Knowledge, attitudes and practices towards COVID-19 among Residence in Mombasa County, Kenya

Background: Infectious disease pandemic of COVID-19 continues to be a global & public health challenge. The knowledge, attitudes and practices of the people towards COVID-19 is critical to the understanding the epidemiological dynamics of the disease. This study sought to assess the awareness of Knowledge, attitudes and practices towards COVID-19. Methods: A cross-sectional quantitative survey was conducted in Mombasa between September-October, 2020. A validated questionnaire was used to collect data. Data collected were analysed using analysis of variance (ANOVA), and Pearson’s correlation and multivariate linear regression tests. A total of 422 participants completed the survey questionnaire. A p<0.05 was statistically significant. Results: The mean age was 29.55?years (SD: 10.7), 252 (59.72%) were female, and 170 (40.28%) were male. Majority 255 (60.4%) were aged between 18-29 years while 200 (47.38%) and 162 (38.39%) were educated up to secondary and university level respectively. Knowledge scores significantly differed across genders, age-groups, categories of marital status, education levels (p<0.05). The mean COVID-19 knowledge score was 7.45 (SD: 1.51), suggesting an overall 62% (7.45/12×100) correct rate on this knowledge test. The majority of the respondents agreed that COVID-19 will finally be successfully controlled (66.35%) and this was significant (p<0.05). The vast majority of the participants had not visited any crowded place (88.35%) and wore masks when going out (74.31%) in recent days. Conclusions: The knowledge about COVID-19 in the Mombasa County population during the outbreak was acceptable, attitudes have been mostly favourable and the practices are mostly adequate.

Association between the RTS,S/AS01 malaria vaccine and under-nutrition in children aged 10 to 59 months in Siaya County, Kenya

Background: Under-nutrition is a global problem associated with infectious diseases including malaria. In this study, we explored the association between the newly introduced malaria vaccine, RTS,S/AS01 and measles vaccine with under-nutrition in children. Methods: We conducted a case-control study using anthropometric data for children aged between 10 and 59 months in Siaya County, Kenya collected from September to December 2021. Malaria and measles vaccines were the exposure variables, and under-nutrition, which is a composite variable including stunting and/or underweight was the outcome. Chi-square was used to test association between under-nutrition and the two vaccines. Further, a binary logistic regression was used to assess association between the vaccines, and independent variables with a confidence interval set at 95%. Results: From a total of 1,701 children, 185 (16.8%) were undernourished. Among the undernourished children, 121 (11.0%) were stunted and 64 (5.81%) were underweight. The undernourished children were matched with children of normal nutritional status at a ratio of 1:1 giving a total of 370. Malaria vaccine coverage was low at 21.1% (39/370) and 17.3% (32/370) among undernourished and children with normal nutritional status respectively. Similarly, the measles vaccine coverage was 30.8% (57/370) and 36.2% (67/370) among cases and controls respectively. Neither exposure to malaria nor measles vaccines showed a statistically significant difference between the cases and controls. Conclusions: We found no statistically significant association between malaria vaccine and under-nutrition in children. While malaria vaccine is important in protecting children from the malaria disease effects, it is not a proxy intervention for under-nutrition.

Assessment of clinical profile among hypertensive patients, Meru, Kenya

Background: Non-communicable diseases (NCDs) are the leading cause of global morbidity and mortality. Globally, more than 1.28 billion adults are hypertensive and in Kenya, 24% of adult population has elevated blood pressure and 56% of these have never been screened for hypertension. Assessment of clinical profile helps guide the management of hypertensive patients towards obtaining normal blood pressure levels. The aim of this study was to investigate the clinical profile of hypertensive patients at the Meru Teaching and Referral Hospital in Kenya. Methods: A cross sectional survey was conducted and systematic random sampling was used to sample 75 hypertensive patients who participated in the study. The collected data were summarized using frequencies and percentages. Chi square was used to assess the relationship between the participants’ demographic characteristics, clinical profile and hypertension. Statistical significance was set at p?0.05. Results: The average mean age of the participants was 58.53 years and majority were female (52%). Thirty-three (33.3%) were overweight and 24% were obese. The mean body mass index (BMI) for both genders was 26.48±5.24, the mean waist-to-hip ratio (WHR) and waist circumference (WC) was 0.94 and 102.09 respectively with 85.3% of the participants having a substantially increased WHR. Diabetes was the most common comorbidity (70.73%). Of the five clinical profiles assessed (BMI, RBS, WHR, presence of comorbidities and drug used) only the presence of comorbidity was associated with BP levels ?2 (10.01,3), p=0.018. Conclusions: Participants had high blood pressure, BMI, WHR and WC readings as well as several comorbidities.

Prognostic awareness and prognostic information preferences among advanced cancer patients in Kenya

Background: Cancer is the third leading cause of death in Kenya. Yet, little is known about prognostic awareness and preferences for prognostic information. Aim: To assess the prevalence of prognostic awareness and preference for prognostic information among advanced cancer patients in Kenya. Setting: Outpatient medical oncology and palliative care clinics and inpatient medical and surgical wards of Moi Teaching and Referral Hospital (MTRH) in Eldoret, Kenya. Methods: The authors surveyed 207 adults with advanced solid cancers. The survey comprised validated measures developed for a multi-site study of end-of-life care in advanced cancer patients. Outcome variables included prognostic awareness and preference for prognostic information. Results: More than one-third of participants (36%) were unaware of their prognosis and most (67%) preferred not to receive prognostic information. Increased age (OR = 1.04, 95% CI: 1.02, 1.07) and education level (OR: 1.18, CI: 1.08, 1.30) were associated with a higher likelihood of preference to receive prognostic information, while increased symptom burden (OR= 0.94, CI: 0.90, 0.99) and higher perceived household income levels (lower-middle vs low: OR= 0.19; CI: 0.09, 0.44; and upper middle- or high vs low: OR= 0.22, CI: 0.09, 0.56) were associated with lower odds of preferring prognostic information. Conclusion: Results reveal low levels of prognostic awareness and little interest in receiving prognostic information among advanced cancer patients in Kenya. Contribution: Given the important role of prognostic awareness in providing patient-centred care, efforts to educate patients in Kenya on the value of this information should be a priority, especially among younger patients.

Characterization of genital chlamydia amongst female sex workers in Nairobi, Kenya

Introduction: genital chlamydia, which is caused by diverse Chlamydia trachomatis genotypes, is largely asymptomatic. We aimed to identify C. trachomatis genotypes causing genital chlamydia among female sex workers attending a sex workers outreach program clinic in Nairobi, Kenya. Methods: this cross-sectional study was conducted between 18 April 2017 and 19 March 2021. Genitourinary complaints from eligible female sex workers were documented using a structured questionnaire. Endocervical swabs were collected for laboratory analysis. C. trachomatis plasmid DNA was extracted, PCR-amplified, and sequenced. Consensus sequences were generated and aligned with reference sequences to determine the C.trachomatis genotypes. Bivariate analysis was used to determine the association between genitourinary complaints and genital chlamydia. Results: endocervical swabs were collected from a total of 348 participants. Of these, 46 (13.2%) were positive for C. trachomatis. Most (297, 85.3%) of the participants presented with pelvic discharge with or without other symptoms. Fifteen (15, 4.3%) had abdominal pain and 3 (0.9%) had an itchy vulva. There was no statistically significant relationship between clinical presentation and genital chlamydia. Twenty-three samples were successfully sequenced. Each sequence was at least 90% identical to each of the 13 references C. trachomatis genotypes A, B, C, D, E, F, G, Ia, J, L1, L2, L2b and L3. Conclusion: we found no significant association between individual genitourinary complaints and genital chlamydia infection. The C. trachomatis genotypes circulating amongst female sex workers in Nairobi could be related to genotypes A, B, C, D, E, F, G, Ia, J, L1, L2, L2b, and L3.

Uptake of HIV and AIDS services among lesbian, gay and bisexual identifying youths aged 18 to 35 years in Nairobi city county, Kenya

Background: The study assessed the general uptake of HIV&AIDS care among the Lesbian, Gay, and Bisexual (LBG) identifying youths in Nairobi County. The focus was on sexual orientation and not gender identity. This research unpacked the depth in which socio-cultural, religious, systemic, personal attitudes and perceptions base contribute to the uptake of HIV&AIDS care and interventions to be scaled up. Methods: Descriptive cross-sectional design, involving qualitative and quantitative methods. The sample size was n=84 determined through the formula n=z2(1 –?/2)(1- P)/?2P due to unknown nature and number of the target population in Nairobi. Used snowball sampling technique and a virtual snowball sampling to reach the population. Purposive sampling was applied to reach key informants. Descriptive statistical analysis was utilized reinforced by cross tabulation. Results: The uptake of HIV&AIDS services was 86% among the lesbian, gay and bisexual youths in Nairobi. The majority access HIV prevention and care services from government/public health facilities followed closely by NGO led facilities. Personal attitude and perception base play a significant role in utilization; 57% engaged in risky sexual activities. A majority (87%) of the respondents experienced injustices while accessing HIV&AIDS services attributed the experiences to their sexual orientation. Conclusions: The health care providers should be adequately trained to provide comprehensive, inclusive, non-judgmental services; policies evaluated to provide non-discriminatory services to eliminate stigmatization of the population. The findings intend to inform programming of HIV&AIDS for this subset of key population and bridge the knowledge gap.

Climate Change in Kenya: Understanding Major Threats and Government Policies for Resilience

This article aims to describe and highlight major climate threats found in Kenya and climate change policy implemented by the government of Kenya from 2010 to 2022. Climate change poses a severe threat to the living conditions of citizens and wildlife worldwide. Numerous studies have demonstrated that in the absence of implemented policies, living conditions can be further deteriorated.While Africa may not contribute significantly to air pollution, there are other human activities that pollute the environment and need to be eliminated, as African people are already suffering from the impacts of climate change. African countries must take necessary steps to initiate sustainable development policies that ensure a better life for their citizens.In the case of Kenya, droughts and floods have resulted in the loss of human and animal lives and have negatively impacted the country's economy. Consequently, the government has implemented necessary measures since 2010 to address the issue of climate change.Various policies such as the National Climate Change Response Strategy (2010), the National Environment Policy (2013), Kenya National Adaptation Plan 2015-2030, Climate Change Bill (2014), National Climate Change Action Plan (NCCAP 2013-2017), National Climate Change Action Plan (2018-2022), and National Drought Management Authority (2016) have been enacted in response to climate change. These policies demonstrate the government's genuine concern for climate change issues. Overall, this study aims to contribute to the understanding of climate change policy in Kenya and raise awareness about the global threat posed by climate change.

The Nexus of Climate Change and Land-use in Kenya

Land as a resource remains a useful in alleviating human risks through provision of food, water, energy and environmental goods/services. There appears to be intertwined relationship between land and climate change, where climate change is perceived as a threat to land, while land and land use remains a major factor in climate change. There are however, few studies that have explored these intricate interrelationships between climate change and land as a nexus approach especially at the local levels. Therefore, the aim of this paper is to bring to light the interconnectedness between land and climate change and land, as well as assesses land impacts on climate change, in Kenya, and further suggests strategies needed to address these issues from a multidimensional perspective in the policy-making process. Scoping review was used to gather data from academic journal articles, book chapters, global databases, national database and conference papers. The objective of scoping reviews is to provide a broad overview of the literature on a specific topic and identify patterns, trends, knowledge clusters, and gaps. The study also obtained secondary data from various sources in the study. The study established that land-use influence climate change through agricultural expansion, urbanization, activities in catchment areas, large scale settlements, deforestation, manufacturing and industrial activities. Climate change then impact the land through reduction in agricultural activities and production, negatives on the forest ecosystems, reducing water resources, as well as detriment to quality of human, animal and plants life. The study concludes that land use change is a major driver of climate change and climate change drives land use activities in a nexus. To further this research, the study recommends ways of exploring land-sensitive approaches to climate change and land use management in a nexus a approach. The nexus approach that allows for the inter-linkages, trade-offs, and synergies existing between climate and land resources need to be developed.

Knowledge on safe sex practices among undergraduate university students at Chuka University, Kenya

Background: The youth and adolescents constitute a quarter of the sexually active population and they represent almost half of all new STI cases globally. However, there is limited current data on knowledge of safe sex practices among Kenyan university students. This study sought to assess knowledge on safe sex practices among undergraduate students. Methods: A cross-sectional analytical study design was adopted for this study. A self-administered questionnaire was used to obtain data from undergraduate students. Simple random sampling method was used to sample the participants. Data were analysed using the statistical package of social sciences (SPSS) v.24. Results: The mean age of the participants was 21.37 (±1.75) years. There were more males (56.5%) than females. Majority of participants (63.1%) came from rural areas and more than three-quarters were Christians (88.6%). Majority were single (83.8%) and most were residing in private hostels (71.9%). The mean knowledge score was 68.15 (±21.59)%. Significant predictors of knowledge level were the place of birth and place of residence; p=0.027, AOR=1.975 and p=0.026, AOR=0.477 respectively. Conclusions: The findings indicated that the University students had high knowledge of safe sex practices which was associated with their place of birth and residence. There is a need to assess if the high knowledge translates to practice among the students. The institutions of higher learning should continue to teach age-appropriate safe sexual practices to the students such as sexually transmitted infections, contraception and other related topics.

Prevalence of fruit and vegetable intake in relation to weight status among undergraduate public university students in Nairobi City County, Kenya

Background: Students in tertiary institutions such as public universities can make poor dietary choices, leaving them exposed to various kinds of malnutrition. The students could underestimate the dietary significance of fruits and vegetables despite their proven importance. This research aimed at establishing the prevalence of fruit and vegetable intake in relation to weight status among public university students in Nairobi County, Kenya. Methods: A sample of 385 students was used where a self-administered questionnaire was used to gather data. Besides, a stadiometer and weighing scale were used to ascertain the height and weight of the students. Descriptive and inferential statistical approaches were used to analyse data using SPSS. Results: The study determined that daily intake of fruits and vegetables by university students was low. Regarding weight status, findings showed 5.2% were underweight, most of the participants (54.9%) were within the normal weight range, 25.3% being overweight, while 14.6% were obese. Correlation results showed that there was a negative and significant linear relationship between intake of fruits and vegetable and BMI. Conclusions: The study concluded that fruits and vegetables are vital for an ideal weight status. The study recommends to students to ensure that they set aside an amount of the daily consumption expenditure to spend on fruits, as these are critical for the health today and in the future. Besides, students are advised to frequently monitor their BMI and take corrective actions before the situation deteriorates.

Vending environment and hygiene practices of street food vendors in an out of campus food environment in Kenya

Background: Street foods (SF) are ready-to-eat foods and the safety and hygiene practices of street food vendors (SFVs) are important in the prevention of food-borne diseases (FBD). This study assessed the food handling practices and vending environments of SFVs operating outside a public university (Chuka University) in Ndagani, Kenya. Methods: The study used an observational cross-sectional design where SFVs were observed during data collection. Census sampling was used to recruit 100 SFVs in Ndagani, Kenya. The collected data were summarized using frequencies and percentages. Chi square and regression analysis were used to assess the association and relationship between the SFVs’ demographic characteristic (sex) and their food handling practices and vending environment. Statistical significance was set at p?0.05. Results: Of the 100 SFVS who participated in the study 87% (n=87) were female. Only 10% (n=10) of the SFVs were vending in a sanitary environment while 88% (n=88) of the SFVs had sub-optimal food handling practices. There was an association between the SFVs sex and vending environment (p=0.003) and their food handling practices (p=0.008). Compared to male SVFs, female SFVs were 10.1 times more likely to vend in an unsanitary environment (OR: 10.1; C.I, 2.41-42.60, p=0.002) and 7.1 times more likely to have sub-optimal food handling practices (OR: 7.1; C.I, 1.84-27.79, p=0.005). Conclusions: The majority of SFVs are working in unsanitary environments and not handling SFs safely and hygienically. SFVs need training on food safety to prevent an outbreak of FBD within the university community.

System barriers to the provision of quality maternal health care in two regional teaching and referral hospitals in Kenya:a qualitative study / 《全球健康杂志（英文）》

Objective:Sub-Saharan Africa accounts for 66％of global maternal deaths.In Kenya,362 maternal deaths occur in every 100 000 live births.Most of these deaths occur as a result of suboptimal quality care of mothers during labor,delivery,or within 24 h of delivery.This study explored barriers that nurse-midwives encounter in trying to provide high-quality obstetric care during these periods. Methods:A qualitative research design utilizing focus group discussion as part of a mixed method study was used to find out the participants'experiences.Data were collected between February and March 2022 in the maternity units of two regional teaching and referral hospitals in Kenya.Eligible participants were nurse-midwives in charge of the maternity unit.The discussion was conducted in English,tape-recorded,and transcribed verbatim.Data were analyzed thematically,following Braun and Clarke 6-step framework.Nvivo version 7.0 computer software was used to facilitate this process. Results:Two focused group discussions each involving seven participants were conducted.The participants agreed that maternal mortality due to postpartum hemorrhage and pregnancy-induced hypertension is a major health concern.Further,maternal care in the two hospitals was substandard.Themes that emerged as barriers were:inadequate supplies;inadequate obstetric knowledge and skills;shortage of nurse-midwives,and inadequate support supervision.The underlying factors include inadequate funding by the county government and high staff turnover. Conclusion:This study showed that nurse-midwives are working under very difficult circumstances which are hindering the provision of quality maternal care.This is mainly due to system failures and inadequate nurse-midwife numbers.Targeted strategies need to be urgently implemented to mitigate these challenges to improve the quality of maternal health care.

Hematological Profiles of Eligible Blood Donors at Kenyatta National Hospital, Kenya

Aim:To determine hematological profile of eligible blood donors at Kenyatta National Hospital (KNH), Kenya.Study Design:Adopted a cross-sectional study.Place and Duration of Study:Kenyatta National Hospital, between March 2021 and August 2021.Methodology:This study recruited 202 eligible blood donors comprising of 173 males and 29 females aged 18-57 years. Blood samples (4ml) were drawn from donated units into ethylene diamine tetraacetic acid (EDTA) tube. Hematological parameters were estimated using a complete blood count (CBC) analyzer (Humacount 5D®). A total of eighteen hematological parameters were analyzed. These parametersincluded; red blood cell (RBC) count, hemoglobin concentration, RBC indices, white blood cell (WBC) count, absolute and differential WBC and platelet (PLT) count. Results were presented in medians and 95% interquartile ranges and compared using Mann–Whitney U test.Results:The median counts for all hematological parameters were within the accepted reference ranges for the adult urban population in Kenya. The median and interquartile range for total red cell count was 4.9×106/μL [0.74], hemoglobin level was 14.3g/dL[1.8], hematocrit was 44.9% [5.1], white blood count was 4.9×103/μL [1.4] and platelet was 234×103/L [64]. Among the red cell parameters analyzed, male donors had a significantly higher RBC count (P<0.001), hematocrit (P=0.001) and hemoglobin (P<0.001) than female donors. Among white blood cell parameters analyzed, only lymphocytes (P=0.011) were significantly higher in female donors than male donors. Platelet count (P<0.001) was also significantly higher in females than male donors.Conclusion:This study showed eligible donors at KNH had significant differences in red cell count, hematocrit, hemoglobin, lymphocytes and platelets between male and female donors. Additionally, it highlighted that some blood donors had hematological parameters belowand above the recommended reference ranges. These findings support the need to review the current donor recruitment criteria recommending the inclusion of complete blood count in screening.

Determinants of inequality in health care seeking for childhood illnesses:insights from Nairobi informal settlements / 《全球健康杂志（英文）》

Background:An in-depth understanding of patterns of inequities in healthcare seeking among the urban residents is critical in identifying appropriate interventions strategies.The study evaluates determinants of inequality in health care seeking for childhood illnesses among informal settlement residents in Nairobi,Kenya.Methods:Data from the second Nairobi Cross-Sectional Slum Survey(NCSS 2012)was examined.The inequality in seeking health care for childhood diarrhea as the prototype illness was assessed using concentration index(CI).The wealth index based on the household possessions and amenities was used as a measure for socioeconomic status.Results:A total of 2 027 qualified women were included in this study.About 16.6％of children born of younger mothers aged＜20 years had diarrhea and a similar proportion of children(16.3％)was observed among mothers who were unemployed.The CI of-0.026 on health care seeking for diarrhea among children points to significant inequality among the urban poor(95％confidence interval:-0.028 to-0.023).Conclusion:Occupation of parents,age of mothers,ethnicity,marital status and children's age were major deter-minants with regard to disease outcome and to a broader extent inequality in health care seeking for childhood illnesses.Enhanced bottom top community health invigoration strategies in health information awareness and services access would be instrumental.

Implementing an intensified mentorship approach towards accelerated medical laboratory accreditation in 10 counties in Kenya

Background: Despite Kenya's roll-out of the Strengthening Laboratory Management Towards Accreditation programme in 2010, most laboratories had not made significant or tangible improvements towards accreditation by 2016. In April 2016, the University of Maryland, Baltimore enrolled 27 facilities in the standard Strengthening Laboratory Management Towards Accreditation programme. Objective: This study aimed to describe and evaluate the implementation of an intensified mentorship strategy on laboratory accreditation. Methods: In October 2017, the University of Maryland, Baltimore implemented intensive mentorship in 27 hospital laboratories in Nairobi, Kiambu, Meru, Embu, Muranga, Nyeri, Laikipia, Nyandarua, Tharaka-Nithi, and Kirinyaga counties in Kenya. Laboratories were paired with competent mentors whose skills were matched to facility gaps. Baseline and follow-up assessments were done between April 2016 and March 2019 using the World Health Organization's Stepwise Laboratory Quality Improvement Process Towards Accreditation Checklist and overall scores of the 12 Quality System Essentials and star ratings (from zero to five, based on scores) used to evaluate the effectiveness of the intensified mentorship.Results: In September 2017, 14 laboratories scored zero stars, three scored one star, eight scored two stars, one scored three stars, and one laboratory was accredited. By March 2019, eight laboratories were accredited, five scored four stars, 10 scored three stars, three scored two stars, and only one scored one star. The average score change with the intensified approach was 81.5 versus 53.9 for the standard approach.Conclusion: The intensified mentorship strategy resulted in fast-tracked progress towards laboratory accreditation and can be adopted in similar resource-limited settings

Evaluation of the Knowledge, Attitudes and Prevention Practices with Regard to Cutaneous Leishmaniasis Caused by Leishmania aethiopica in Mount Elgon Focus, Kenya

Leishmaniasis has spread beyond the traditional areas of the Rift Valley and North Eastern provinces. There is more evidence of emergence and spread of leishmaniasisin Western Kenya. However, there is currently no comprehensive study on knowledge, attitude and prevention practices on leishmaniasis among the risk populations in the endemic Mount Elgon region of westernKenya. This has hindered the protocol for understanding the epidemiology of leishmaniasis.The descriptive survey design study was carried out from April to June, 2019 and it sought for information on KAP related to cutaneous leishmaniasis (C.L) in Mount Elgon region. Using stratified simple random sampling technique, a total of 340 household participants were selected in the study area. Structured questionnaire was used to collect the data. Regarding the responses given to knowledge, attitude and practice, a score of 1 was given for each right response and 0 for unsure responses. Data analysis was conducted using IBM SPSS version 23 statistical software. Descriptive statistics that include frequency and percentage were used to analyze the results. Out of 340 individuals were participated in our study 214 (62.9%) of the participants were males and 126 (37.1%) were females. The result of the present study in terms of knowledge showed that most of the respondents scored less than four items out of six correctly, hence described as having poor knowledge of CL.With regard to attitude respondents believed that CL was a problem in their area and had positive attitude towards the treatment of the disease. TheOriginal Research Article study also found out that majority of the respondents practiced well, as indicated by scoring positively in more than three items. In terms of plants used in the treatment of the disease,Olea europaea, Kigelia Africana, Terminial mollis, Croton macrostachyus, Tylosema fassoglense andBridella micrantha were mentioned. It was concluded that, people were less knowledgeable, had positive attitude towards the treatment especially using plant extracts could act as the basis for future research on alternative drugs against the disease

Uptake of Isoniazid Preventive Therapy (IPT) and Its Associated Factors among People Living with HIV (PLWHIV) in Kajiado County, Kenya

Isoniazid Preventive Therapy (IPT) involves use of isoniazid by People Living with HIV (PLWHIV) who havelatent TB for a period not less than six months to prevent active TB infection. Despite the critical role of IPT in reducing HIV/TB co-infection related morbidity and deaths, not much has been done to examine why its full implementation has not been achieved and the probable solution. The objective of this study was to determine uptake of isoniazid preventive therapy and its associated factors among people living with HIV in Kajiado County, Kenya. Analytical Cross-sectional study was carried out in purposely selected four Hospitals. Two hundred and seventy two(272) study participants were recruited through systematic sampling with 100% response rate. Data were collected using structured questionnaires. Cross tabulation, bivariate and multivariate analysis was carried out to identify factors influencing IPT uptake. The study found out that IPT uptake was at 72%. Logistic regression analysis, established the existence of a significant positive association (p-value=0.000, βii=1.729) between patient knowledge among PLHIV and IPT uptake. A correlation analysis outcome shows the existence of a significant positive relationship (r=0.332, sig. =0.000) between patients knowledge and having ever used IPT at 0.01 level in a two tailed.The 72% of IPT uptake was sufficient. Patient knowledge factors had the highest influence on IPT amongst PLWHIV. The role of health care givers and health centers as IPT information disseminators and IPT knowledge source respectively, was invaluable in this study

Socioeconomic Factors and Cultural Practices Influencing the Resurgence of Bedbugs (Cimex hemipterus): A Case of Nakuru Town, Kenya

Bedbugs are parasitic insects that feed mostly on blood (human). Cimex hemipteruscommonly known as the Tropical bedbug resurge in warmer climates like Africa, Asia and America. Over the years bedbug infestation has remained a major public health concern among the residents of Nakuru Town Kenya. The purpose of this study was to determine socioeconomic factors and cultural practices that influence the resurgence of bedbugs in Nakuru Town, Kenya.This study adopted analytic epidemiological study design and used cross sectional descriptive survey for data collection. It was conducted in seven estates in Nakuru Town, Kenya with an estimated population of 32,856 in a period of seven months. Cluster sampling was used to sample the households in the estates with the study surveillance being done in four hundred and twenty two (422) households whereas 57% and 43% of the participants were male and female respectively The main source of income among the respondents was self-employment with only 27% of the participants being employed. According to the findings of this study 31% of the residents were earning between 5000 and 10000 with only 4% of their monthly income been allocated to healthcare.The current socioeconomic status among the residents of Nakuru Town is inhibiting the fight against bedbug elimination. Cultural beliefs like witchcraft are limiting the eradication of bedbugs and leads to the resurgence in some of the households.In conclusion, the current socioeconomic status among the residents of Nakuru Town is inhibiting the fight against bedbug elimination. The findings of this study will be used to inform the policy makers in the Nakuru County government on measures to be taken to improve the socioeconomic status of its residents so that in the future residents are empowered to eradicate the bedbugs.

A qualitative perinatal audit at a rural health facility in Eldoret, Kenya

Background: Objectives of the study were to ascertain the pattern of occurrence of perinatal mortality by applying the World Health Organization (WHO), International Classification of Diseases, tenth revision (ICD-10) to deaths during the perinatal period, ICD perinatal mortality (ICD-PM), following the introduction of a qualitative perinatal audit process at a rural health facility in Kenya.Methods: A single centre retrospective analysis demonstrating the application of the WHO, ICD-PM. Data pertaining to perinatal deaths for the period from 1st May 2017 to 31st August 2018 was obtained from Plateau Mission Hospital perinatal audit records.Results: There were 22 perinatal deaths during the study period, 17 were included in the study. The overall perinatal death rate was 11 per 1000 births. Antepartum deaths were as a consequence of fetal growth related problems (33.3%), infection (33.3%) or unexplained (33.3%) with pregnancy-related hypertensive disorders (gestational hypertension, pre-eclampsia and eclampsia) being the most frequent medical condition associated with the mortalities. Neonatal deaths (47.1%) were the most frequent in the study and were a consequence of low birth weight and prematurity (25.0%), Convulsions and disorders of cerebral status (25.0%). The maternal condition in most of these cases being complications of placenta, cord and membranes. Acute intrapartum events and were least in this setting accounting for 17.4% of deaths.Conclusions: The ICD-PM is generalizable and its use in perinatal death classification emphasises focus on both mother and baby. Our study showed the majority of perinatal deaths occurred in the early neonatal period & affected mostly preterm infants.

Status of healthcare waste management in small and medium sized healthcare facilities in Nakuru East Sub County, Kenya

Background: Health care waste (HCW) is unwanted materials produced from hospitals, laboratories and research centres. HCW is of public health importance because hazardous HCW carries significant health risks. If poorly handled, it can lead to significant public health crises. Consequently, guidelines for proper management of HCW have been legislated. Unfortunately, not all healthcare facilities adhere to the guidelines. Diseases spread by inadequately disposed HCW are becoming increasingly prevalent especially in developing nations. This study was therefore conducted to establish the status of HCW management in six purposefully selected healthcare facilities in Nakuru East Sub-County (NESC), Kenya.Methods: A cross sectional study design was used to conduct this study. Six healthcare facilities (HCFs) in NESC, Kenya were purposefully selected. The HCFs were selected based on level and patient volumes and categorised as small or medium sized. HCW from each of the HCFs was weighed and categorised. Observation checklists and interviews were used to determine techniques used in HCW management.Results: The total weekly weight of HCW was 187.65 kg (mean 31.3 kg). Small sized HCF produced 49.55 kg/week while medium sized HCFs produced 138.1 kg/week. Total weekly weight of general HCW was 143.7 kg (76.5%); 33.8 kg (18%) was infectious while 10.2 kg (5.4%) was sharps.Conclusions: Healthcare facilities in NESC produce significant quantities of HCW. General HCW was predominant, followed by infectious waste and sharps. A considerable proportion of the HCFs did not comply with the stipulated guidelines for safe management of HCW. Concerned authorities in all HCFs should be alert and proactive regarding proper management of HCW.