RÉSUMÉ
In certain regions of Kenya, such as Nyahururu, Kabarnet, Kasikeu, and Mbooni, inadequate access to healthcare services contributes to avoidable deaths. Organizations like the Kenya Medical Training College (KMTC) address this challenge by organizing free medical camps, involving both local and international volunteer healthcare workers. This study explored the effectiveness of KMTC's free medical camps through interviews with 18 key informants, including faculty, non-faculty members, and community leaders from purposefully sampled hardship areas, namely, Nyahururu, Kabarnet, Kasikeu, and Mbooni. The study found that KMTC's free clinics offered crucial services like curative care, immunization, maternal and child health services, disease sensitization, reproductive health services, and substance abuse education. However, limitations were identified, including a shortage of medications, lack of specialized screening, follow-up care, and referral services. Resources available included community health volunteers, KMTC and hospital staff, socio-structural support, and physical infrastructure. Challenges faced by volunteers included motivation issues, inadequate facilitation, limited stakeholder involvement in planning, and perceived service comprehensiveness issues. Despite these challenges, the community acknowledged the vital role of medical camps in delivering essential services to marginalized groups. Addressing resource shortages, enhancing stakeholder engagement, improving service comprehensiveness, and boosting volunteer motivation were highlighted as crucial steps to maximize community benefits.
RÉSUMÉ
Background: Technology continues to impact various spheres of life, including learning. Over the years, eLearning has experienced a steady rise in popularity. At Kenya Medical Training College (KMTC), the influence of technology on education became more noticeable due in part to a policy directive. This directive, prompted partly by the COVID-19 pandemic, emphasized adopting online teaching to address the loss of instructional hours. This study addressed a specific gap in KMTC's internal quality assurance efforts by accumulating evidence related to the extent of E-learning and user satisfaction. Methods: The study employed a descriptive cross-sectional design, utilizing qualitative and quantitative techniques. It involved KMTC campuses conveniently selected from the Coast and Nairobi regions, with 1139 students selected through simple random, stratified, and proportionate sampling methods. A mixed questionnaire (both open and closed-ended questions) was used to collect data. Specifically, the study aimed to assess the level of eLearning utilization among students in selected KMTC campuses and identify the determinants of this utilization. Results: Most of the respondents (89.2%) participated in online classes; 11.8% of those who did not participate cited reasons such as lack of gadgets, bundles, and poor internet connectivity, among others. Despite widespread e-learning utilization, 76.8% of learners strongly preferred face-to-face classes. Conclusions: Key factors linked to e-learning utilization included effective instructional strategies, quality technical support, and well-conducted online classes. The choice of communication channels, particularly platforms like WhatsApp, was strongly linked to e-learning utilization. Therefore, this study recommends that KMTC should acknowledge the strong preference for face-to-face classes and offer hybrid learning options. Further, the KMTC should address accessibility challenges and competing responsibilities at home by supporting data connectivity, ensuring user-friendly online platforms, and providing flexible scheduling options for diverse learner needs.
RÉSUMÉ
<p><b>INTRODUCTION</b>The use of non-fluoroscopic systems (NFS) to guide radiofrequency catheter ablation (RFCA) for the treatment of supraventricular tachycardia (SVT) is associated with lower radiation exposure. This study aimed to determine if NFS reduces fluoroscopy time, radiation dose and procedure time.</p><p><b>METHODS</b>We prospectively enrolled patients undergoing RFCA for SVT. NFS included EnSiteTM NavXTM or CARTO® mapping. We compared procedure and fluoroscopy times, and radiation exposure between NFS and conventional fluoroscopy (CF) cohorts. Procedural success, complications and one-year success rates were reported.</p><p><b>RESULTS</b>A total of 200 patients over 27 months were included and RFCA was guided by NFS for 79 patients; those with atrioventricular nodal reentrant tachycardia (AVNRT), left-sided atrioventricular reentrant tachycardia (AVRT) and right-sided AVRT were included (n = 101, 63 and 36, respectively). Fluoroscopy times were significantly lower with NFS than with CF (10.8 ± 11.1 minutes vs. 32.0 ± 27.5 minutes; p < 0.001). The mean fluoroscopic dose area product was also significantly reduced with NFS (NSF: 5,382 ± 5,768 mGy*cm2 vs. CF: 21,070 ± 23,311 mGy*cm2; p < 0.001); for all SVT subtypes. There was no significant reduction in procedure time, except for left-sided AVRT ablation (NFS: 79.2 minutes vs. CF: 116.4 minutes; p = 0.001). Procedural success rates were comparable (NFS: 97.5% vs. CF: 98.3%) and at one-year follow-up, there was no significant difference in the recurrence rates (NFS: 5.2% vs. CF: 4.2%). No clinically significant complications were observed in both groups.</p><p><b>CONCLUSION</b>The use of NFS for RFCA for SVT is safe, with significantly reduced radiation dose and fluoroscopy time.</p>