School of Health Sciences
http://ir.jooust.ac.ke/handle/123456789/43
2024-03-28T10:27:15ZPrevalence and Factors Associated With the Management of Tungiasis in Ikolomani Sub-County, Kakamega County, Western Kenya
http://ir.jooust.ac.ke/handle/123456789/13170
Prevalence and Factors Associated With the Management of Tungiasis in Ikolomani Sub-County, Kakamega County, Western Kenya
Owino, Perez; Onguru, Daniel; Ayodo, George
Background: Tungiasis is a neglected tropical disease caused by skin penetration by female jigger fleas, predominantly Tunga penetrans, most commonly in resource-limited settings with sub-optimal basic hygiene standards, mainly in developing countries. Objective: We investigated the factors associated with tungiasis management in Ikolomani Sub County, Kakamega County in Western Kenya. Design: Descriptive study using mixed-methods approach, involving clinical observation, questionnaire, and environmental observation. Setting: Ikolomani Sub-County, Kakamega County, Western Kenya Participants: tungiasis patients identified at community. Outcome measures: Quantitative data underwent descriptive and inferential analysis (α = 0.05) using SPSS v.23, qualitative data was analyzed thematically. Results: Overall Tungiasis prevalence was 65% (95% CI: 60–70%), Idakho South and Idakho North recording the highest prevalence. Toes and soles were the most common sites of infestation. Only 91(34.5%) respondents sought medical treatment. Thorns (13.9%) and hydrogen peroxide (15.2%) were the common methods for jigger extraction. Residents from Idakho Central (aOR 0.44, 95%CI (0.23-0.83)) and Idakho East (aOR 0.43, 95%CI (0.22-0.85)) were less likely to suffer from tungiasis than those from Idakho North. Those with previous tungiasis were 7.24 times (aOR 7.24, CI (4.54-13.9)) more likely to be infested. Good/ hospitable healthcare staff was the major reason for choice of treatment. Sleeping on the floor was the main cause of tungiasis and its manifestation presents as a painful swelling. The major intervention of tungiasis was to remove them as mentioned by the participants. Spraying of animals was the preventive measure for Tungiasis. Conclusion: Residence and previous jigger infestation were independently associated with tungiasis infestation. Stigma, discrimination, and difficulty wearing shoes were some of the major challenges faced by tungiasis patients. Recommendation: There is need for enhanced intervention and health education in Ikolomani Sub County community on risk factors and management of tungiasis.
2024-02-26T00:00:00ZAdverse Neonatal Complications from Pregnancies Complicated by Gestational Diabetes Mellitus in a Poor Resource Setting, Kenya
http://ir.jooust.ac.ke/handle/123456789/13076
Adverse Neonatal Complications from Pregnancies Complicated by Gestational Diabetes Mellitus in a Poor Resource Setting, Kenya
Ottaro, Anita Amukhuma; Ayodo, George; Amolo, Asito Stephen
Gestational diabetes Mellitus (GDM) is a disorder at pregnancy causing insulin intolerance thus contributing to adverse pregnancy outcomes. The aim of this study was to evaluate neonatal outcomes associated with gestational diabetes mellitus among pregnant women with GDM in Kisumu County, Kenya. A case-control study was carried out among 210 pregnant women in Kisumu County. Screening and diagnosis were performed using the 2013 WHO criteria. Data was collected using a checklist, mother-baby booklet and gynaecological files. Descriptive and inferential statistical analysis were done in SPSS V.23 using Chi-square (χ2) test to test for associations. Analysis revealed that of the 105 GDM cases, majority were in 30-34 years age group, married and employed. Further analysis revealed that neonatal macrosomia and neonatal admission to intensive care unit (all p<0.001) were significantly associated with GDM. Therefore, these findings suggests that due to these adverse neonatal outcomes, there is need for interventions such as early GDM screening and management among the women at high-risk group.
2024-01-01T00:00:00ZGenotypes and Associated Risk Levels of Human Papilloma Virus among Female Patients Attending Rabuor Sub County Hospital, Kisumu
http://ir.jooust.ac.ke/handle/123456789/12691
Genotypes and Associated Risk Levels of Human Papilloma Virus among Female Patients Attending Rabuor Sub County Hospital, Kisumu
Okwaro, Irene Adhiambo; Onguru, Daniel; Ogolla, Sidney; Odongo, Esther
Background: Human papillomavirus is the main factor in the etiology of cervical cancer, with over 99.7% of cases being associated with high-risk human papillomavirus infection. Although the majority of HPV infections are asymptomatic and self-limiting, persistent HPV infection can result in genital warts, oropharyngeal cancer, and cervical cancer in women, in addition to various anogenital malignancies and other genital warts in both men and women.
Method: This was a cross-sectional descriptive study which employed a convenience sampling technique where both qualitative and quantitative methods were used for data collection. A total of 374 participants were enrolled in the study and a semi structured questionnaire was administered to collect socio-demographic, reproductive and sexual history data. Laboratory analysis involved detection of HPV DNA hybrids with a chemiluminescent substrate, Digene Hybrid Capture 2 technology. Descriptive and inferential (logistic regression) analyses at level of significant (a=0.05) were used to summarize the data, and results illustrated using charts and tables.
Results: The study findings reported a significant risk level of human papillomavirus among female of age group 40-49 years (AOR; 0.15, 95% CI: 0.03-0.79; p = 0.026). Furthermore, in bivariate logistic regression the circulating HPV genotypes among the respondents was significantly characterized among women of the same age group (95% CI; 0.09-0.7; p = 0.008) as well as in the multivariate regression (AOR = 0.13; 95% CI: 0.02-0.72; p = 0.019).
Conclusion: The study thus concluded that there is 23/94 (25.67%) risk of developing cervical cancer due to high risk level HPV (with the presence of low risk level HPV 71/94 (74.33%) known for causing various forms of warts. Therefore, there is need for combined efforts from the Ministry of health and stakeholders to avail and train health care workers on the usage of HPV DNA kits to ensure timely detection of low and high-risk levels HPV. This will ensure timely identification of women at increased risk for the development of cervical cancer, thereby reducing mortality rate.
2023-02-14T00:00:00ZFactors Associated with Utilization of Malaria Preventive and Control Measures among Pregnant Women Attending Antenatal Clinic at Kisumu County Referral Hospital in Kisumu City Western Kenya
http://ir.jooust.ac.ke/handle/123456789/12673
Factors Associated with Utilization of Malaria Preventive and Control Measures among Pregnant Women Attending Antenatal Clinic at Kisumu County Referral Hospital in Kisumu City Western Kenya
Amimo, Fred; Odongo, Esther; Otieno, Judith Atieno; Okwaro, Irene; Kai, Mudis Ogutu; Asito, Stephen Amolo
In Kenya, one of the strategies to control malaria during pregnancy is through the use of intermittent preventive treatment of malaria in pregnancy (IPTp) and insecticide-treated bed nets (ITNs) in conjunction with other intervention methods. But the uptake of these services among pregnant women is not fully optimized. The study assessed the knowledge on malaria and determined factors associated with utilization of malaria preventive and control measures among pregnant women in Kisumu City. A descriptive cross sectional study design was used during the survey, it was a one-point survey and the participants were met only once with no follow up done. A random sampling technic was employed and quantitative data collection method used. The method allowed the investigator to measure disease knowledge of the study participants and determined economic and demographic factors associated with utilization of malaria preventive and control measures among pregnant women in the study area. A total of 349 pregnant women aged between aged 14-49 years, with viable pregnancy (any gravidae) who had stayed in the study area for the last six months, attended ANC at Kisumu County Referral Hospital (KCRH) were enrolled in the study in the study. A structured questionnaire was used to collect data on knowledge level on malaria disease, social - economic and demographic factors that were associated with utilization of malaria prevention and control measures among pregnant women. Sample size was calculated based on malaria prevalence of 28% in the study area. Binary logistic regression, chi square and multivariate analysis (p p<0.05 ) were used to determine if there was any association for the categorical variables with utilization of malaria preventive and control measures among pregnant women. The finding reported knowledge levels about signs and symptoms of malaria was at 95.42%, malaria transmission at 90.54%, impact of malaria at 65.04%, malaria intervention methods at 89.68% and IPTp was at 57.59%. The main factors associated with utilization of malaria preventive and control measures among pregnant women were knowledge of malaria intervention methods (AOR 3.16, 95% C.1 1.38-7.21,p=0.006), knowledge of IPTp as malaria preventive method (AOR=4.55,95% CI=2.44-8.p=0.001), permanent employment and employment (AOR 2.08, 95%C.I,1.12-3.84, p=0.02). In this study, participants education was not statistically significant. The data from this study has shown risk of malaria in pregnant women within Kisumu city is high. The findings reported knowledge on disease transmission, signs and symptoms, sources of information and complications involved during pregnancy affected utilization of malaria preventive and control measures by the respondents. A bigger proportion of the respondents had knowledge on malaria intervention methods but use of IPTp as malaria intervention method was low. However, knowledge and use of Coartem® as antimalarial was high by the respondents. The finding also reported that socioeconomic factors influenced the utilization of malaria preventive and measures by the respondents. Demographic factors of the participants influenced utilization of malaria preventive and control measures by the respondents.
2023-02-01T00:00:00ZAwareness of the Spectrum Condition of Autism among Pre-Primary School Teachers in Western Kenya
http://ir.jooust.ac.ke/handle/123456789/12090
Awareness of the Spectrum Condition of Autism among Pre-Primary School Teachers in Western Kenya
Sadia, Moses; Ayodo, George; Amimo, Fred; Itotia, Serah; Obinju, Christine; Ściborski, Romuald J.
Autism is a spectrum of neurodevelopmental disorders exhibited in early childhood with variable manifestations as children grow up. However, the level of awareness of the condition is poorly understood among pre-primary school teachers. This study, therefore, assessed the awareness of the spectrum condition of autism among pre-primary school teachers in western Kenya. A descriptive cross-sectional study design was employed and data collected from 321 participants using semi-structured questionnaires and Key Informant interviews. The participants were selected using purposive sampling. The quantitative data were analyzed using SPSS version 20 and qualitative data analyzed thematically. The response rate was 76.9% with 16.8% (41) males and 83.2% (203) females. A total of 41.5% (n=110) of the teachers had never heard of autism. Of all teachers who had heard of autism, 100% (7) were from special needs schools, and 64.4% (67) and 45.1% (60) were from public and private schools, respectively. About 78.8% (105) of teachers perceived autism as a neurodevelopmental disability and academically challenged children, 15% (20) as a psychiatric illness similar to madness, 4.5% (6) as spiritual affliction/demon-possessed children and 1.5% (2) as parental neglected children. This study shows that pre-primary school teachers have inadequate awareness of the spectrum condition of autism, and this limits educational service delivery. This study therefore recommends special training for pre-primary school teachers and improvement of the curriculum and training to include the spectrum condition of autism.
2023-06-13T00:00:00ZAssociations between Stunting, Wasting and Body Composition: A Longitudinal Study in 6- to 15-Month-Old Kenyan Children
http://ir.jooust.ac.ke/handle/123456789/12088
Associations between Stunting, Wasting and Body Composition: A Longitudinal Study in 6- to 15-Month-Old Kenyan Children
Konyole, Silvenus O.; Omollo, Selina A.; Kinyuru, John N.; Owuor, Bethwell O.; Estambale, Benson B.; Michaelsen, Kim F.; Filteau, Suzanne M.; Wells, Jonathan C.; Roos, Nanna; Friis, Henrik; Owino, Victor O.; Grenov, Benedikte
Early growth and body composition may influence the risk of obesity and health in adulthood. Few studies have examined how under nutrition is associated with body composition in early life. We assessed stunting and wasting as correlates of body composition in young Kenyan children. Nested in a randomized controlled nutrition trial, this longitudinal study assessed fat and fat-free mass (FM, FFM) using deuterium dilution technique among children at age 6 and 15 months. This trial was registered at http://controlled-trials.com/ (ISRCTN30012997). Cross-sectional and longitudinal associations between z-score categories of length-for-age (LAZ) or weight-for-length (WLZ) and FM, FFM, fat mass index (FMI), fat-free mass index (FFMI), triceps, and subscapular skinfolds were analyzed by linear mixed models. Among the 499 children enrolled, breastfeeding declined from 99% to 87%, stunting increased from 13% to 32%, and wasting remained at 2% to 3% between 6 and 15 mo. Compared with LAZ >0, stunted children had a 1.12 kg (95% CI: 0.88, 1.36; P < 0.001) lower FFM at 6 mo and increased to 1.59 kg (95% CI: 1.25, 1.94; P < 0.001) at 15 mo, corresponding to differences of 18% and 17%, respectively. When analyzing FFMI, the deficit in FFM tended to be less than proportional to children’s height at 6 mo (P ≤ 0.060) but not at 15 mo (P > 0.40). Stunting was associated with 0.28 kg (95% CI: 0.09, 0.47; P = 0.004) lower FM at 6 mo. However, this association was not significant at 15 mo, and stunting was not associated with FMI at any time point. A lower WLZ was generally associated with lower FM, FFM, FMI, and FFMI at 6 and 15 mo. Differences in FFM, but not FM, increased with time, whereas FFMI differences did not change, and FMI differences generally decreased with time. Overall, low LAZ and WLZ among young Kenyan children were associated with reduced lean tissue, which may have long-term health consequences.
2023-04-01T00:00:00ZComorbidities Associated with Increased Risk of Death among Children Aged 2-59 Months with Severe Pneumonia in Western Kenya
http://ir.jooust.ac.ke/handle/123456789/12087
Comorbidities Associated with Increased Risk of Death among Children Aged 2-59 Months with Severe Pneumonia in Western Kenya
Akoo, Timon Kwach; Awandu, Shehu Shagari; Oluoch, Felix; Kemunto, Lorine; Ochung, Antony; Ayodo, George
Globally, severe pneumonia remains the leading infectious cause of death in children younger than 5 years. Comorbidities increase the risk of death among children with severe pneumonia across age groups and regions; however, the data is scanty on specific comorbidities. The study, therefore, was aimed at improving an understanding of the risk of death due to different comorbidities among children with severe pneumonia. The findings will not only inform the clinical practices but also improve the interventions. We conducted a hospital-based cross-sectional study of 141 children aged 2-59 months in Bondo Sub-County hospital in Western Kenya using inpatient data health records of children admitted to the pediatric ward. Both descriptive and inferential statistics were used to determine the occurrence of comorbidities and the risk of death due to comorbidities. The findings show that 57.5% of the children had at least one type of comorbidity including 36.5% malnutrition, 28.6% HIV exposed uninfected, 25.4% sickle cell disease, 7.9% HIV infected and 1.6% other comorbidities. Our findings showed that a child admitted to the hospital with comorbidities had six times increased risk of death compared to a child with severe pneumonia only [OR 6.06 (1.32-27.78) P = 0.02]. We also observed four times increased risk of death among HIV-exposed uninfected children [OR 3.92 95% CI (1.18-13.04) P = 0.03] and the risk of death increased six times when children had both HIV-exposed uninfected and malnutrition as comorbidities [OR 6.02 95% CI (1.61-22.58) P = 0.008] High comorbidities among children with severe pneumonia and increased risk of death, in HIV-exposed uninfected and malnourished children. There is a need for improved clinical practice and intervention for severe pneumonia, HIV exposed uninfected children. There should be a review of the immunization schedule for pneumonia among HIV-exposed uninfected children.
2023-05-19T00:00:00ZIncreased Risk of Diabetes Mellitus among Hypertensive Patients with HIV/AIDS Infection in Western Kenya
http://ir.jooust.ac.ke/handle/123456789/12086
Increased Risk of Diabetes Mellitus among Hypertensive Patients with HIV/AIDS Infection in Western Kenya
Otieno, Paul Mathews; Ochung, Antony; Kemunto, Lorine; Awandu, Shehu Shagari; Ayodo, George
With the increasing prevalence of hypertension and diabetes mellitus in areas with high prevalence of HIV/AIDS, it is important to understand the co-existence of the conditions. More importantly, understanding the risk factors for improved prevention and clinical practice. A cross-sectional survey was conducted among 240 hypertensive patients with co-morbidities such as diabetes mellitus and HIV/ AIDS in Homa Bay County, western Kenya. Data was collected using a structured questionnaire and multiple regressions were used to identify the risk of diabetes mellitus controlling for age, smoking and HIV/AIDS infection. The study shows co-existing co-morbidities with 50% suffering from HIV/AIDS and another 50% from Diabetes mellitus among the hypertensive patients. In addition, the risk for diabetes mellitus were; smoking (COR=2.89, 95%CI=1.63-5.11, P<0.001) and HIV/AIDS (COR=2.40, 95%CI=1.40-4.08, P=0.001). Also, observed that between 45 and 75 years, the risk of diabetes increased two-fold and when we controlled for age and smoking, the risk of diabetes among the hypertensive patients with HIV/AIDS increased by 1.4 folds (AOR=3.30, 95% CI=1.79-6.05,P<0.001). The study shows high co-existence of hypertension, HIV/AIDS and diabetes mellitus. Further, shows age, smoking and HIV/AIDS as the risk factors for diabetes in the population. The findings underscore the need for improved health promotion on the risk of age and smoking and clinical practice for the co-existing health conditions.
2023-04-17T00:00:00ZGrowth Performance and Carcass Composition of African Catfish (Clarias Gariepinus Burchell, 1822) Fed on Black Soldier Fly (Hermetia Illucens Linnaeus, 1758) Larvae Based Diets
http://ir.jooust.ac.ke/handle/123456789/11983
Growth Performance and Carcass Composition of African Catfish (Clarias Gariepinus Burchell, 1822) Fed on Black Soldier Fly (Hermetia Illucens Linnaeus, 1758) Larvae Based Diets
Mundida, General Beven; Julius Otieno, Manyala; James, Madzimure; Rono, Kenneth
A 12-week feeding trial was conducted to evaluate the effects of replacing fishmeal with black soldier fly larvae (BSFL) meal on growth performance and carcass composition of African catfish fingerlings. Five isonitrogenous (40% CP) diets of 0 (Control), 25, 50, 75 and 100% fishmeal with BSFL were used in triplicate. A randomized complete block design was used, and 600 fingerlings (0.46±0.02g) were randomly selected and stocked at a rate of 40 fingerlings in 15 plastic tanks respectively. Results showed that the treatment diets significantly (P<0.05) affected growth indexes, feed utilisation indices, and carcass composition of fish. Furthermore, 25% fishmeal could be replaced by BSFL meal without significantly reducing growth indexes and feed utilisation indices. However, water quality and condition factors between treatments were not significantly (P>0.05) affected by the diets. Decreased concentration of crude protein, ash, nitrogen free extracts in carcass composition of fingerlings with corresponding increase in dietary BSFL meal inclusion was observed. Increasing inclusion levels of
BSFL meal and decreasing levels of fishmeal increased the concentration of ether extracts and fibre contents of the body composition. Therefore, BSFL meal protein can be used to partially replace fish meal up to 25% to improve growth performance and feed utilization.
2023-01-20T00:00:00ZRisk Factors for Gestational Diabetes Mellitus among Pregnant Women Attending Antenatal Clinic in Kisumu City, Western Kenya
http://ir.jooust.ac.ke/handle/123456789/11982
Risk Factors for Gestational Diabetes Mellitus among Pregnant Women Attending Antenatal Clinic in Kisumu City, Western Kenya
Ottaro, Anita Amukhuma; Ayodo, George; Amolo, Asito S.
Background:
Globally there is a rapid increase in the prevalence of Gestational diabetes mellitus (GDM) associated with adverse maternal and neonatal outcomes. However, screening for GDM is not part of the standard routine antenatal (ANC) services in Kenya. There is a paucity of data on the factors associated with and predictors of GDM. Therefore, this study sought to determine factors associated with and predictors of GDM among pregnant women in western Kenya.
Methods: A case-control study was conducted from September 2021-October 2022. Using a validated questionnaire, data were obtained from 210 randomly sampled pregnant women attending antenatal clinic at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) in Kisumu city, western Kenya. Screening and diagnosis for Gestational Diabetes mellitus was performed using the 2013 World Health Organization (WHO) criteria. Both descriptive and inferential statistical analysis were done in SPSS V.23 using Chi-square (χ2) test to test for associations and Binary logistic regression analysis to determine predictors of GDM.
Results:
Among the 105 GDM cases, majority were in 30-34 years age group (51%), overweight with a
BMI of 25-29.9 kg/m2 (56%), had history of hypertension (53%), had hypertensive relatives (64%), had history of glycosuria (64%), were multiparous (69%), had history of cesarean delivery (61%), had history of macrosomic delivery (63%) and had history of neonatal intensive care unit (NICU) admission (53%). Multivariate analysis revealed that living in peri-urban area (adjusted OR [aOR] 3.30, 95%CI: 1.04-11.3,p=0.048), having a diabetic relative (aOR 8.09, 95%CI: 1.44- 73.0, p=0.031), being on iron-folic acid supplementation (IFAS) (aOR 13.0, 95%CI: 4.37-47.8, <0.001), having history of neonatal intensive care
unit admission (NICU) (aOR 13.9, 95%CI: 3.45-70.5, p<0.001) and history of caesarean delivery (aOR 5.02,95%CI: 1.42-19.5, p=0.015) significantly increased the odds of having GDM.
Conclusion:
The predictors of GDM include having a diabetic relative, history of cesarean section, NICU
admission and being on IFAS. There is need to incorporate GDM screening in the standard ANC services for optimal pregnancy outcomes. Multicenter studies looking at the long term effects of IFAS should be carried out to inform evidence based nutrition interventions during pregnancy.
2023-02-25T00:00:00Z