Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 8 de 8
Filter
1.
JPRAS Open ; 40: 286-290, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38708387

ABSTRACT

An amputated hand in a child is considered an absolute indication for re-implantation. A key contributor to good functional outcome is the level of amputation, type of injury, warm ischemic time as well hand rehabilitation services. The role of parents in rehabilitation services has not been well defined. In our case report, we share the functional outcome of a six year old child that was successfully re-implanted followed by multiple sessions of physiotherapy during the Covid 19 pandemic period done by the parents. The functional outcomes for motor and sensory were closely comparable to the non-injured hand at one year of follow up. Parents should play an active role in rehabilitation of paediatric patients after re-implantation. They provide a supplementary approach to rehabilitation that could be cheaper and effective in ensuring good functional outcome.

2.
Sex Transm Dis ; 28(7): 367-71, 2001 Jul.
Article in English | MEDLINE | ID: mdl-11460019

ABSTRACT

BACKGROUND: Sexual and health-seeking behaviors are important components of sexually transmitted disease (STD) control. GOALS: To generate data for improved STD prevention and care, and to assess sexual behavior and relevant health-seeking behavior. STUDY DESIGN: A questionnaire to elicit social, demographic, healthcare-seeking, and sexual behavior information was administered to 471 patients attending the referral clinic for STDs in Nairobi, Kenya. RESULTS: A large proportion of the patients had sought treatment in public and private sectors before attending the clinic for STDs. Women waited longer than men to seek medical care. In addition, women more than men engaged in sex while symptomatic, mostly with their regular partner. Condoms were used rarely during illness. In their self-reports, 68% of the men admitted to having extramarital affairs, and 30% to paying for sex, yet they blamed their wives for their STDs. CONCLUSION: Health education messages in Kenya need adaptation to improve health-seeking behavior and safe sex practices.


Subject(s)
Patient Acceptance of Health Care/psychology , Patient Acceptance of Health Care/statistics & numerical data , Sexual Behavior/psychology , Sexual Behavior/statistics & numerical data , Sexually Transmitted Diseases/psychology , Adult , Condoms/statistics & numerical data , Educational Status , Extramarital Relations , Female , Health Education , Health Knowledge, Attitudes, Practice , Humans , Income/statistics & numerical data , Kenya/epidemiology , Male , Marital Status/statistics & numerical data , Needs Assessment , Private Sector/statistics & numerical data , Public Sector/statistics & numerical data , Risk Factors , Sex Education , Sex Work/statistics & numerical data , Sexually Transmitted Diseases/epidemiology , Sexually Transmitted Diseases/prevention & control , Socioeconomic Factors , Surveys and Questionnaires , Time Factors , Urban Health/statistics & numerical data
3.
Sex Transm Dis ; 27(7): 417-23, 2000 Aug.
Article in English | MEDLINE | ID: mdl-10949433

ABSTRACT

BACKGROUND: In Kenya, sexually transmitted disease (STD) clinics care for large numbers of patients with STD-related signs and symptoms. Yet, the etiologic fraction of the different STD pathogens remains to be determined, particularly in women. GOAL: The aim of the study was to determine the prevalence of STDs and of cervical dysplasia and their risk markers among women attending the STD clinic in Nairobi. STUDY DESIGN: A cross-section of women were interviewed and examined; samples were taken. RESULTS: The mean age of 520 women was 26 years, 54% had a stable relationship, 38% were pregnant, 47% had ever used condoms (1% as a method of contraception), 11% reported multiple partners in the previous 3 months, and 32% had a history of STDs. The prevalence of STDs was 29% for HIV type 1, 35% for candidiasis, 25% for trichomoniasis, 16% for bacterial vaginosis, 6% for gonorrhea, 4% for chlamydia, 6% for a positive syphilis serology, 6% for genital warts, 12% for genital ulcers, and 13% for cervical dysplasia. Factors related to sexual behavior, especially the number of sex partners, were associated with several STDs. Gonorrhea, bacterial vaginosis, cervical dysplasia, and genital warts or ulcers were independently associated with HIV infection. Partners of circumcised men had less-prevalent HIV infection. CONCLUSION: Most women reported low-risk sexual behavior and were likely to be infected by their regular partner. HIV and STD prevention campaigns will not have a significant impact if the transmission between partners is not addressed.


Subject(s)
Ambulatory Care Facilities , Sexually Transmitted Diseases/epidemiology , Adolescent , Adult , Female , Humans , Kenya/epidemiology , Middle Aged , Prevalence , Referral and Consultation , Risk Factors , Sexual Behavior , Sexually Transmitted Diseases/etiology , Uterine Cervical Dysplasia/diagnosis , Uterine Cervical Dysplasia/epidemiology
4.
Sex Transm Infect ; 76(1): 33-8, 2000 Feb.
Article in English | MEDLINE | ID: mdl-10817066

ABSTRACT

OBJECTIVE: To evaluate the validity of different algorithms for the diagnosis of gonococcal and chlamydial infections among pregnant and non-pregnant women consulting health services for vaginal discharge in Nairobi, Kenya. METHODS: Cross sectional study among 621 women with complaints of vaginal discharge in three city council clinics between April and August 1997. Women were interviewed and examined for symptoms and signs of sexually transmitted infections (STIs). Specimens were obtained for laboratory diagnosis of genital infections, HIV, and syphilis. The data were used to evaluate the Kenyan flow chart as well as several other generated algorithms. RESULTS: The mean age was 24 years and 334 (54%) were pregnant. The overall prevalence rates were: 50% candidiasis, 23% trichomoniasis, 9% bacterial vaginosis, 7% gonorrhoea, 9% chlamydia, 7% syphilis, and 22% HIV. In non-pregnant women, gonococcal and chlamydial infection was significantly associated with (1) demographic and behavioural risk markers such as being single, younger than 20 years, multiple sex partners in the previous 3 months; (2) symptom fever; and (3) signs including presence of yellow or bloody vaginal discharge, cervical mucopus, cervical erythema, and friability. Among pregnant women only young age, dysuria, and fever were significantly associated with cervical infection. However, none of these variables was either sensitive or specific enough for the diagnosis of cervical infection. Several algorithms were generated and applied to the study data. The algorithm including risk markers performed slightly better than the current Kenyan algorithm. CONCLUSION: STIs form a major problem in the Nairobi area and should be addressed accordingly. None of the tested algorithms for the treatment of vaginal discharge would constitute a marked improvement of the existing flow chart. Hence, better detection tools for the specific aetiology of vaginal discharge are urgently needed.


Subject(s)
Algorithms , Pregnancy Complications, Infectious/diagnosis , Sexually Transmitted Diseases/diagnosis , Vaginal Discharge/microbiology , Adult , Animals , Candidiasis/diagnosis , Chlamydia Infections/diagnosis , Cross-Sectional Studies , Female , HIV Infections/diagnosis , Humans , Kenya , Logistic Models , Neisseriaceae Infections/diagnosis , Pregnancy , Prevalence , Reproducibility of Results , Risk Factors , Syphilis/diagnosis , Trichomonas Vaginitis/diagnosis , Trichomonas vaginalis , Vaginosis, Bacterial/diagnosis
5.
Int J STD AIDS ; 11(12): 804-11, 2000 Dec.
Article in English | MEDLINE | ID: mdl-11138916

ABSTRACT

Our objectives were to describe the baseline findings of a trial of antibiotic prophylaxis to prevent sexually transmitted infections (STIs) and HIV-1 in a cohort of Nairobi female sex workers (FSWs). A questionnaire was administered and a medical examination was performed. HIV-negative women were randomly assigned to either one gram azithromycin or placebo monthly. Mean age of the 318 women was 32 years, mean duration of sex work 7 years and mean number of clients was 4 per day. High-risk behaviour was frequent: 14% practised anal intercourse, 23% sex during menses, and 3% used intravenous drugs. While 20% reported condom use with all clients, 37% never use condoms. However, STI prevalence was relatively low: HIV-1 27%, bacterial vaginosis 46%, Trichomonas vaginalis 13%, Neisseria gonorrhoeae 8%, Chlamydia trachomatis 7%, syphilis 6% and cervical intraepithelial neoplasia (CIN) 3%. It appears feasible to access a population of high-risk FSWs in Nairobi with prevention programmes, including a proposed trial of HIV prevention through STI chemoprophylaxis.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Azithromycin/therapeutic use , HIV Infections/prevention & control , HIV-1 , Sex Work , Sexually Transmitted Diseases/prevention & control , Adolescent , Adult , Anti-Bacterial Agents/administration & dosage , Azithromycin/administration & dosage , Cohort Studies , Drug Administration Schedule , Female , HIV Infections/microbiology , Humans , Incidence , Kenya/epidemiology , Middle Aged , Prevalence , Risk-Taking , Sexual Behavior , Sexually Transmitted Diseases/epidemiology , Vaginosis, Bacterial/epidemiology
6.
Int J STD AIDS ; 10(8): 543-7, 1999 Aug.
Article in English | MEDLINE | ID: mdl-10471106

ABSTRACT

We aimed to determine the knowledge and attitudes towards HIV/STDs among women attending an STD clinic by interviewing 520 randomly selected women. Nearly all had heard of HIV/AIDS/STDs, with posters, pamphlets and the radio being the main source of their information. The years of schooling was the only predictive factor of knowing a preventive measure of HIV. Two-thirds thought they were at risk of contracting HIV from their regular partner. Knowledge of the sexual habits of their male partners was low with 260 (50%) of the women distrusting their partner. Only 52 (10%) of respondents admitted to sex in exchange for gifts or money. In the event of a positive HIV test result, the perceived partner response would be to blame the woman for introducing the infection into the relationship. After a positive HIV test result, only 3.5% would resort to using condoms while another 3.7% would try to pass on the disease to other people. The quality of their knowledge of the transmission of HIV was low in spite of the fact that most respondents have heard of HIV/AIDS/STDs. Violence against women was expected in relation to a positive test result. There is a need for better educative effort on the modes of transmission and prevention of HIV, also in 'low risk' populations.


Subject(s)
HIV Infections , Health Knowledge, Attitudes, Practice , Women , Acquired Immunodeficiency Syndrome/prevention & control , Acquired Immunodeficiency Syndrome/transmission , Adult , Cross-Sectional Studies , Female , HIV Infections/prevention & control , HIV Infections/transmission , Humans , Kenya , Male , Prejudice , Random Allocation , Socioeconomic Factors , Women/education , Women/psychology
7.
Int J STD AIDS ; 10(6): 405-8, 1999 Jun.
Article in English | MEDLINE | ID: mdl-10414884

ABSTRACT

Untreated maternal syphilis during pregnancy will cause adverse pregnancy outcomes in more than 60% of the infected women. In Nairobi, Kenya, the prevalence of syphilis in pregnant women of 2.9% in 1989, showed a rise to 6.5% in 1993, parallel to an increase of HIV-1 prevalence rates. Since the early 1990s, decentralized STD/HIV prevention and control programmes, including a specific syphilis control programme, were developed in the public health facilities of Nairobi. Since 1992 the prevalence of syphilis in pregnant women has been monitored. This paper reports the findings of 81,311 pregnant women between 1994 and 1997. A total of 4244 women (5.3%) tested positive with prevalence rates of 7.2% (95% CI: 6.7-7.7) in 1994, 7.3% (95% CI: 6.9-7.7) in 1995, 4.5% (95% CI: 4.3-4.8) in 1996 and 3.8% (95% CI: 3.6-4.0) in 1997. In conclusion, a marked decline in syphilis seroprevalence in pregnant women in Nairobi was observed since 1995-96 (P<0.0001, Chi-square test for trend) in contrast to upward trends reported between 1990 and 1994-95 in the same population.


PIP: This study presents the trend in syphilis prevalence among 81,311 pregnant women in Nairobi, Kenya, from 1994 to 1997. Clinic nurses performed syphilis serology using a rapid plasma reagin (RPR) card test in 10 NCC clinics and Chi square; these were used to study trends over time. Results showed that a total of 4244 women (5.3%) tested positive with prevalence rates of 7.2% (95% CI: 6.7-7.7) in 1994, 7.3% (95% CI: 6.9-7.7) in 1995, 4.5% (95% CI: 4.3-4.8) in 1996, and 3.8% (95% CI: 3.6-4.0) in 1997. Thus, a significant decrease in syphilis seroprevalence among pregnant women in Nairobi was observed since 1995-96, by contrast with the rising trend in syphilis prevalence reported in 1990 and 1994-95 in the same population. This decline was attributable in large part to the syphilis control program initiated in Nairobi in June 1992, which focused on sexual behavior modifications, changes in health care seeking behavior and improved health care services.


Subject(s)
Pregnancy Complications, Infectious/epidemiology , Syphilis/epidemiology , Female , Humans , Kenya/epidemiology , Mass Screening , Pregnancy , Prevalence , Sexually Transmitted Diseases
8.
AIDS ; 13(5): 583-9, 1999 Apr 01.
Article in English | MEDLINE | ID: mdl-10203383

ABSTRACT

OBJECTIVES: To monitor and analyse trends in HIV-1 seroprevalence among antenatal women in Nairobi, Kenya. DESIGN: Six sequential surveys were carried out among antenatal clinic attenders at four Nairobi City Council health centres between November 1991 and April 1997. METHODS: A total of 6828 women attending for first antenatal clinic visit were administered a standard questionnaire to obtain demographic information and were screened for HIV-1. RESULTS: HIV-1 seroprevalence rose from 12.1% in the first survey to 16.2% in the third, completed in October 1993. No rise was observed in subsequent surveys, and seroprevalence among women under the age of 20 declined after the third survey. Significant differences in seroprevalence (P < 0.001) were observed in all survey rounds between women who reported that their province of origin was Nyanza (22.4% overall), compared with those from other provinces in western Kenya (14.1%), and the eastern group of provinces (8.9%). The rise in HIV-1 seroprevalence observed between 1991 and 1993 was almost entirely attributable to the rising seroprevalence among women from Nyanza. There were considerable differences in HIV-1 seroprevalence among the four health centres, partly accounted for by differences in the proportion of clinic attenders from different provinces of origin, which also changed significantly over time. CONCLUSIONS: HIV-1 seroprevalence has stabilized in antenatal women attending these health centres in Nairobi, and may be declining among women in the youngest age group. This may reflect stabilization of HIV-1 incidence, but further observation is required. The levels of infection among Nairobi residents reflect the evolution of the HIV epidemic in their provinces of origin, and changing client composition influences HIV-1 seroprevalence at different clinics. HIV sentinel surveillance should be carried out at multiple sites in large urban centres to monitor accurately the evolution of the HIV epidemic and the impact of control efforts in reducing transmission.


Subject(s)
HIV Infections/epidemiology , HIV-1 , Adolescent , Adult , Female , HIV Infections/blood , Humans , Kenya/epidemiology , Mass Screening , Middle Aged , Prevalence
SELECTION OF CITATIONS
SEARCH DETAIL
...