The East and Central Africa Medical Journal 最新文献

{"title":"Autism Society of Kenya","authors":"Autism Society of Kenya","doi":"10.33886/ecamj.v3i1.70","DOIUrl":"https://doi.org/10.33886/ecamj.v3i1.70","url":null,"abstract":"Autism Society of Kenya (ASK) is an NGO founded in Kenya in 2003 with the objectives to raise awareness about the existence of autism in the country, sensitize the communities and to lobby the Government of Kenya on issues about appropriate policies and acts regarding Autism Spectrum Disorder (ASD). Issues related to strategies were proposed to improve identification, diagnosis, management and support delivery for ASD affected individuals.","PeriodicalId":293196,"journal":{"name":"The East and Central Africa Medical Journal ","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129431532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autism Spectrum Disorder (ASD) in Kenya","authors":"N. Muhoho","doi":"10.33886/ECAMJ.V3I1.67","DOIUrl":"https://doi.org/10.33886/ECAMJ.V3I1.67","url":null,"abstract":"In the commentary section of this issue, The Autism Society of Kenya (ASK) describes its role and objectives to sensitize and promote levels of awareness on Autism Spectrum Disorder (ASD) and to advocate for policies that would enhance the existing disease interventions. The syndrome is widely spread in Kenya but in the write up this is a neglected none communicable disease that is not well understood neither by the public health authority nor by the general community. Unlike malaria and other tropical infectious diseases, Autism Spectrum Disorder (ASD) is a worldwide health burden which is well understood and addressed in the developed world but there is no clear data in Africa","PeriodicalId":293196,"journal":{"name":"The East and Central Africa Medical Journal ","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116879890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perforated uterus","authors":"Justus W Ngatia","doi":"10.33886/ecamj.v3i1.68","DOIUrl":"https://doi.org/10.33886/ecamj.v3i1.68","url":null,"abstract":"Early pregnancy failure is a major health problem worldwide which occurs in 15-20% of pregnancies. During evacuation, uterine perforation is a potential complication. Careful post-evacuation follow-up helps in early detection of perforation. Perforation often requires laparotomy or laparoscopy to repair the defect and evaluate for injury to adjacent organs. Our patient had pregnancy loss at 12 weeks and uterine perforation during a dilatation and curettage procedure. She had laparotomy, evacuation through the perforation site and uterine repair with good outcome.","PeriodicalId":293196,"journal":{"name":"The East and Central Africa Medical Journal ","volume":"138 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134061368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of acute Intestinal obstruction in Uasin Gishu County, Kenya","authors":"G. Jumbi, R. Tenge, B. Khwa-Otsyula, D. Menya, S. Bwombengi, B. Ombito","doi":"10.33886/ECAMJ.V3I1.42","DOIUrl":"https://doi.org/10.33886/ECAMJ.V3I1.42","url":null,"abstract":"Background: Acute Intestinal Obstruction (AIO) is a common life threatening emergency in all general hospitals all over the world. This study provides a population based incidence of acute intestinal obstruction derived from hospital data within a period of seven years preceding the year of the study (2008/9). Inpatient records can provide a fairly accurate data on the incidence of acute intestinal obstruction since almost all the cases are admitted in hospitals. \u0000Objectives: This study aims at determining the incidence and other epidemiological characteristics of AIO in Uasin Gishu County based on the hospital records and the national population census. \u0000Methods: The study was conducted in twelve hospitals (six within Uasin Gishu County) and six from the surrounding counties. Patient records for seven years preceding the period of study (2008) were retrieved and demographic information of the disease and treatment outcome (mortality) were analyzed against the projected population for the seven year period covered by the study (2001-2007). The population projections (the denominators) were based on Kenya population census and housing survey, 1999. \u0000Results: There were 444 cases of AIO from Uasin Gishu County during the seven year period of the study (2001-2007). There were 319 males (71.8%) and 125 females (28.1%) (male/female ratio =2.6/1). The mean age was 31.4 years and the median age was 29 years. The population of Uasin Gishu County (1999 census) on which the population growth projections was based was 622,705. Mean annual incidence for the seven year period was 8.8 per 100,000 persons and this was significantly related to age and gender (p-values = 0.0001). Recovery (survival) rate was 93.5% and mortality (case fatality) rate was 6.5%. Mortality rate was not significantly related to age and gender (p-value>0.05). \u0000Conclusion: The observed annual incidence of acute intestinal obstruction in Uasin Gishu County was very low compared to available global data. Our findings could be a pointer to the general burden of AIO in Kenya (given the similarity of Uasin Gishu County and rest of the country in relation to demography, infrastructure and the state of health care services). The incidence increased exponentially with age. A prospective population based study on incidence could shed more light and confirm the low incidence found in this study.","PeriodicalId":293196,"journal":{"name":"The East and Central Africa Medical Journal ","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131875640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of devolution on the trends of paediatric malaria admissions and mortality in Homa-Bay County, Kenya","authors":"M. Kodhiambo, B. Amugune, J. Oyugi","doi":"10.33886/ECAMJ.V3I1.39","DOIUrl":"https://doi.org/10.33886/ECAMJ.V3I1.39","url":null,"abstract":"AbstractBackground: Malaria is a leading cause of paediatric admissions, morbidity and mortality. Malaria burden is endemic in Homa Bay County in the Lake Region in Kenya. Low social-economic status in Homa Bay County enhances malaria transmission, morbidity and mortality. Paediatric malaria admission and mortality have recently increased in the lake region unlike the rest of Kenya. Literature review did not show studies interrogating health policy correlates of this malaria problem in the region. The policy of the recently devolvement of the government system in Kenya was to bring services closer to the people. Devolved government in which the county governments are now responsible for healthcare delivery may have unique challenges that may influence disease morbidity and mortality. \u0000Objective: The aim of this study was to investigate the impact of devolution on paediatric malaria admission and mortality trends in public health facilities in Homa Bay County. \u0000Methods: This was a retrospective quasi-experimental study in which paediatrics records of 36 months before and 36 months after the devolvement of government were retrieved and analyzed for malaria incidence and deaths. All records of paediatric malaria cases reported in all 164 public health facilities in Homa-Bay County were examined. Data from the sub-County was obtained from the electronic records at the County Hospital. Hard copy data from health facilities in eight sub-Counties was also inspected at the sub-County level. Analysis of the data was accomplished by use of the Interrupted Time Series (ITS). Permission to conduct the study was obtained from the appropriate authorities. Data coding system was used in order to ensure confidentiality. \u0000Results: From January 2013, deaths increased gradually until around the 33rd month when it rose abruptly to nearly 800 then declined to levels below 200 in the 34 th month, which was around the time of devolution. This was followed by a period of stability. Admissions had a similar trend. Conclusions: There was a slight raise in paediatric malaria admissions and in the number of deaths due to malaria morbidity in Homa Bay County after the devolvement of government system in Kenya a factor which could be attributed to teething challenges of devolution. More studies are necessary to assess progress towards universal access to good healthcare services post devolution.","PeriodicalId":293196,"journal":{"name":"The East and Central Africa Medical Journal ","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133982267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food safety knowledge, attitudes and practices among food handlers working in meat selling establishments in the City of Nairobi","authors":"J. Mathenge, M. Gicheru, P. Okemo, P. Ng’ang’a, J. Mbaria","doi":"10.33886/ECAMJ.V3I1.40","DOIUrl":"https://doi.org/10.33886/ECAMJ.V3I1.40","url":null,"abstract":"Introduction: Food-borne diseases have been increasing in recent years with a greater impact on health and economies of developing countries. Good levels of knowledge towards food safety among food handlers and the effective practices in food handling are imperative in reducing such illnesses. \u0000Objective: The aim of the present study was to evaluate the level of knowledge, attitudes and practices in food safety among food handlers working in meat selling and processing points within Nairobi city. \u0000Methodology: A cross-sectional study was conducted in the City of Nairobi. Data were collected from 100 food handlers working in food establishments selling meat in the city using an interviewer administered questionnaire. \u0000Results: Majority of the participants were male (80.0%) and Christians (89.0%). The median (interquartile range (IQR)) age of the participants was 30.5 (26.0-38.0) years. The respondents demonstrated above average proficiency in the assessments involving Knowledge, Attitudes and Practices (KAP). The overall KAP scores were not associated with age, gender, level of education and marital status. On the other hand, respondents who had ever attended a food handling and/or food safety course had a statistically significantly higher KAP mean score than their counterparts who had never attended (respectively, 31.5±0.2 versus 30.3±0.3, p=0.003). \u0000Conclusion: The level of knowledge, attitude, and practice on food safety and food handling amongst the sampled food handlers were found to be favorable. Training, motivation and initiatives should be provided to encourage food handlers to sustain this positive trend in knowledge, attitude, and practices in food safety.","PeriodicalId":293196,"journal":{"name":"The East and Central Africa Medical Journal ","volume":"305 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122317177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of overweight and obesity among hypertensive and diabetic patients seeking care at a rural Kenyan hospital","authors":"V. Mwenda, J. Njuguna, M. Musa","doi":"10.33886/ecamj.v3i1.36","DOIUrl":"https://doi.org/10.33886/ecamj.v3i1.36","url":null,"abstract":"Background: The current global epidemic of overweight and obesity contributes significantly to disease burden through mortality and morbidity. This study aimed at estimating the burden of overweight and obesity among hypertensive and diabetic patients. \u0000Methods: We conducted a retrospective review of medical records at the medical outpatient clinic at Consolata Hospital, Meru County. Records with complete demographic information, specified diagnosis, Body Mass Index (BMI) recorded at least once in the previous three visits were eligible for inclusion. Records for patients below 18 years and above 69 years were excluded. The data was then cleaned in Ms-Excel and analyzed using Statistical Package for Descriptive and differential statistics were calculated. \u0000Results: A total of 350 records were eligible; mean age 58.2 years (56.8-59.6) while 67% were female. Hypertension was present in 49% of the study subjects, 36% had type 2 diabetes while the rest had both conditions co-existing. The mean BMI overall was 26.6kg/m 2 (24.5-27.2) . Females had a higher mean BMI by 0.95kg/m 2 (95% C.I, -2.07-0.16, P=0.093). Overall, 54% of males had a BMI of 25-29kg/m 2 while 18% had a BMI of 30kg/m 2 and above. This is compared to 59% and 26% of the females, respectively. \u0000Conclusion: Overweight and obesity is highly prevalent in this population of hypertensive and/or type 2 diabetic patients. Weight management needs to be integrated in the package of care for these patients.","PeriodicalId":293196,"journal":{"name":"The East and Central Africa Medical Journal ","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121202388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Six year review of malignant oral and maxillofacial neoplasms attended at Muhimbili National Hospital, Dar es Salaam, Tanzania","authors":"K. Sohal, J. Moshy","doi":"10.33886/ECAMJ.V3I1.35","DOIUrl":"https://doi.org/10.33886/ECAMJ.V3I1.35","url":null,"abstract":"Background: Cancers of the head and neck constitute an important group of human malignancies. It is estimated that head and neck cancers constitute about 5–8% of all malignancies world-wide. These neoplasms affect speech and deglutition due to their location and might result in tooth mobility, expansion and destruction of adjacent structures.This study aimed at determining the types, prevalence and demographic distribution of malignant oral and maxillofacial tumours among patients treated at Muhimbili National Hospital (MNH). \u0000Methods: This was a retrospective study where by histological results of lesions that occurred in oral and maxillofacial region from 1st January 2008 to 31st December 2013 were analyzed. The lesions were grouped into carcinomas, lymphomas and sarcomas; histological diagnoses of the top ten lesions with higher frequency of occurrence were picked for analysis. \u0000Results: Malignant orofacial lesions accounted for 37.8% of all lesions that were biopsied from oral and maxillofacial region. Males comprised 51.4% of the patients. Age distribution was 3 to 98 years, mean 50.86 ± 19.89 years. Lymphomas and sarcomas occurred mostly in the patients below 40 years of age, while carcinomas were predominant above age 40 years. Squamous cell carcinoma was the most common malignant lesion (62.2%) followed by Kaposi’s sarcoma (13.1%) and adenoid cystic carcinoma (7.4%). \u0000Conclusion: Our analysis demonstrated 51 different types of malignant lesions in which squamous cell carcinomas were the most common. In general, carcinomas were prevalent group of malignant lesions, with its incidence increasing with advancement of age. The results provide a clue to the clinicians in establishing differential diagnosis hence aiding in correct identification and early diagnosis of orofacial cancer in Tanzania.","PeriodicalId":293196,"journal":{"name":"The East and Central Africa Medical Journal ","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127197240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of hospital services during delivery among post-natal mothers in Thika urban and Kangundo rural Counties, Kenya","authors":"P. Kabue, M. Keraka, J. Simbauni","doi":"10.33886/ECAMJ.V3I1.33","DOIUrl":"https://doi.org/10.33886/ECAMJ.V3I1.33","url":null,"abstract":"Background: Maternal mortality rate due to pregnancy-related complications in Kenya remains high at 362 per 100,000 live births. Hospital deliveries are low despite government strategies on improving health system and human resources. Home delivery practice is common in many parts of Kenya, especially in the rural areas. Generally, midwifery in home delivery lacks the necessary expertise to identify, resolve or prevent maternal complication, a situation which could raise maternal delivery related morbidity and mortality rates. \u0000Objectives: The study aimed to determine the rates of hospital deliveries both in urban and the rural hospital settings and establish the factors that determined the choice for hospital services. \u0000Methods: The study population was composed of post-natal mothers attending Maternal Child Health Clinics in an urban hospital setting and a rural hospital setting. The mothers were those who had delivered less than one year earlier. Thika Level 5 Hospital in Kiambu County represented the urban setting while Kangundo Level 4 Hospital represented the rural setting. A total of 400 post-natal mothers in each of the two hospitals were interviewed using a structured questionnaire to collect the relevant data in each hospital. Focus Group Discussions and Key informants interviews were also conducted in each hospital. \u0000Results: Client specific factors that were associated with hospital delivery included a steady source of income and occupation (p = 0.028, p = 0.007), ability to pay for hospital expenses and remedies (p = 0.000, p = 0.00), accessibility and short distance from the health facility (p= 0.001, p = 0.029), and client having a positive experience from a previous delivery and hope for a better services in the hospital (p = 0.000, p = 0.000) respectively. Health facility factors were lack of privacy (p = 0.000) manner in which the mother was handled by the health care worker (p = 0.0901) and the expected care (p =0.017). \u0000Conclusion: The study concludes that mothers fail to utilize the health facility for delivery due to service related factors such as long distance from the hospital, negative attitude of health workers, lack of privacy and poor quality of care, an improvement of which will make them deliver in hospitals and not at home.","PeriodicalId":293196,"journal":{"name":"The East and Central Africa Medical Journal ","volume":"110 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122881665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The levels of utilization of visual inspection screening of cervical cancer in Kitui, Kenya","authors":"J. Mwangi, A. Gachau, E. Kabiru","doi":"10.33886/ECAMJ.V3I1.34","DOIUrl":"https://doi.org/10.33886/ECAMJ.V3I1.34","url":null,"abstract":"Background: Cervical cancer is a disease of public health importance with a high global morbidity and mortality. More than 266,000 women die every year,with 87% of them coming from low and middle-income countries. These are the areas where programmes for screening and treatment are either deficient or underutilized. The morbidity and the mortality rates remain high in Kenya despite the screening and treatment services that the Ministry of Health has rolled out all over the country. Low levels of utilization of the established screening systems leads to increased morbidity and mortality. The problem is more prevalent in the rural Kenya where socioeconomic status of the majority in the population is low. Kitui County is such a rural region in Kenya. \u0000Objective: To determine the factors influencing the levels of utilization of the Visual Inspection method (VIA/VILI) for cervical cancer screening services in Kitui County, Kenya. \u0000Methodology: This was a descriptive study involving 370 women of reproductive age attending public MCH/FP clinics in Kitui County Kenya. Systematic random sampling method was used to select the participants. Exit interview was the main data collection technique. Key informants were also interviewed and facilities’ preparedness to provide adequate screening services was assessed using a facility survey checklist. \u0000Results: A total of 370 women were interviewed, 69.2% of whom were aged below 29 years, 68% were married, 75% had three or fewer children, 19% did not have the basic level of formal education and 61% were earning less than 50 US$per month. The level of awareness on cervical cancer and its prevention was 53.8%, with significant difference in relation to VIA/VILI utilization (OR 3.0675 p=0.000). Significance difference was also observed in cervical cancer testing and level of education (X 2 =21.728, df=3, P= 0.000), the main source of income, (X 2 = 15.030, df=2, P=0.01), average monthly income, (X 2 =27.942, df=4, P=0.0001) and the main decision maker in the family, (X 2 =6.908, df=2, p=0.032). Public health facilities were not adequately equipped and well staffed to provide the VIA/VILI screening services. \u0000Conclusion: Low levels (53.8%) of awareness about cervical cancer and its prevention among eligible clients in Kitui Central Sub-county Kenya, which was below the national target of over 70%, low coverage of health facilities and shortage of manpower lead to low levels of VIA/VILI screening. Therefore, there is a need to strengthen the existing services and interventions strategies, and enhance cancer awareness campaigns in order to reduce the incidence of the disease.","PeriodicalId":293196,"journal":{"name":"The East and Central Africa Medical Journal ","volume":"200 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116382807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}