ABSTRACT
OBJECTIVES: To determine the relative frequency of acute radiation morbidity and their perceived effect on quality of life among head and neck cancer patients treated with radical radiotherapy. DESIGN: A cross-sectional study. SETTING: Kenyatta National Hospital, Nairobi. SUBJECTS: Thirty eight patients comprising 28 males and 10 females with ages ranging between 21 and 69 years were evaluated. RESULTS: Most of the tumours occurred in the nasopharynx (38.6%). The rest of the tumours were equally divided between the oral cavity and larynx (31.6%). All tumours except two were carcinomas. The two exceptions were a glomus tumour and a malignant melanoma. The patients had received doses of radiotherapy ranging between 58.5 Grey and 75.5 Grey. Of the 38 patients, 22 (53%) completed their treatment in the prescribed time while 16 (47%) had treatment interruption on account of radiation morbidity. The cumulative radiation done at the time of interruption ranged between 20 and 46 Grey. The most frequent symptom was dryness of the mouth while the most troublesome symptom was difficulty in tasting foods. The quality of life (QOL) did not vary by age, gender or tumour site. Patients who had treatment interruption had a better QOL than those who did not. CONCLUSION: This study provides information that should aid in communicating with the head and neck cancer patients scheduled for radiotherapy and in the design of preventive and interventional strategies aimed at enhancing patient support and rehabilitation.
Subject(s)
Head and Neck Neoplasms/radiotherapy , Quality of Life , Adult , Aged , Confidence Intervals , Cross-Sectional Studies , Female , Head and Neck Neoplasms/epidemiology , Humans , Male , Middle Aged , Morbidity , Physician-Patient Relations , Psychometrics , Radiotherapy/adverse effects , Surveys and Questionnaires , Young AdultABSTRACT
Background: Community studies on children and adolescents in Western settings suggest prevalence rates of anxiety and depressive symptoms that require intervention. Aim: To establish equivalent prevalence rates in a Kenyan (developing country) situation. Method: Self-administered questionnaires for socio-demographic data; three Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV)-based instruments for anxiety symptoms and syndromes in children; one instrument for depression and one culture sensitive instrument for depression and anxiety were administered in three different sets to 3 775 randomly sampled students drawn from a stratified sample of 34.7of all public secondary schools in Nairobi; Kenya. Results: The prevalence rates of anxiety and depression symptoms and syndromes varied widely depending on sex and age and also on the emphasis of the different instruments used; and also according to the cut-off points for the various syndromes and instruments. Clinical diagnostic scores for depression were recorded in 43.7of all the students. Using the cut-off points for the Multidimensional Anxiety Scale for Children (MASC); anxiety was recorded in 12.9of all students. Nearly half (40.7) of the respondents who completed the Short Leyton Obsessional Inventory for Children and Adolescents had positive scores for obsessive disorder; 81.1were positive for compulsive disorder and an average of 69.1had positive scores for both obsessive and compulsive disorders combined. Amongst those who completed the Ndetei-Othieno-Kathuku (NOK) scale for Depression and Anxiety; 49.3had positive scores for moderate to severe anxiety with or without depression. The Screen for Child Anxiety Related Disorders - Revised (SCARED-R) yielded high levels (50-100) for the different syndromes; with obsessive-compulsive disorder at 99.3; just below separation anxiety and school phobia at 100. Suicidal thoughts and plans were prevalent at 4.9-5.5. Conclusion: Anxiety and depression were found at prevalence rates no less than is found in the West. This calls for appropriate clinical practices and policies
Subject(s)
Adolescent , Anxiety , Child , Depression , Signs and SymptomsABSTRACT
Background: Community studies on children and adolescents in Western settings suggest prevalence rates of anxiety and depressive symptoms that require intervention. Aim: To establish equivalent prevalence rates in a Kenyan (developing country) situation Method: Self-administered questionnaires for socio-demographic data; three Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV)-based instruments for anxiety symptoms and syndromes in children; one instrument for depression and one culture sensitive instrument for depression and anxiety were administered in three different sets to 3 775 randomly sampled students drawn from a stratified sample of 34.7of all public secondary schools in Nairobi; Kenya. Results: The prevalence rates of anxiety and depression symptoms and syndromes varied widely depending on sex and age and also on the emphasis of the different instruments used; and also according to the cut-off points for the various syndromes and instruments. Clinical diagnostic scores for depression were recorded in 43.7of all the students. Using the cut-off points for the Multidimensional Anxiety Scale for Children (MASC); anxiety was recorded in 12.9of all students. Nearly half (40.7) of the respondents who completed the Short Leyton Obsessional Inventory for Children and Adolescents had positive scores for obsessive disorder; 81.1were positive for compulsive disorder and an average of 69.1had positive scores for both obsessive and compulsive disorders combined. Amongst those who completed the Ndetei-Othieno-Kathuku (NOK) scale for Depression and Anxiety; 49.3had positive scores for moderate to severe anxiety with or without depression. The Screen for Child Anxiety Related Disorders - Revised (SCARED-R) yielded high levels (50-100) for the different syndromes; with obsessive-compulsive disorder at 99.3; just below separation anxiety and school phobia at 100. Suicidal thoughts and plans were prevalent at 4.9-5.5.Conclusion: Anxiety and depression were found at prevalence rates no less than is found in the West.This calls for appropriate clinical practices and policies
Subject(s)
Adolescent , Anxiety , Child , Depression , Prevalence , Signs and SymptomsABSTRACT
Background: Community studies on children and adolescents in Western settings suggest prevalence rates of anxiety and depressive symptoms that require intervention. Aim: To establish equivalent prevalence rates in a Kenyan (developing country) situation Method: Self-administered questionnaires for socio-demographic data; three Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV)-based instruments for anxiety symptoms and syndromes in children; one instrument for depression and one culture sensitive instrument for depression and anxiety were administered in three different sets to 3 775 randomly sampled students drawn from a stratified sample of 34.7of all public secondary schools in Nairobi; Kenya. Results: The prevalence rates of anxiety and depression symptoms and syndromes varied widely depending on sex and age and also on the emphasis of the different instruments used; and also according to the cut-off points for the various syndromes and instruments. Clinical diagnostic scores for depression were recorded in 43.7of all the students. Using the cut-off points for the Multidimensional Anxiety Scale for Children (MASC); anxiety was recorded in 12.9of all students. Nearly half (40.7) of the respondents who completed the Short Leyton Obsessional Inventory for Children and Adolescents had positive scores for obsessive disorder; 81.1were positive for compulsive disorder and an average of 69.1had positive scores for both obsessive and compulsive disorders combined. Amongst those who completed the Ndetei-Othieno-Kathuku (NOK) scale for Depression and Anxiety; 49.3had positive scores for moderate to severe anxiety with or without depression. The Screen for Child Anxiety Related Disorders - Revised (SCARED-R) yielded high levels (50-100) for the different syndromes; with obsessive-compulsive disorder at 99.3; just below separation anxiety and school phobia at 100. Suicidal thoughts and plans were prevalent at 4.9-5.5.Conclusion: Anxiety and depression were found at prevalence rates no less than is found in the West.This calls for appropriate clinical practices and policies
Subject(s)
Anxiety , Depression , PrevalenceABSTRACT
OBJECTIVE: To evaluate chemotherapy induced myelosuppression, its management and outcome. DESIGN: Retrospective analysis of patients aged 13 years and above. SETTING: Hurlingham Oncology Clinic and the Nairobi Hospital during the period of June 1998 to June 2003. SUBJECTS: Two hundred and two solid tumour and lymphoma patients treated with pulsed chemotherapy at Hurlingham Oncology Clinic and those treated by the same service at the Nairobi Hospital. RESULTS: Two hundred patients were evaluable for nadir blood counts. World Health Organisation (WHO) grade 3 neutropaenia complicated 57 (26.1%), and grade 4 complicated 56 (25.7%) treatments. Grade 0 neutropaenia was seen in 40 (18.4%) treatments, 33 having included prophylactic Granulocyte-Colony Stimulating Factors (G-CSF). Neutropaenia was worst following the first and sixth courses, and repeated second line courses but the difference was not statistically significant (p = 0.154). Fever complicated 6 grade 3 and 21 grade 4 neutropenic episodes (23.1% of 117 evaluable). Twenty eight patients were hospitalised because of severe neutropaenia (23 febrile, and five afebrile initially but with absolute neutrophil counts < 0.01 x 10(9)/litre). Eight of them died, six attributable to infections (21.4% mortality) and two attributed to other causes. Median time to neutrophil recovery to 21.5 x 10(9)/litre was three days with a mean of 4.6 days. Anaemia and thrombocytopaenia were not commonly experienced. CONCLUSION: Prophylactic use of G-CSF may have prevented severe neutropaenia and its use in severe neutropaenia may have reduced the duration and severity of neutropaenia but the mortality rate for febrile neutropaenia remained high.
Subject(s)
Carcinoma/drug therapy , Granulocyte Colony-Stimulating Factor/therapeutic use , Lymphoma/drug therapy , Neutropenia/chemically induced , Thrombocytopenia/chemically induced , Adolescent , Adult , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma/mortality , Female , Humans , Kenya , Lymphoma/mortality , Male , Middle Aged , Neutropenia/prevention & control , Retrospective Studies , Survival Rate , Thrombocytopenia/prevention & controlABSTRACT
OBJECTIVE: To re-evaluate clinico-pathologic categorisation of patients with Hodgkin's lymphoma, treatments offered and their appropriateness, and outcome of this disease at Kenyatta National Hospital in the 1990s. DESIGN: Retrospective survey of Hodgkin's lymphoma patients aged 13 years and above at the Kenyatta National Hospital. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: Patients aged 13 years and above, with diagnosis of Hodgkin's lymphoma. RESULTS: There were 75 males and 36 females. One case had no clear gender details. 14.2% of the cases were of lymphocyte predominant histologic subtype, 23.6% nodular sclerosis, 26.4% mixed cellularity and 17% Lymphocyte depletion (Rye Modification of Lukes and Butler Classification). Disease stages IIIB, IVA and IVB (Ann Arbor) were found in 24.5% of the cases. The majority of the patients (60.3%) were treated with the COPP protocol and 17% with ABVD. Complete remission was realised in 56% of the cases and most cases were lost to follow-up, making it difficult to correlate survival with known prognostic parameters, apart from early stage disease and attainment of complete remission which correlated with prolonged durations of follow-up. CONCLUSION: The patients had earlier stage diseases than in earlier studies locally, the histologic classification is still wanting, and the COPP protocol appeared still popular instead of being abandoned. Response rates were lower than expected and losses to follow-up made it difficult to properly evaluate prognostic parameters. Early disease stage and attainment of complete remission appeared to correlate with longer follow-up duration.
Subject(s)
Hodgkin Disease/pathology , Hodgkin Disease/therapy , Adolescent , Adult , Female , Humans , Kenya , Male , Retrospective StudiesABSTRACT
OBJECTIVES: To determine the clinico-pathologic and prognostic factors, treatment and outcome of non-Hodgkin's lymphomas as seen at the Kenyatta National Hospital in the 1990s. DESIGN: Retrospective study of patients with non-Hodgkin's Iymphoma. SETTING: Kenyatta National Hospital, Nairobi, Kenya, between January 1990 and January 2000 inclusive. SUBJECTS: Patients aged 13 years and above, with non-Hodgkin's Iymphomas. RESULTS: Case records were available for 207 patients, 146 males and 60 females, with one having had gender not clarified. Fifty two per cent of the patients were aged less than 40 years and 18.4% over 60 years. Forty one per cent were not properly classified histologically, seventy patients out of 190 evaluable (36.8%) had stages IVA and IVB disease at diagnosis. Twenty five out of 77(32.5%) tested positive for HIV infection, none of them being of the indolent variety. Up to 57.1% of cases of Burkitt's lymphoma tested positive for HIV infection. Cyclophosphamide, doxorubicin, vincristine and prednisone, (CHOP) chemotherapy was given to 68.7% of the patients with complete remission rates of 55.6% for those who got a minimum of six courses of chemotherapy. Only 15.3% of 105 patients evaluable were followed up for 36 months and above, the majority of patients having been lost to follow-up. Poor performance status at diagnosis correlated with shorter follow-up durations (p<0.05). CONCLUSION: A good percentage of the patients were not comprehensively characterized pathologically. Standard treatment was offered to the majority of patients, and those who could afford to purchase the medicines stood good chance of achieving complete remission. Poor performance status at diagnosis correlated with shorter follow-up durations and early stage disease correlated with longer follow-up durations. Overall, the outlook for NHLs treated at KNH in the 1990s appears to have improved tremendously.
Subject(s)
Lymphoma, Non-Hodgkin/epidemiology , Adolescent , Adult , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Cyclophosphamide/administration & dosage , Doxorubicin/administration & dosage , Female , Humans , Kenya/epidemiology , Lymphoma, AIDS-Related/diagnosis , Lymphoma, AIDS-Related/drug therapy , Lymphoma, AIDS-Related/epidemiology , Lymphoma, Non-Hodgkin/diagnosis , Lymphoma, Non-Hodgkin/drug therapy , Male , Middle Aged , Prednisolone/administration & dosage , Retrospective Studies , Vincristine/administration & dosageABSTRACT
OBJECTIVE: To assess post-surgical management of patients with breast cancer at the Kenyatta National Hospital. DESIGN: Retrospective analysis of patients treated for breast carcinoma at Kenyatta National Hospital between January 1989 and January 2000. SETTING: Kenyatta National Hospital. SUBJECTS: Three hundred and seventy-four patients who had surgery or biopsy for breast cancer at the Kenyatta National Hospital. INTERVENTION: Chemo-hormonal therapy and/or radiotherapy for adjuvant, metastatic, or palliative purposes. RESULTS: Twenty-two patients received adjuvant chemotherapy, and 21 patients received chemotherapy for metastatic disease. Forty-six patients received adjuvant radiotherapy and 53 had radiotherapy for palliative purposes. One hundred and twenty-six patients were given tamoxifen for adjuvant and metastatic purposes. The median duration of follow-up was 20 months. CONCLUSION: Chemotherapy is grossly underutilized in the treatment of breast cancer at the Kenyatta National Hospital, and radiotherapy is also underutilized. Follow-up durations are dismal and if this is used as a surrogate measure for survival then survival durations for breast cancer patients are also dismal at the Kenyatta National Hospital.
Subject(s)
Breast Neoplasms, Male/surgery , Breast Neoplasms/surgery , Carcinoma/surgery , Hospitals/statistics & numerical data , Postoperative Care/statistics & numerical data , Adolescent , Adult , Aged , Female , Humans , Kenya , Male , Middle AgedABSTRACT
OBJECTIVE: To determine the clinical and haematological factors associated with treatment and outcome of chronic myeloid leukaemia (CML) at Kenyatta National Hospital. DESIGN: Retrospective survey of patients treated for chronic myeloid leukaemia. SETTING: Kenyatta National hospital, Nairobi, Kenya, between April 1990 and August 2000. SUBJECTS: Patients with chronic myeloid leukaemia. RESULTS: One hundred and four patients, 55 males and 49 females, age range 10-72 years with a median age of 35 years. Treatment with busulphan getting less popular in favour of hydroxyurea. Median follow-up 20 months with none of the clinical and haematological parameters impacting significantly on duration of follow-up. CONCLUSION: CML occurs at a younger age-group in Kenya, and none of the clinical or haematological parameters appears to impact on follow-up duration.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/epidemiology , Adolescent , Adult , Age Distribution , Aged , Antineoplastic Agents, Alkylating/administration & dosage , Busulfan/administration & dosage , Child , Female , Humans , Hydroxyurea/administration & dosage , Kenya , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/blood , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/complications , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis , Leukocyte Count , Male , Middle Aged , Retrospective Studies , Severity of Illness Index , Splenomegaly/classification , Splenomegaly/etiology , Survival Analysis , Treatment OutcomeABSTRACT
OBJECTIVE: To determine the impact on neutrophils if adriamycin is administered at 60 mg/m2 and cyclophosphamide at 600/m2 (AC 60/600); and at 50 mg/m2 and 500 mg/m2 (50/500) in the treatment of breast cancer. DESIGN: Restrospective analysis of nadir neutrophil counts in female mammary carcinoma patients treated with adriamycin/cyclophosphamide combination. SETTING: Hurlingham Oncology Clinic, Nairobi and The Nairobi Hospital between March 1995 and August 1999. SUBJECTS: Eighteen patients with breast cancer were treated either for adjuvant purposes or for metastatic disease. INTERVENTION: Chemotherapy with adriamycin and cyclophosphamide at 60/600 or 50/500. Patients were advised to avoid crowded places and given prophylactic broadspectrum antibiotics whenever grade 4 neutropenia occurred at nadir. RESULTS: Grade 3-4 neutropenia occurred in 75.5% of treatments at 60/600 and in 56.8% of the treatments at 50/500. Febrile neutropenia followed only one treatment and did not result in death. CONCLUSION: Neutropenia is frequent and severe at A/C 60/600 and need to be watched out for. Sepsis on the other hand is prevented if meticulous attention is given and corrective measures taken. A/C 50/500 was associated with less occurrences of neutropenia though still very high. Neutropenia should therefore be checked and steps be taken to prevent sepsis even at this dosage.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/blood , Breast Neoplasms/drug therapy , Neutrophils/cytology , Adult , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Cyclophosphamide/administration & dosage , Cyclophosphamide/adverse effects , Doxorubicin/administration & dosage , Doxorubicin/adverse effects , Drug Administration Schedule , Female , Humans , Leukocyte Count , Middle Aged , Neutropenia/chemically induced , Retrospective StudiesABSTRACT
OBJECTIVES: To evaluate the frequency and severity of occurrence of vincristine-associated neurotoxicity. DESIGN: A retrospective case series study. SETTING: Hurlingham Oncology Clinic, Nairobi. SUBJECTS: Thirty-eight patients treated for various neoplasms with vincristine containing chemotherapeutic regimens. MAIN OUTCOME MEASURES: The frequency and degree of neurotoxicity when vincristine was given at the standard dose of 1.4 mg/m2. RESULTS: Five patients (13.2%) developed peripheral neuropathy, one having had it even before vincristine was started. Therefore only four (10.5%) had it attributed to vincristine. Four of the patients who developed neuropathy (80%) were HIV-positive. Neuropathy grade 2 (severe) occurred in only two patients leading to discontinuation of the drug. All the neurotoxicity resolved after discontinuation of vincristine. CONCLUSION: Vincristine induced neuropathy occurred but was rarely severe at a dose of 1.4 mg/m2. It appeared to be more frequent in HIV infected individuals, but controlled studies with bigger sample sizes are required to determine whether this may warrant routine capping of the dose at a maximum of 2 mg.
Subject(s)
Antineoplastic Agents, Phytogenic/adverse effects , Peripheral Nervous System Diseases/chemically induced , Vincristine/adverse effects , Adolescent , Adult , Aged , Female , HIV Infections/complications , Humans , Male , Middle Aged , Neoplasms/drug therapy , Retrospective StudiesABSTRACT
OBJECTIVES: To estimate the effect of improved stoves on the prevalence of ARI and conjunctivitis among children aged below five years and women aged between 15 and 60 years. METHOD: A field trial or intervention study design, in which cluster and random sampling were used to recruit households with improved stoves. Nearest households with traditional three-stone stoves were recruited as controls. Prevalence of ARI and conjunctivitis among the study subjects was estimated by clinical evaluation and physical observation, and by history (including clinical and socioeconomic information), and compared between the two study groups. RESULTS: The prevalence of ARI among children aged below five years and among women aged between 15 and 60 years were significantly higher in households with the traditional three-stone stoves than in those with the improved stove chi 2 = 31.45 rho = 0.00000, relative risk = 2.6, C.I. 1.86,3.63, and chi 2 = 30.13, rho = 0.00000, Relative Risk = 2.8, C.I. 1.93, 4.06, respectively). Similarly the prevalence of conjunctivitis among children aged below five years and among women aged between 15 and 60 years were significantly higher in households with traditional three-stone stoves than in those with the improved stoves (c2 = 24.18, p = 0.00000, Relative Risk = 3.3, C.I. 2.05,5.32, and chi 2 = 7.6, rho = 0.0057, Relative Risk = 3, C.I. 1.38, 6.54, respectively). CONCLUSION: Prevalence of ARI and conjunctivitis among children aged below five years and also among women aged between 15 and 60 years in households with the traditional three-stone stoves was significantly higher than that in households with improved stoves.
Subject(s)
Air Pollution, Indoor/adverse effects , Child Welfare , Conjunctivitis/epidemiology , Conjunctivitis/etiology , Cooking/instrumentation , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/etiology , Rural Health , Women's Health , Acute Disease , Adolescent , Adult , Air Pollution, Indoor/prevention & control , Child , Child, Preschool , Conjunctivitis/prevention & control , Female , Humans , Infant , Kenya/epidemiology , Middle Aged , Prevalence , Respiratory Tract Infections/prevention & controlABSTRACT
One hundred and twenty consecutive patients above 12 years of age with dyspepsia were studied from June 1993 to September 1994. They underwent upper gastrointestinal endoscopy to find the mucosal lesions which were associated with their dyspeptic symptoms. At endoscopy gastric mucosal biopsies were taken in order to identify Helicobacter pylori (H. pylori) using three different techniques: culture, histology and the rapid urease test. Normal looking mucosa was the commonest single endoscopic finding, accounting for 34.2%, followed by gastritis 31.7% and duodenal ulcer 29.2%. However, when duodenal ulcers and gastric ulcers were put together, then peptic ulcer was the most prevalent finding accounting for 38.4%. Peptic ulcer was the most prevalent pathological finding in both young (less than 50 years) and older patients (50 years and above). Duodenal ulcer was more prevalent than gastric ulcer in the younger age group with a ratio of 5.8:1, however, the ratio in the older age group was 1:1. Gastric cancer was only found in patients aged 50 years and above, accounting for 17.4% of dyspeptic symptoms in this age group. Females were found to have more normal endoscopic findings than males (59.6%, versus 17.8% respectively). The difference being statistically significant (p < 0.001). All our cases of peptic ulcer disease had evidence of H. pylori infection while dyspeptic patients with normal endoscopic mucosal findings had H. pylori in 80.5% of cases. The difference in prevalence of H. pylori in the two groups was statistically significant (p < 0.001). Surprisingly, evidence of H. pylori in gastric cancer cases was very low in this study, being found in only 25% of patients.
Subject(s)
Dyspepsia/microbiology , Gastritis/microbiology , Gastritis/pathology , Helicobacter Infections/complications , Helicobacter pylori , Peptic Ulcer/microbiology , Peptic Ulcer/pathology , Stomach Ulcer/microbiology , Stomach Ulcer/pathology , Adolescent , Adult , Age Distribution , Aged , Biopsy , Child , Female , Gastric Mucosa/pathology , Gastroscopy , Humans , Kenya , Male , Middle Aged , Prevalence , Prospective Studies , Sex DistributionABSTRACT
A study was carried out to determine the range of antimalarial drugs stocked and also to determine the knowledge and practice patterns of shopkeepers and their customers on antimalarial products stocked and bought. It was hoped that the information thus obtained could be used to improve the selling and buying practices and hence contribute positively to malaria control. Up to seventeen different brands of antimalarial drugs including thirteen different brands of chloroquine and four different second line drugs were stocked by shopkeepers. A multiplicity of drugs, dosages and combinations were used for treating malaria. Only 38% of the shopkeepers felt they knew enough on the use of the drugs used in the treatment of malaria while 23% of the customers felt they knew enough on the use of the drugs. Most of the respondents wanted to know more on the use of the drugs. Knowledge desired by the shopkeepers included the correct dosage, combination with other drugs and side effects while information needed by the customers was on correct dosage, combination with other drugs as well as adverse effects. The person mentioned by the shopkeepers and the consumers to be in the best position to give the information was the doctor. The dissemination method preferred by the shopkeepers as well as the consumers was the radio.
Subject(s)
Antimalarials/supply & distribution , Commerce , Community Pharmacy Services , Health Knowledge, Attitudes, Practice , Malaria/drug therapy , Adult , Antimalarials/therapeutic use , Child , Drug Therapy, Combination , Humans , Kenya , Surveys and QuestionnairesABSTRACT
Records were available for 197 patients with malignant lymphomas (MLs) aged 13 years and above seen at Kenyatta National Hospital (KNH) between the years 1973 and 1986. There were 110 cases of Hodgkin's disease (HD) and 87 cases of non-Hodgkin's lymphomas (NHLs). The distribution of the two groups according to sex and histologic sub-types was not significantly different. HD patients were on average significantly younger than NHL patients (28.8 years versus 41.1 years). Over 70% of both HD and NHL cases presented in stages III and IV and the distribution of the groups according to stage of disease was not statistically significant. There was no significant correlation between stage of disease at diagnosis and histologic subtypes for either group. Losses to follow-up were high in both groups. Female sex was associated with longer periods of follow-up in both groups, being statistically significant for HD and not so for NHLs. Age was not correlated with duration of follow-up for NHLS whereas for HD cases, older age (above 53 years) was associated with shortened follow-up periods. The mortality rate was higher in NHLs than in HD cases.