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The JOOUST Repository aims to store, preserve, disseminate, and provide access to scientific and intellectual outputs, ensuring the preservation of the University’s intellectual memory.
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Item type: Item , Access status: Open Access , Unmasking Non-Malarial Mosquito Borne Infections Among Febrile Children in Malaria-Endemic Regions of Western Kenya(Scientific Reports, 2026-04-07) Ogony, Jack; Karanja, Simon; Ayodo, George; Akinyi, Ivy; Onguru, Daniel; Angira, Charles; Menya, Diana; Mangeni, JudithAlmost half of under-five children in health facilities are febrile in sub-Saharan Africa. The non-specific clinical symptoms coupled with; limited diagnostics capacities, overlapping endemicity and the surveillance gaps complicates accurate cause identification of an acute febrile illnesses in resource limited settings. This challenge leads to misdiagnosis, overtreatment, and delays in appropriate management, increasing morbidity and mortality. Health systems are often overloaded, with providers attributing fevers to the most common pathogen, while other emerging infections are the cause. This study unpacked the febrile illness by testing for dengue fever in parallel to malaria. Febrile ill children below 5 years seeking health services public health facilities in Busia and Kisumu Counties were screened using an approved malaria and dengue fever rapid test kits at the outpatient department. Those who screened positive were recruited into the study. A total of 1004 children were screened, 380 met the recruitment criteria. 215 (21.4%) tested positive for P. falciparum alone, 90 (8.9%) tested positive for dengue fever alone while 75 (7.5%) had co-infections. Busia had the highest P. falciparumonly infection (23.4%) while Kisumu had the highest dengue-only infections (12.6%). Dengue fever is a re-emerging neglected tropical, climate change driven disease in malaria endemic regions. Other than creating awareness to build capacity for diagnosis, this study unmasked and confirmed dengue as a major contributor to the non malarial febrile illnesses among children. There is need to revise the screening algorithm for febrile patients to improve arboviral surveillance.Item type: Item , Access status: Open Access , Depressive Symptoms, Alcohol, and Drug Dependence among Female Sex Workers in Kisumu, Kenya: A Cross-Sectional Study(African Journal of Reproductive Health, 2026-07) Osire, Edyth A.; Awandu, Shehu S.; Otieno, Fredrick O.; Zulaika, Garazi; Akinyi, Cynthia; Phillips-Howard , Penelope A.; Mehta, Supriya D.Female sex workers (FSW) have increased likelihood of depressive symptoms, alcohol and drug dependence. Analysis of cross-sectional baseline data from 407 women in a trial of menstrual cups was done to assess depressive symptoms (PHQ-9), alcohol (AUDIT) and drug dependence (DAST). Multinomial logistic regression identified factors associated with having 2 or 3 elevated scores, relative to having no elevated score. Median age was 27.3 years; 60% of the FSWs had less than secondary education, 41% had other jobs besides sex work, and over half (52.9%) reported experiencing sexual abuse during childhood. The prevalence of depressive symptoms was 20% (15% mild, 5% moderate or higher). One quarter (25%) of participants had some classification for alcohol dependence, and 15% were classified as having potentially hazardous drug dependence. Multiple problems were identified in 14.4% of participants. The results highlight the interconnectedness of mental health, drugs and alcohol use among FSWs in western Kenya. (Afr J Reprod Health 2026; 30 [14]:75-85).Item type: Item , Access status: Open Access , To Explore the Use of Object, Play Materials as a Pedagogical Approach by Teachers in Facilitating Literacy Development in Pre-Primary Schools in Kenya(International Journal of Education Humanities and Social Science, 2026-06-26) Onyango, Stephen Omondi; Odongo, Benson Charles; Owiko, Cleophas OwinoThis study explored the use of object play materials as a pedagogical approach by teachers in facilitating literacy development in pre-primary schools in Kenya. Grounded in Jean Piaget’s Theory of Cognitive Development which posits that children actively construct knowledge through interaction with their physical environment. A qualitative research approach with phenomenological design was adopted to gain deep insights into teachers’ lived experiences and practices. The target population included pre-primary school teachers, lead teachers, head teachers, and ECDE sub-county coordinator. Purposive and saturated sampling techniques were used to select a total of 40 participants. Data were collected using in-depth interviews, focus group discussions and classroom observation protocols. Trustworthiness was ensured through credibility, transferability, dependability, and confirmability. Data were analyzed thematically. The findings revealed that teachers recognized object play materials as effective tools for enhancing literacy skills such as vocabulary building, letter recognition, and comprehension. However, challenges such as limited resources, lack of training, and large class sizes impeded their full utilization. The study concludes that object play enhances learner engagement and literacy acquisition when properly integrated into instruction. It recommends teacher training, provision of adequate play materials, and inclusion of object play strategies in instructional guidelines to strengthen literacy outcomes in early years’ education.Item type: Item , Access status: Open Access , Financial Determinants of Effective Hypertension and Diabetes Care in Rural Primary Health Facilities in Kisumu, Kenya-A Mixed-Methods Study(BMC Public Health, 2026-03-11) Amollo, Nichodemus Werre; Ogol, Japheth; Museve, Elijah; Owenga, Jane Adhiambo; Aduda, Dickens Omondi; Onguru, DanielBackground Noncommunicable diseases (NCDs), including hypertension and diabetes, account for approximately 27% of all deaths in Kenya, with 26% of adults having elevated blood pressure. Despite devolution of health services to county governments in 2013, financing for NCD management at the primary health care (PHC) level remains weak. This study examines financial determinants shaping hypertension and diabetes care in PHC facilities within a devolved county health system in rural Kisumu County, Kenya. Methods We conducted a convergent parallel mixed-methods cross-sectional study in seven public PHC facilities in Seme Sub-County, providing new facility-level evidence on how the interaction between devolution’s financing architecture, facility-level financial autonomy constraints, and resource allocation mechanisms shapes chronic disease care effectiveness in rural Kenya. Quantitative data were collected via structured questionnaires and retrospective document review of financial records (January–August 2024). Qualitative data were gathered through key informant interviews (n=7) with facility in-charges exploring planning, budgeting, and resource allocation. Descriptive statistics were produced in STATA v16; qualitative data were analyzed thematically in R. Results All seven facilities prepared annual workplans and budgets, but none achieved comprehensive NCDspecific planning (workplan+budget+dedicated NCD budget line). Funding sources were narrow: 71.4% (n=5) of the facilities depended on NHIF reimbursements and donor support, while only 28.6% (n=2) received direct county funding; 57.1% (n=4) of the facilities relied on only two funding streams. Although all facilities held bank accounts, none had formal financial autonomy and expenditures required county-level approval, typically taking 3–4 weeks (57.1%, n=4) to over two months (28.6%, n=2). Combined with unreliable central supplies, this lack of autonomy meant facilities could not procure locally when stockouts occurred; consequently 85.7% (n=6) of the facilities reported frequent medication stockouts. Facility in-charges attributed these failures to inadequate, unpredictable funding and centralized approval processes that prevented timely local procurement Conclusions Rural PHC facilities operate under structural governance failures in Kenya’s devolved health financing system that systematically undermine effective NCD care. The centralization of financial authority at county level, absence of ring-fenced NCD budgets, and misalignment between planning processes and resource allocation represent system-level policy contradictions rather than facility-level operational deficiencies. Addressing these governance failures requires not only increased funding but constitutional fiscal decision-space for facilities, mandatory NCD budget protection, and reformed disbursement mechanisms essential for equitable chronic care under Kenya’s UHC agenda. The sustainability of chronic care depends fundamentally on facility decision space, not only on funding volume. These findings are transferable to other Kenyan counties under the same devolved framework and to decentralized health systems in sub-Saharan Africa facing similar tensions between fiscal accountability and operational autonomy for chronic disease management.Item type: Item , Access status: Open Access , On Certain Norm Inequalities for Inner Product Type Integral Transformers(The Pečarić Journal of Mathematical Inequalities (PJMI), 2026-06-17) Wafula, Anthony; Okelo, Benard; Kangogo, WillyStudies on inner-product-type integral transformers have been considered in many research works from various perspectives, including spectra, numerical ranges, and operator inequalities. An open problem remains concerning inequalities related to norm estimates for inner-product-type integral transformers whose spectra are contained in the unit disc. It has been observed that the norms of such transformers can be attained under the condition that one of the implementing operators is normal. In this note, we address this problem by establishing norm inequalities for inner-product-type integral transformers in a general Banach space setting.