquantel is the most effective drug against all adult stages of human Schistosomiasis, being the drug of choice for morbidity control of Schistosomiasis. However it is not a satisfying situation to have one drug used for the treatment. Ideally other drugs should be availed in order to avoid development of drug resistance. The use of plant extracts in treatment of diseases is universal. The results obtained showed that Ocimum americanum and Bridelia micrantha plant extracts had antischistosomal activity as indicated by high worm reduction and reduced gross pathology. Histopathology showed no or few granuloma in the liver tissue. Further work should be done on the efficacious extracts, towards drug development.
Demographic Factors Associated with Health-Related Quality of Life Among Urban and Rural Tuberculosis Patients in Kenya
(Bilingual Publishing, 2019-12-31) Oguya, Francis; Mbuti, Humphrey; Mwaniki, Elizabeth
Background: Tuberculosis is one of the deadliest and disabling diseases in the world today. The infection exacts its greatest toll on individuals during their most productive years. TB patients record different perceived health related qualities of life(PHRQoL) which could be attributed to certain environmental,social and physical factors. The objective of the study was to determine the demographic factors associated with the PHRQoL among urban and rural Tuberculosis patients in Kenya. Cross sectional design was adopted. The study applied the multi-stage sampling technique. Random sampling method was used to select the TB clinics that participated in the study. Simple random sampling according to probability proportionate to TB patient’s population was preferred to select the study participants. Chisquare test determined association between the various demographic factors and the PHRQoL while ANOVA tests demonstrated the overall association of demographic factors and PHRQoL. Statistical Significance was evaluated at p<0.05. Descriptive statistics summarized and described the data. The study established that demographic factors are associated with PHRQoL (p=0.008). Specifically, age, levels of education, marital status and house hold size (P<0.05). Gender and Household head were not significantly associated with the PHRQoL (p>0.05). These findings will persuade the TB management policy towards developing an intervention programs directed at the social-demographic characteristics of the TB patients for improved treatment outcomes.
Development and Comparison of Capture Enzyme Linked Immunosorbent Assay and Indirect Immunofluorescent Test in Determination of Nairobi Sheep Disease Virus.
(2016-04-13) Waiganjo, Naomi; Nganga, Zipporah; Binepal, Yatinder
Abstract The diagnosis of Nairobi Sheep Disease relies on the inoculation of tissue culture, Baby Hamster kidney (BHK-21), with suspensions of infected samples followed by identification of the virus using indirect Immunofluorescent assay. These tests have a number of drawbacks including low specificity; visual reading of results which requires highly skilled expertise and tissue culture facilities therefore development of capture Enzyme linked Immuno Sorbent assay (ELISA) would improve the diagnosis of NSD in infected sheep. Nairobi Sheep Disease Virus (NSDV) was isolated, purified and titrated to determine the best working titer for immunization of animals. The purified virus subjected to IIFA test and fluorescence indicated the presence of NSDV. The animals immunized were rabbits and goat which were used for production of antibodies for C-ELISA test. C-ELISA was set-up using anti-goat sera as the primary antibody, purified NSDV as antigen and anti-rabbit sera as the secondary antibody. A 1:400 dilution was established as best dilution for true positive and negative samples. The diagnostic specificity and specificity of the developed C-ELISA was estimated. False positive samples were picked by IIFA, which was confirmed by tissue culture technique. The level of agreement between developed CELISA and IIFA used as a gold test was 95%, and the Kappa index was 0.86. The perfect agreement indicated by Kappa values is a sign that both tests can be used. However, C-ELISA is a better test in that it is more flexible and less subjective. The sensitivity and specificity of C-ELISA was estimated at 80% and 100% respectively. The results showed high diagnostic specificity of developed C- ELISA which could be adapted to test a large number of samples over short periods of time. The test is useful during outbreaks of NSD without need for tissue culture facilities.
Dietary Patterns and Obesity among Pre- Adolescents in Nairobi, Kenya
(Journal of Nursing and Health Science, 2017-04) Malla, Janet Kajuju; Waudo, Judith; Kithinji, Ciriaka T.
Abstract: Food continues to be a major factor in the development of the whole person throughout the growing years. Food becomes a means of communication; it is intimately associated with the emotions; and its acceptance or rejection is highly personal. The pattern for obesity is often set in infancy where sometimes overeating becomes a habit. Continued nibbling of food between meals and night eating syndrome where patients suffer from a voracious appetite after the usual evening meal is also associated with obesity. This was a descriptive study aimed at investigating the relationship between dietary patterns and obesity among Pre-adolescents. Systematic random sampling was used to select pupils from two day private primary schools in Nairobi making a sample of 120 pupils. Quantitative data were analyzed by computer through the use of Statistical Package for Social Sciences (SPSS). Linear regression analysis was used to test the hypothesis. The study showed a significant relationship between dietary patterns of the pre-adolescents and obesity. Regression Analysis results showed that eating food three times a day and eating any time were positively correlated with obesity. Skipping meals was significant at (p<0.05) significant level.
Effect of Moringa Oleifera fortified porridge consumption on protein and vitamin A status of children with cerebral palsy in Nairobi, Kenya: A randomized controlled trial
(PLOS Global Public Health, 2022-11-04) Malla, Janet Kajuju; Ochola, Sophie; Ogada, Irene; Munyaka, Ann
Abstract Background Malnutrition due to inadequate dietary intake is commonly reported in children with Cerebral palsy (CP). Poor dietary intakes are majorly caused by feeding dysfunctions secondary to oro-motor impairment characteristic of the condition. Strategies that improve nutrient densities in foods can help enhance nutrient intakes by these children. Objective This study investigated the effect of consumption of fermented finger millet porridge fortified with Moringa oleifera leaf powder (MoLP) on the protein and vitamin A status of children with CP. Design A randomized controlled trial was conducted among 113 children aged 5–11 years with CP. The study had two arms (intervention [N = 57] and control [N = 56]). The intervention group received a daily serving of fortified finger millet porridge for 3 months while the control group received non-fortified finger millet porridge servings. All children received the same amounts of porridge servings. The levels of serum albumin and retinol between the groups were compared at both baseline and end line. The BMI-for-age Z-scores (BMIAZ) and morbidity prevalence of the children were also assessed. Results At baseline, the two study groups were similar in all demographic and socio-economic characteristics, nutrient intakes, serum levels of albumin and retinol, weight status and morbidity. At end line, the children from the intervention group had significantly higher intakes of vitamin A at 717.12±432.7 μg/d (p = 0.038) and protein at 44.367±17.2 g/d (p = 0.031) respectively. The serum nutrients levels increased significantly from baseline by 0.456±0.12 g/dL (p<0.001) for albumin and by 0.243±0.10 μmol/L (p<0.001) for retinol among children in the intervention group. Among the children in the control group, the changes in the levels of both serum albumin 0.012±0.07 g/dL (p = 0.868) and serum retinol [0.0021±0.02 μmol/L (p= 0.890)] were not significant. At endline, the BMI-for-age Z-scores results showed that 10.52% and 34.0% of children from intervention and control group respectively were undernourished [χ2 = 30.985; p = 0.037]. Among the children in the intervention, group there was a significant change in the weight status between baseline and endline (p = 0.036). The weight status among children in the control group was not significantly different between baseline and endline (p = 0.109). Significant difference in morbidity prevalence between the two groups was also observed at endline (p = 0.003) with the prevalence being 24.6% and 51.8% among children in the intervention and control group respectively. Conclusion Consumption of M. oleifera fortified porridge significantly improved the children’s serum albumin and retinol levels, as well as BMIAZ.
Factors associated with default from treatment among tuberculosis patients in Nairobi province, Kenya: A case control study
(BMC Public Health, 2011) Oguya, Francis; Keraka, Margaret N; Kimuu, Peter K
Background: Successful treatment of tuberculosis (TB) involves taking anti-tuberculosis drugs for at least six months. Poor adherence to treatment means patients remain infectious for longer, are more likely to relapse or succumb to tuberculosis and could result in treatment failure as well as foster emergence of drug resistant tuberculosis. Kenya is among countries with high tuberculosis burden globally. The purpose of this study was to determine the duration tuberculosis patients stay in treatment before defaulting and factors associated with default in Nairobi. Methods: A Case-Control study; Cases were those who defaulted from treatment and Controls those who completed treatment course between January 2006 and March 2008. All (945) defaulters and 1033 randomly selected controls from among 5659 patients who completed treatment course in 30 high volume sites were enrolled. Secondary data was collected using a facility questionnaire. From among the enrolled, 120 cases and 154 controls were randomly selected and interviewed to obtain primary data not routinely collected. Data was analyzed using SPSS and Epi Info statistical software. Univariate and multivariate logistic regression analysis to determine association and Kaplan-Meier method to determine probability of staying in treatment over time were applied. Results: Of 945 defaulters, 22.7% (215) and 20.4% (193) abandoned treatment within first and second months (intensive phase) of treatment respectively. Among 120 defaulters interviewed, 16.7% (20) attributed their default to ignorance, 12.5% (15) to traveling away from treatment site, 11.7% (14) to feeling better and 10.8% (13) to side effects. On multivariate analysis, inadequate knowledge on tuberculosis (OR 8.67; 95% CI 1.47-51.3), herbal medication use (OR 5.7; 95% CI 1.37-23.7), low income (OR 5.57, CI 1.07-30.0), alcohol abuse (OR 4.97; 95% CI 1.56-15.9), previous default (OR 2.33; 95% CI 1.16-4.68), co-infection with Human immune-deficient Virus (HIV) (OR 1.56; 95% CI 1.25-1.94) and male gender (OR 1.43; 95% CI 1.15-1.78) were independently associated with default. Conclusion: The rate of defaulting was highest during initial two months, the intensive phase of treatment. Multiple factors were attributed by defaulting patients as cause for abandoning treatment whereas several were independently associated with default. Enhanced patient pre-treatment counseling and education about TB is recommended.
Focusing the HIV response through estimating the major modes of HIV transmission: a multi-country analysis
(2015-09-15) Oguya
Objective An increasing number of countries have been estimating the distribution of new adult HIV infections by modes of transmission (MOT) to help prioritise prevention efforts. We compare results from studies conducted between 2008 and 2012 and discuss their use for planning and responding to the HIV epidemic. Methods The UNAIDS recommended MOT model helps countries to estimate the proportion of new HIV infections that occur through key transmission modes including sex work, injecting drug use (IDU), men having sex with men (MSM), multiple sexual partnerships, stable relationships and medical interventions. The model typically forms part of a country-led process that includes a comprehensive review of epidemiological data. Recent revisions to the model are described. Results Modelling results from 25 countries show large variation between and within regions. In sub-Saharan Africa, new infections occur largely in the general heterosexual population because of multiple partnerships or in stable discordant relationships, while sex work contributes significantly to new infections in West Africa. IDU and sex work are the main contributors to new infections in the Middle East and North Africa, with MSM the main contributor in Latin America. Patterns vary substantially between countries in Eastern Europe and Asia in terms of the relative contribution of sex work, MSM, IDU and spousal transmission. Conclusions The MOT modelling results, comprehensive review and critical assessment of data in a country can contribute to a more strategically focused HIV response. To strengthen this type of research, improved epidemiological and behavioural data by risk population are needed.
Immunological Responses of Mice After Treatment with Ocimum Americanum Hexane and Bridelia Micrantha Water Plant Extracts
(2016-04-13) Waiganjo, Naomi; Yole, Dorcas; Ochanda, Horace
Abstract : Background-The T helper 1 (TH1) and TH2 dichotomy was first shown in murine CD4+ lymphocytes clones and these cells could be differentiated in terms of the cytokines they secrete. The TH1 subsets produce interleukin 2 (IL-2,) interferon gamma (IFN-γ) and lymphotoxin, TH2 subsets produce IL-4, IL-5, IL-6 IL-10 and IL-13. An important function of the TH2 response during infection is to produce cytokines that can prevent or dampen the production or effector functions of potentially dangerous inflammatory mediators. Results The results obtained showed that Ocimum americanum hexane (OAH) and Bridelia micrantha (BMW) water extract had antischistosomal activity. This was indicated by low worm recovery, high worm reduction, and reduced gross pathology with histopathology showing no or few granulomas in the liver tissue, which was similar to Praziquantel (PZQ). The two extracts had both cellular and humoral responses as demonstrated by IFN-γ, IL-5 and IgG responses. OAH and BMW were significantly similar to PZQ; however BMW had higher IgG responses. BMW had higher IFN-γ responses for both spleen and lymph node cells. Conclusion this implied that treatment groups were able to produce the TH-1 response which is important for cell mediated immunity. Although both extracts induced production of IL-5 for both lymph node and spleen cells, OAH generated more IL-5.
Nutritional Value and Sensory Acceptability of M. oleifera Fortified Finger Millet Porridge for Children with Cerebral Palsy in Nairobi County, Kenya
(Canadian Center of Science and Education, 2021-10-10) Malla, Janet Kajuju; Ochola, Sophie; Ogada, Irene; Munyaka, Ann
Abstract Nutritional deficiencies and other nutritional comorbidities commonly affect children with cerebral palsy. Interventions through fortification to enhance nutrient densities of foods for these groups may improve their intakes and consequently their nutritional and health status. This study was undertaken to determine the nutritional value and sensory acceptability of a finger millet porridge fortified with Moringa oleifera leaf powder. Standard methods approved by the Association of Official Analytical Chemists were adopted for determination of nutrient and anti-nutrient content of samples. Sensory evaluation was conducted according to the method of Larmond (1977). Statistical analysis was conducted with the aid of Statistical Package for Social Sciences software version 20. One-way analysis of variance with a post-hoc test of Least Significant Difference to separate the means was used to compare the nutrient and anti-nutrient content of samples. Independent t-test was used to test difference in mean sensory scores between fortified and control porridge. The results showed that Moleifera leaf powder had significantly higher contents of protein and β-carotene, which were the target nutrients for fortification of the fermented finger millet flour. Fermentation reduced the levels of anti-nutrients in finger millet flour. Fortification of the fermented finger millet flour with M. oleifera leaf powder at the ratio of 9:1 significantly improved the protein and β-carotene content of the fortified flour and did not significantly affect the sensory acceptability of the fortified porridge. This study confirmed the potential for Moleifera as suitable fortificant in finger millet porridge formulations to improve both protein and β-carotene intake in target populations
Obesity and Factors that Contribute to Obesity among Pre- Adolescents Attending Day Private Primary Schools in Nairobi, Kenya
(2015-09-15) Malla, Janet Kajuju; Waudo, Prof. Judith; Kithinji, Dr. Ciriaka T.
Obesity is a diet-related condition and it refers to an abnormally high proportion of body fat. Various studies carried out in the United States reveal that obesity stems right from childhood. Childhood obesity is the most prevalent and common nutritional condition among the urban population and it is becoming an area of public concern. Cited literature suggests that feeding habits, especially during infancy and childhood predisposes the child to obesity in adulthood. This was a descriptive study aimed at investigating obesity and factors that contribute to obesity among Pre-adolescents. The respondents were randomly selected from two day private primary schools in Nairobi. Systematic random sampling was used to select pupils from each school making a sample of 120 pupils. School head-teachers were also included in the sample. Data were collected by use of questionnaires, an interview schedule and an observation checklist. Both qualitative and quantitative data were collected. Qualitative data were analyzed by coding raw data into common themes to form patterns. Quantitative data were analyzed by computer through the use of Statistical Package for Social Sciences (SPSS). Linear regression analysis was used to test the hypothesis. Results were reported using frequencies and percentages. The study showed that there was a significant relationship between eating habits of the pre-adolescents and obesity. Eating food three times a day and eating any time were positively correlated with obesity. In the schools studied, 40% of the respondents ate food three times in a day while (50%) consumed food at any time of the day. The reasons given for these trends of food consumption were: availability of money, peer pressure, boredom and influence by media. Skipping meals had a very significant relationship with obesity. The t-statistic of –2.88 was significant at 5% significant level. This implied that an obese person could reduce their BMI by 2.0 points by skipping meals. On the other hand, eating between meals was positively correlated with obesity and the result was significant at 10% significant level. Data collected indicated that 55.8% of the respondents ate between meals. A third of the respondents were found to have a BMI of over 26, which indicates evidence of overweight.
Phytochemical analysis of the selected five plant extracts
(2016-04-13) Waiganjo, Naomi; Ochanda, Horace; Yole, Dorcas
Abstract Herbal medicine is still the mainstay of about 75 - 80% of the whole population, and the major part of traditional therapy involves the use of plant extracts and their active constituents. Plants were collected, identified, dried then extracted using hexane, Dichloromethane/methanol and water. Identification assays to test the presence of various chemical constituents were carried out. The five plants were: Sonchus luxurians, Ocimum americanum, Bridelia micrantha, Croton megalocarpus and Aloe secundiflora. The Phytochemical screening of the compounds present in the plant extracts were; alkaloid, glycosides, Saponins, reducing sugar, Steroid, Flavones and Catecholics. The most common compound in all the plant extracts was Catecholics. Steroids are used in medicine to treat many diseases. The Plant extracts can be possible candidates for drug development.
Randomized Control Trial Study On The Effect Of Health Education In Promoting Adherence To Treatment Among The Urban And Rural Tuberculosis Patients In Kenya
(RESEARCH SQUARE, 2020-11-18) Oguya, FRANCIS OCHIENG; Mbuti, Humphrey Kimani; Mwaniki, Elizabeth; Warutere, Peterson
Background: Tuberculosis is a global health concern and the incident rate in Kenya remains high. Because of the long duration of standard treatment (six months), there is a risk of treatment default by patients. Low adherence to treatment may result in the emergence of resistant strains of the Mycobacterium Tuberculosis in turn increasing mortality and prolonging the treatment duration. The rising TB cases in Kenya have been associated with poor adherence and low cure rate arising from inappropriate health education. Directly Observed Therapy, Short-course (DOTS) Strategy, in combination with patient education have proved to be more effective in reducing TB incident than the DOTS Strategy alone. However, there is lack of Evidence Based Protocol to guide Medical Professionals through the implementation of health education for TB patients. Objective: The main objective of this study was to determine the effect of health education in promoting adherence to treatment among the urban and rural tuberculosis patients in Kenya. The study used the PRECEDE-PROCEED model. Design: The study adopted Randomized Controlled Trial Design with pre-and post-test assessment. The Multi-Stage Sampling Technique was applied to select the study respondents. Random sampling was adopted to select the hospitals, health centers and dispensaries. Simple random sampling method was also used to assign the patients into experimental and control groups. Setting: The study was conducted in fourteen public health facilities in Nairobi and Murang’a Counties; 2 Hospitals, 7 health centers, 5 dispensaries. Participants: A total of 450 patients were recruited from the selected health facilities by random sampling according to probability proportionate to TB patient’s population. Only 373 met the eligibility criteria for the study. Intervention: Health Education Program for 10-15 minutes on average, twice a month for the next 6+ months as the Patient went for the weekly drug ration. Main measurement outcome: Level of adherence to TB treatment in patients. Methods: The study was conducted between September 2019 and February 2020. Only patients aged 18 years and above who had been on DOTS for at least two weeks were selected. Health education was given to those in the experimental group while those in the control group did not receive the intervention. After the six months of treatment the two groups were compared. Standard Questionnaire was used to collect data. Multivariate Analysis of Variance, Odds Ratio and Chi-square tests were used to evaluate the association between health education and adherence to TB treatment. Results: 450 patients were recruited (experimental group=225, control group=225). 77 patients did not meet the eligibility criteria leaving 373 patients (experimental group=186, control group=187). 83.3% of patients in the experimental group had high level adherence after intervention in the post- test phase Page 3/29 compared to 60.4% of patients who had high level adherence in the control group in the post-test phase. Wilk’s Λ had an F value of 18.540, p<0.001, Odds Ratio was 3.274 and χ²= 24.189, p<0.001, indicating that the health education intervention improved adherence to medication. Gender, levels of education, marital status and primary occupation were also found to be significantly associated with adherence to medication (p<0.05). Conclusions: Health education enhanced patients’ adherence to TB treatment regime. A health education program should be adopted and rolled out to health facilities and health care settings that provide TB services in Kenya.
Rapid situational assessment of people who inject drugs (PWID) in Nairobi and coastal regions of Kenya: a respondent driven sampling survey
(BMC Public Health, 2021) Oguya, FRANCIS; Kenya, Patrick R.; Ongecha, Francisca; Mureithi, Patrick
Background: A Cross-sectional Rapid Situational Assessment of People Who Inject Drug (PWIDs) applying Respondent Driven sampling techniques (RDS) was used to recruit subjects/participants in a study aimed at assessing HIV prevalence and risk behaviors among injecting drug users in Nairobi and Coastal regions of Kenya. There is paucity of data and information on injecting drug use in sub-Saharan Africa and there is sufficient evidence of existence of the environment for development and growth of injecting drug use. Past studies on PWID and its association to HIV and AIDS that have been conducted in Kenya do not provide sufficient information to support effective planning and comprehensive national response to the HIV and AIDS epidemic. Methods: A cross-sectional study design was adopted in which a set of initial subjects referred to as ‘seeds’ were first identified from which an expanding chain of referrals were obtained, with subjects from each wave referring subjects of subsequent waves. The seeds were drawn randomly from the population and interviewed to pick the one with the largest network and other unique characteristics. A maximum of twelve seeds were recruited. The second stage involved conducting assessment visits to the sites to identify potential collaborators that included non-governmental organizations (NGOs), drug treatment centres, health facilities, community based organizations (CBO’s) among others. Three NGOs located in the coast region and one in Nairobi region were identified to assist in identifying drug injection locations and potential participants. Key informant interviews (KIIs) and Focus Group Discussions (FGDs) were also conducted using interview guides. Results: A total of 646 individuals (344 in Nairobi and 302 at the coast) were recruited for the study between January and March 2010. Of these 590 (91%) were male and 56 (9%) were female. Findings showed that most PWIDs initiated injecting drug use between the ages of 20–29 years, with the youngest age of initiation being 11 years and oldest age being 53 years. Most commonly injected drug was heroin (98%), with a small (2%) percentage injecting cocaine. Other non-injecting methods such as smoking or combining these two drugs with other drugs such as cannabis or Rohypnol were also common. Most PWIDs used other substances (cigarettes, alcohol, and cannabis) before initiating injecting drug use. The adjusted national HIV prevalence of PWIDs was 18.3% (19.62% unadjusted) with PWIDs in Nairobi region registering 18.33% (20.58% unadjusted) compared PWIDs for Coastal region indicating 18.27% (18.59% - unadjusted). The gender based HIV prevalence showed that women were more at risk of acquiring HIV (44.51%-adjusted) compared to men (15.97%-adjusted). The age specific HIV prevalence showed that PWIDs who initiated injecting at 11–19 years (44.7% adjusted) were most at risk in Nairobi compared to those who initiated injecting at age 20–24 years (23.2% - adjusted) in the coastal region. While all PWIDs continue to be at risk in the two regions, those from the Western parts of Nairobi, Kenya were at a relatively higher risk given their increased propensity for sharing injecting equipment and solutions. Conclusions: Compared to the national HIV prevalence of (4.9%), the results show that People Who Inject Drugs (PWIDs) are at particularly high risk of infection in Kenya and there is urgent need for intervention (KenPHIA, 2018). This study also showed clear evidence that 70% of PWIDs are primary school educated, engage in high risk injecting and sexual behaviors comprising sharing of injecting equipment, unprotected heterosexual and homosexual sex. Given that initiation of injecting drug use begins early and peaks after formal school years (20–29 years), prevention programmes should be targeted at primary and secondary school students, college and out of school youth. Further, to protect People who inject drugs (PWIDs) from HIV infection, the country should introduce free Needle Syringe Programs (NSP) with provision of condoms and Methadone Assisted Therapy (MAT) as a substitute for drug use.
Rapid situational assessment of people who inject drugs (PWID) in Nairobi and coastal regions of Kenya: a respondent driven sampling survey
(BMC Public Health, 2021) Oguya, Francis O.; Kenya, Patrick R.; Ongecha, Francisca; Mureithi, Patrick
Background: A Cross-sectional Rapid Situational Assessment of People Who Inject Drug (PWIDs) applying Respondent Driven sampling techniques (RDS) was used to recruit subjects/participants in a study aimed at assessing HIV prevalence and risk behaviors among injecting drug users in Nairobi and Coastal regions of Kenya. There is paucity of data and information on injecting drug use in sub-Saharan Africa and there is sufficient evidence of existence of the environment for development and growth of injecting drug use. Past studies on PWID and its association to HIV and AIDS that have been conducted in Kenya do not provide sufficient information to support effective planning and comprehensive national response to the HIV and AIDS epidemic. Methods: A cross-sectional study design was adopted in which a set of initial subjects referred to as ‘seeds’ were first identified from which an expanding chain of referrals were obtained, with subjects from each wave referring subjects of subsequent waves. The seeds were drawn randomly from the population and interviewed to pick the one with the largest network and other unique characteristics. A maximum of twelve seeds were recruited. The second stage involved conducting assessment visits to the sites to identify potential collaborators that included non-governmental organizations (NGOs), drug treatment centres, health facilities, community based organizations (CBO’s) among others. Three NGOs located in the coast region and one in Nairobi region were identified to assist in identifying drug injection locations and potential participants. Key informant interviews (KIIs) and Focus Group Discussions (FGDs) were also conducted using interview guides.
A Review of Dietary Intake and Nutritional Status of Children with Cerebral Palsy
(Machakos University, 2022-04) Malla, Janet Kajuju
Abstract Cerebral palsy (CP) is a group of neurologic disorders typically caused by a non-progressive lesion or abnormality of the developing brain that appears in infancy or early childhood and permanently affects body movement, muscle coordination, and balance. It is the most common cause of physical disability in childhood and is a significant health problem with major effects over the lifespan. The global prevalence of CP ranges between 2-10 per 1000 children in community-based samples with prevalence varying widely from country to country. Children are vulnerable to protein energy malnutrition (PEM) as well as micronutrient deficiencies because of their continuing growth that hikes their bodies’ demand for nutrients. This risk of malnutrition is increased in neurologically impaired (NI) children due to a number of nutritional and non-nutritional factors. Among the nutritional factors is insufficient dietary intake due to feeding difficulties resulting from impaired chewing and swallowing. Cerebral palsy may be associated with a host of comorbidities such as undernutrition (46% to 90% of the patients), Studies have reported increased prevalence of morbidity and mortality secondary to compromised nutritional status among children with CP compared to their normal counterparts in the same age group. This review is aimed at assessing the effect of dietary intake on nutrition status of children with cerebral palsy. A review of various publications was conducted using the key words, Cerebral Palsy, disability, and feeding difficulties. This review shows that feeding difficulties due to motor dysfunction is common in children with CP and may reduce their dietary intake resulting to poor health and nutritional status. There is need to develop effective interventions aimed at improving the dietary intake of children with CP. Such interventions could help mitigate poor nutritional status as well as improve their quality of life.
Snacking and its effect on nutritional status of adolescents in two national high schools in Nairobi Kenya
(2015-09-15) Nguu-Gutu, Catherine Muthoni; Imungi, Jasper K.; Ngatia, Edith M.
Snacking is defined as any intake of food or energy-containing beverage outside of breakfast, lunch and dinner (Bellisle, 2007). Previous studies have shown that snacking among adolescents is most common in the afternoon (Cross et al., 1994; Howarth et al., 2007). This study focused on snacking and its effect on dietary intake of macronutrients from normal school balanced meals and nutritional status of adolescents in two public national high schools namely Nairobi School for boys and Kenya High School (KHS) for girls, in Kenya. These schools were purposefully and randomly selected. A cross-sectional study on nutritional status and level of snacking was carried out involving 172 and 180 adolescent girls and boys respectively aged 13 to 18 years. A total of 352 adolescent high school girls and boys were assessed. A semi- structured questionnaire was used to collect quantitative data on socio-economic status (SES) of the respondents’ families while qualitative data were collected through focus group discussions, key informant interviews and observations. Anthropometric measurements on height and weight for nutritional status were used. Food consumption frequency was used to assess food intake from school meals and snacks. Energy and protein intake data were collected using a 24-hour recall based on a sub-sample of 31 students (14 boys and 17 girls). Eleven percent (11.0%) boys and 10.2% girls was stunted. Almost an equivalent number of both boys and girls (45.2% and 44.1% respectively) were found to be normal and nourished. Although, the girls are more likely to be stunted than boys stunting was not significantly different between the two groups and underweight was significantly higher in boys than in girls. Significantly more girls were overweight and obese than boys. Among the students who reported to be snacking, 10.4% were underweight and 76.9% had normal BMI-for-age as compared to those who did not snack where 20.0 % were underweight and 63.3% with normal BMI-for-age. It was observed that amongst those who snacked, an equal number of boys and girls at 5.2% were underweight while 6.9% more girls than boys (5.9%) were overweight. Most of the students who snacked had a normal (89.3%) height-for-age. Amongst those who snacked and based on gender, more boys (5.9%) than girls (4.8%) were found to be stunted. Among the gender the difference between those who snacked and those who didn’t was insignificant There were almost an equivalent percentage of those who snacked at 10.7% and those who didn’t at12.0% and were stunted. There was no significant difference between the BMI-for-age among those who were snacking and those who were not (χ2=5.84, p value=0.120). Whether one snacks or not there is no significant relationship between snacking, BMI- for-Age, and hence nutritional status of both adolescent boys and girls in national boarding high schools. This study shows that snacking has no effect on adolescents’ nutritional status.
Social Demographic Factors Associated with Adherence to Treatment Among Urban and Rural Tuberculosis Patients in Kenya.
(International Journal of Medical Science and Health Research, 2020) Oguya, Francis; Mbuti, Humphrey; Mwaniki, Elizabeth
Background: Tuberculosis is a Global Public Health concern with serious Economic and Social Burden to the Patient and the Household. Because of the long duration of Standard Treatment there is a Risk of Treatment Default by Patients. The Objective of the Study was to determine the Social Demographic Factors Associated with Adherence to Treatment among the Urban and Rural Tuberculosis Patients in Kenya. The Cross Sectional Study Design was adopted. The Study applied the Multi-Stage Sampling Technique. Random Sampling Method was used to select the TB Clinics that Participated in the Study. Simple Random Sampling according to Probability Proportionate to TB Patient’s Population was preferred to select the Study Participants. Chi-Square Test determined Association between the various Social Demographic factors and the Adherence to treatment while ANOVA Test demonstrated the overall Association of Social Demographic factors and Adherence to TB Treatment. Statistical Significance was evaluated at p<0.05. Descriptive Statistics summarized and described the data. The Study established that Demographic Factors were Associated with adherence to TB treatment. Specifically, Gender, Level of Education, Place of Residence were found to be Significant (P<0.05). Age, Marital Status, Primary Occupation and Household Head were not Significantly Associated with adherence to TB treatment (p>0.05). These Findings will persuade the TB Management Policy towards developing Intervention Programs directed at the Social-Demographic Characteristics of the TB patient for improved Treatment Outcomes.

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