Background: School children travel to and from school on daily basis. Active transportation such as walking, running and cycling contribute significantly to the increase in physical activity, health, and wellbeing in children. However, there has been a growing concern on the effect of carrying heavy backpack on the health of school going children who are at an important developmental stage of their lives. Objective: To determine the prevalence of musculoskeletal pain linked to backpack use and associated ergonomic factors among pupils in Nairobi City County in Kenya. Design: Descriptive cross-sectional study. Setting: Primary schools in Nairobi County Subjects: 379 school-going children Results: The study results indicate that a significant number of pupils (73.6%) complain of musculoskeletal pain. Low back pain (25.1%) was the most prevalent musculoskeletal pain followed by neck pain (16.9%). There was a significant association (p=0.001) between backpack weight-to-schoolchild body weight (BTSW %) and the presence of musculoskeletal pain. The proportion of pupils carrying school bag weighing more than 15% of their body weight was 28%. Conclusion: Prevalence of musculoskeletal pain related to backpack usage among Kenyan school going children is high. School children who carry backpacks that weigh more than 15% of their body weight (BTSW %) are at risk of experiencing musculoskeletal pain.
{"title":"Musculoskeletal pain and backpack usage among school children in Nairobi County, Kenya","authors":"S. Ogana, J. Osero, L. Wachira","doi":"10.4314/EAMJ.V94I6","DOIUrl":"https://doi.org/10.4314/EAMJ.V94I6","url":null,"abstract":"Background: School children travel to and from school on daily basis. Active transportation such as walking, running and cycling contribute significantly to the increase in physical activity, health, and wellbeing in children. However, there has been a growing concern on the effect of carrying heavy backpack on the health of school going children who are at an important developmental stage of their lives. Objective: To determine the prevalence of musculoskeletal pain linked to backpack use and associated ergonomic factors among pupils in Nairobi City County in Kenya. Design: Descriptive cross-sectional study. Setting: Primary schools in Nairobi County Subjects: 379 school-going children Results: The study results indicate that a significant number of pupils (73.6%) complain of musculoskeletal pain. Low back pain (25.1%) was the most prevalent musculoskeletal pain followed by neck pain (16.9%). There was a significant association (p=0.001) between backpack weight-to-schoolchild body weight (BTSW %) and the presence of musculoskeletal pain. The proportion of pupils carrying school bag weighing more than 15% of their body weight was 28%. Conclusion: Prevalence of musculoskeletal pain related to backpack usage among Kenyan school going children is high. School children who carry backpacks that weigh more than 15% of their body weight (BTSW %) are at risk of experiencing musculoskeletal pain.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70523145","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}
Background: The bi directional association between major mental health disorders (MMHD) and diabetes mellitus (DM) is well established. Presently, there is little information on the risk and prevalence of DM in Nigerians with MMHD. Objective: To determine the risk and prevalence of DM in Nigerians with MMHD. Design: Cross-sectional study Setting: New World Psychiatry Hospital, Ibadan, Nigeria Subjects: Plasma levels of glucose was determined after an overnight fast and at 120 minutes (2-h PG) of a standard 75-g oral glucose tolerance test in 124 patients with MMHD. Thereafter, normoglycaemia, pre-diabetes and diabetes were defined using the American Diabetes Association criteria. Also, the risk of developing DM within 10 years was assessed using the Finnish Diabetes Association DM Risk Assessment Form. Results: Seventy eight (62.9%), 37 (29.8%) and 9 (7.3%) of the patients had normoglycaemia, pre-diabetes and DM respectively. Only 2 patients had high diabetes risk score. There was progressive rise in 2-h PG level as the diabetes risk score increases. The mean 2-h PG was significantly higher in moderate-and-high risk group combined (MHR) compared with the low risk (LR) group. Also, the proportion of patients with pre-diabetes increased progressively from LR through MHR. Conclusion: Dysglycaemia is not a rare occurrence in Nigerians with MMHD and it appears to be more prevalent in them than in the Nigerian general population. Also, high diabetes risk score could be a strong indication for glucose tolerance testing.
背景:重度精神健康障碍(MMHD)与糖尿病(DM)之间的双向关联已被证实。目前,关于尼日利亚MMHD患者患糖尿病的风险和患病率的信息很少。目的:确定尼日利亚MMHD患者患糖尿病的风险和患病率。设计:横断面研究设置:尼日利亚伊巴丹新世界精神病院受试者:124例MMHD患者在禁食过夜和进行标准75克口服葡萄糖耐量试验120分钟(2小时PG)后测定血浆葡萄糖水平。此后,根据美国糖尿病协会的标准定义了正常血糖、糖尿病前期和糖尿病。此外,使用芬兰糖尿病协会糖尿病风险评估表评估10年内患糖尿病的风险。结果:正常血糖78例(62.9%),糖尿病前期37例(29.8%),糖尿病前期9例(7.3%)。仅有2例患者糖尿病风险评分较高。随着糖尿病风险评分的增加,2 h PG水平逐渐升高。中高危组(MHR)的平均2小时PG明显高于低危组(LR)。此外,糖尿病前期患者的比例从LR到MHR逐渐增加。结论:血糖异常在尼日利亚MMHD患者中并不罕见,而且在他们中比在尼日利亚一般人群中更为普遍。此外,高糖尿病风险评分可能是葡萄糖耐量测试的有力指标。
{"title":"Risk and prevalence of type 2 diabetes mellitus in patients with major mental health disorders","authors":"K. Akinlade, V. Lasebikan, O. Satope, S. Rahamon","doi":"10.4314/eamj.v94i8","DOIUrl":"https://doi.org/10.4314/eamj.v94i8","url":null,"abstract":"Background: The bi directional association between major mental health disorders (MMHD) and diabetes mellitus (DM) is well established. Presently, there is little information on the risk and prevalence of DM in Nigerians with MMHD. Objective: To determine the risk and prevalence of DM in Nigerians with MMHD. Design: Cross-sectional study Setting: New World Psychiatry Hospital, Ibadan, Nigeria Subjects: Plasma levels of glucose was determined after an overnight fast and at 120 minutes (2-h PG) of a standard 75-g oral glucose tolerance test in 124 patients with MMHD. Thereafter, normoglycaemia, pre-diabetes and diabetes were defined using the American Diabetes Association criteria. Also, the risk of developing DM within 10 years was assessed using the Finnish Diabetes Association DM Risk Assessment Form. Results: Seventy eight (62.9%), 37 (29.8%) and 9 (7.3%) of the patients had normoglycaemia, pre-diabetes and DM respectively. Only 2 patients had high diabetes risk score. There was progressive rise in 2-h PG level as the diabetes risk score increases. The mean 2-h PG was significantly higher in moderate-and-high risk group combined (MHR) compared with the low risk (LR) group. Also, the proportion of patients with pre-diabetes increased progressively from LR through MHR. Conclusion: Dysglycaemia is not a rare occurrence in Nigerians with MMHD and it appears to be more prevalent in them than in the Nigerian general population. Also, high diabetes risk score could be a strong indication for glucose tolerance testing.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70523706","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}
Background : In Kenya, breast cancer is one of the most prevalent diseases among women. Early diagnosis and stage-directed treatment are vital in reducing morbidity and mortality associated with it. The Kenya National Cancer Guidelines (KNCG) was developed in 2013. Utility of the guidelines is expected to improve early detection, timely diagnosis, harmonize and standardize treatment of cancer. This study sought to assess whether health care providers at Kenyatta National Hospital are utilizing the guidelines in diagnosis and staging of breast cancer. Study objective : To evaluate adherence to KNCG on diagnosis and staging of breast cancer. Study design : Retrospective descriptive study was conducted within five months. Study subjects : Two hundred and fifty (250) patients’ records with diagnosis of breast cancer between September 2013 and September 2015. Results : Most patients were female 95.6 % with mean age of 47.5±15.5 years. Duration from referral point to index breast clinic review was 10.9±11.1 days. Duration from index breast clinic review to surgery was 64.0 ±114.4 days. Documentation on findings from clinical assessment varied between 24.8 to 86.4%. Documentation on radiological assessment of the breast varied between 3.6 to 35.2% whereas for metastatic assessment varied between 3.6 to 64.0 %. Laboratory investigations documentation varied between 8.4 to 94.8% whereas pathologic diagnosis and tumour biology documentation varied between 3.6-62.4%. American joint cancer committee- tumour, node and metastasis (AJCC-TNM) staging was documented in 16 % of the records reviewed. Conclusion : From this study, triple assessment for breast cancer was incomplete and inconsistent which could result in negatively impacting management of these patients. Every effort should be put in place to track as well as prioritize patients with breast cancer in terms of investigations and surgical interventions in a timely manner. Clinical, radiologic and pathologic assessment must adhere to KNCG and be accurately documented. Clinician should undergo knowledge, attitude and practice (KAP) survey on KNCG so as to identify possible gaps and institute measures aimed at compliance which ultimately could improve care of patients with breast cancer at KNH.
{"title":"Evaluating compliance to Kenya national cancer guidelines on diagnosis and staging of breast cancer at Kenyatta national hospital","authors":"S. Miima, A. Muturi, D. Ojuka, A. Ndung’u","doi":"10.4314/EAMJ.V94I7","DOIUrl":"https://doi.org/10.4314/EAMJ.V94I7","url":null,"abstract":"Background : In Kenya, breast cancer is one of the most prevalent diseases among women. Early diagnosis and stage-directed treatment are vital in reducing morbidity and mortality associated with it. The Kenya National Cancer Guidelines (KNCG) was developed in 2013. Utility of the guidelines is expected to improve early detection, timely diagnosis, harmonize and standardize treatment of cancer. This study sought to assess whether health care providers at Kenyatta National Hospital are utilizing the guidelines in diagnosis and staging of breast cancer. Study objective : To evaluate adherence to KNCG on diagnosis and staging of breast cancer. Study design : Retrospective descriptive study was conducted within five months. Study subjects : Two hundred and fifty (250) patients’ records with diagnosis of breast cancer between September 2013 and September 2015. Results : Most patients were female 95.6 % with mean age of 47.5±15.5 years. Duration from referral point to index breast clinic review was 10.9±11.1 days. Duration from index breast clinic review to surgery was 64.0 ±114.4 days. Documentation on findings from clinical assessment varied between 24.8 to 86.4%. Documentation on radiological assessment of the breast varied between 3.6 to 35.2% whereas for metastatic assessment varied between 3.6 to 64.0 %. Laboratory investigations documentation varied between 8.4 to 94.8% whereas pathologic diagnosis and tumour biology documentation varied between 3.6-62.4%. American joint cancer committee- tumour, node and metastasis (AJCC-TNM) staging was documented in 16 % of the records reviewed. Conclusion : From this study, triple assessment for breast cancer was incomplete and inconsistent which could result in negatively impacting management of these patients. Every effort should be put in place to track as well as prioritize patients with breast cancer in terms of investigations and surgical interventions in a timely manner. Clinical, radiologic and pathologic assessment must adhere to KNCG and be accurately documented. Clinician should undergo knowledge, attitude and practice (KAP) survey on KNCG so as to identify possible gaps and institute measures aimed at compliance which ultimately could improve care of patients with breast cancer at KNH.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70523169","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}
F. Jaguga, A. Mwangi, M. Mahugu, R. Songole, B. Gakinya, D. Ayuku, D. Kinyanjui, E. Kwobah, L. Atwoli
Background: Modern contraceptive methods form a critical pillar in maternal health provision and population control initiatives. The Kenyan government promotes the use of family planning through provision of these services at various health facilities across the country. Baringo County has a prevalence rate of 33.1% for modern contraceptives use among women aged 15-49 while the national average is 53.2%. Consequently, many women in this county remain vulnerable to unplanned pregnancy and unsafe abortions.Objective: The determinants of the uptake of modern contraceptives in Baringo County in Kenya using data from the Kenya Demographic and Health Survey of 2014 (KDHS, 2014) were evaluated. Design: A probit model was used to statistically explore the factors that influence uptake of modern contraceptives. Results and Conclusion: Level of education, number of children, and interaction with a health service provider, marital status, religious beliefs and income level were statistically significant in determining the uptake of modern contraception by women of reproductive age in Baringo County. A woman with secondary and/or a higher level of education, of middle or higher income and with knowledge about family planning from a healthcare facility had a higher probability of taking up modern contraceptives. It was recommended that poverty alleviation measures combined with increased access to formal education will positively influence the attitudes of women in the reproductive ages to embrace modern contraceptive methods.
{"title":"Determinants of the use of modern contraceptives in Baringo County","authors":"F. Jaguga, A. Mwangi, M. Mahugu, R. Songole, B. Gakinya, D. Ayuku, D. Kinyanjui, E. Kwobah, L. Atwoli","doi":"10.4314/eamj.v95i7","DOIUrl":"https://doi.org/10.4314/eamj.v95i7","url":null,"abstract":"Background: Modern contraceptive methods form a critical pillar in maternal health provision and population control initiatives. The Kenyan government promotes the use of family planning through provision of these services at various health facilities across the country. Baringo County has a prevalence rate of 33.1% for modern contraceptives use among women aged 15-49 while the national average is 53.2%. Consequently, many women in this county remain vulnerable to unplanned pregnancy and unsafe abortions.Objective: The determinants of the uptake of modern contraceptives in Baringo County in Kenya using data from the Kenya Demographic and Health Survey of 2014 (KDHS, 2014) were evaluated. Design: A probit model was used to statistically explore the factors that influence uptake of modern contraceptives. Results and Conclusion: Level of education, number of children, and interaction with a health service provider, marital status, religious beliefs and income level were statistically significant in determining the uptake of modern contraception by women of reproductive age in Baringo County. A woman with secondary and/or a higher level of education, of middle or higher income and with knowledge about family planning from a healthcare facility had a higher probability of taking up modern contraceptives. It was recommended that poverty alleviation measures combined with increased access to formal education will positively influence the attitudes of women in the reproductive ages to embrace modern contraceptive methods.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70523691","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}
J. Mangeni, D. Ongore, A. Mwangi, J. Vulule, W. O'Meara, A. Obala
Background: Although current reports have shown a reduction in malaria cases, the disease still remains a major public health problem in Kenya. In most endemic regions, the majority of infections are asymptomatic which means those infected may not even know and yet they remain infectious to the mosquitoes. Asymptomatic infections are a major threat to malaria control programs since they act as silent reservoirs for the malaria parasites.Objective: The study sought to determine the prevalence of asymptomatic malaria infections, whether they show heterogeneity spatially, across age groups and across time as well as their determinants in a high transmission region.Study Design: This was part of a larger prospective cohort study on malaria indices in the HDSS.Study Setting: The study was conducted in the Webuye Health and Demographic Surveillance Site in Bungoma East Sub-County.Study Subjects: Quarterly parasitological surveys were conducted for a cohort of 400 participants from randomly selected households located in known fever “hotspots” and “coldspots”. Follow-up of all the participants continued for a period of one year. Generalized estimating equations were used to model risk factors associated with asymptomatic parasitemia.Results: Of the total 321 malaria infections detected during the five cross-sectional surveys conducted over the period of one year, almost half (46.3%) of these were asymptomatic. Overall, most of the asymptomatic cases (67%) were in households within known fever “hotspots”. The proportion of infections that were asymptomatic in the coldspots were 73.1%, 31.8%, 13.3%, 55.6% and 48.2% during the first, second, third, fourth and fifth visits respectively. In the known fever “hotspots”, the proportion of infections without symptoms was 47.7%, 48.5%, 35%, 41.3% and 47.5% during the first, second, third, fourth and fifth visits respectively. Factors associated with asymptomatic malaria include; the village one lives: people living in village M were twice likely to be asymptomatic (A.O.R: 2.141, C.I: 0.03 - 1.488), age: children aged between 6 to 15 years were more than twice likely to be asymptomatic (A.O.R: 2.67, C.I. 0.434 - 1.533) and the season: infections during the dry season (January) were less likely to be asymptomatic (A.O.R: 0.26, C.I: -2.289 - 0.400).Conclusion: The prevalence of asymptomatic infections in this region is still very high. The highest proportion of asymptomatic infections was registered in a fever coldpspot village which may explain why the village is a fever coldspot in the first place. There is a need for active surveillance to detect the asymptomatic cases as well as treat them in-order to reduce the reservoir. Targeting interventions to the asymptomatic individuals will further reduce the transmission within this region.
{"title":"Prevalence, heterogeneity of asymptomatic malaria infections and associated factors in a high transmission region","authors":"J. Mangeni, D. Ongore, A. Mwangi, J. Vulule, W. O'Meara, A. Obala","doi":"10.4314/EAMJ.V94I12","DOIUrl":"https://doi.org/10.4314/EAMJ.V94I12","url":null,"abstract":"Background: Although current reports have shown a reduction in malaria cases, the disease still remains a major public health problem in Kenya. In most endemic regions, the majority of infections are asymptomatic which means those infected may not even know and yet they remain infectious to the mosquitoes. Asymptomatic infections are a major threat to malaria control programs since they act as silent reservoirs for the malaria parasites.Objective: The study sought to determine the prevalence of asymptomatic malaria infections, whether they show heterogeneity spatially, across age groups and across time as well as their determinants in a high transmission region.Study Design: This was part of a larger prospective cohort study on malaria indices in the HDSS.Study Setting: The study was conducted in the Webuye Health and Demographic Surveillance Site in Bungoma East Sub-County.Study Subjects: Quarterly parasitological surveys were conducted for a cohort of 400 participants from randomly selected households located in known fever “hotspots” and “coldspots”. Follow-up of all the participants continued for a period of one year. Generalized estimating equations were used to model risk factors associated with asymptomatic parasitemia.Results: Of the total 321 malaria infections detected during the five cross-sectional surveys conducted over the period of one year, almost half (46.3%) of these were asymptomatic. Overall, most of the asymptomatic cases (67%) were in households within known fever “hotspots”. The proportion of infections that were asymptomatic in the coldspots were 73.1%, 31.8%, 13.3%, 55.6% and 48.2% during the first, second, third, fourth and fifth visits respectively. In the known fever “hotspots”, the proportion of infections without symptoms was 47.7%, 48.5%, 35%, 41.3% and 47.5% during the first, second, third, fourth and fifth visits respectively. Factors associated with asymptomatic malaria include; the village one lives: people living in village M were twice likely to be asymptomatic (A.O.R: 2.141, C.I: 0.03 - 1.488), age: children aged between 6 to 15 years were more than twice likely to be asymptomatic (A.O.R: 2.67, C.I. 0.434 - 1.533) and the season: infections during the dry season (January) were less likely to be asymptomatic (A.O.R: 0.26, C.I: -2.289 - 0.400).Conclusion: The prevalence of asymptomatic infections in this region is still very high. The highest proportion of asymptomatic infections was registered in a fever coldpspot village which may explain why the village is a fever coldspot in the first place. There is a need for active surveillance to detect the asymptomatic cases as well as treat them in-order to reduce the reservoir. Targeting interventions to the asymptomatic individuals will further reduce the transmission within this region.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70523366","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}
Background: The incidence of surgical site infection (SSI) following emergency abdominal operation contributes to significant morbidity. There are patient-related as well as perioperative risk factors that seem to contribute to this incidence. This study determined incidence and risk factors following emergency bowel surgery at Kenyatta National Hospital. Objective: To determine incidence and risk factors of surgical site infection following emergency laparotomy at Kenyatta National Hospital. Design: Prospective cross sectional study. Subjects: One hundred and twenty (120) Patients, 13 years and above scheduled to undergo emergency laparotomy. Results: Overall incidence of SSI was 30.8% with male patients having infection rate of 20.8%, while patients who consumed alcohol had infection rate of 5.8%. Incidence of SSI was highest in patient who had preoperative duration of 48 hours at 12% and intraoperative duration of 90 minutes at 7.5%. Dirty wounds accounted for 60% with infection rate of 26.7%. Patients with ASA score of 1 had infection rate of 23.3%, with patients who received perioperative transfusion having infection rate of 6.6%. Conclusion: Overall incidence of SSI is high, majority of patients were male who were young with ASA score of one had highest rate of infection. Prolonged preoperative and intraoperative duration, dirty wounds and perioperative transfusion was associated with increased rate of SSI. Surveillance on SSI by surgical team, public health education on alcohol and cigarettes consumption, prompt surgical intervention and judicial use of blood could reduce incidence of SSI.
{"title":"Incidence and risk factors for surgical site infection following emergency laparotomy at Kenyatta National Hospital","authors":"S. E. Miima, J. S. Oliech, P. Ndaguatha, E. Opot","doi":"10.4314/EAMJ.V93I8","DOIUrl":"https://doi.org/10.4314/EAMJ.V93I8","url":null,"abstract":"Background: The incidence of surgical site infection (SSI) following emergency abdominal operation contributes to significant morbidity. There are patient-related as well as perioperative risk factors that seem to contribute to this incidence. This study determined incidence and risk factors following emergency bowel surgery at Kenyatta National Hospital. Objective: To determine incidence and risk factors of surgical site infection following emergency laparotomy at Kenyatta National Hospital. Design: Prospective cross sectional study. Subjects: One hundred and twenty (120) Patients, 13 years and above scheduled to undergo emergency laparotomy. Results: Overall incidence of SSI was 30.8% with male patients having infection rate of 20.8%, while patients who consumed alcohol had infection rate of 5.8%. Incidence of SSI was highest in patient who had preoperative duration of 48 hours at 12% and intraoperative duration of 90 minutes at 7.5%. Dirty wounds accounted for 60% with infection rate of 26.7%. Patients with ASA score of 1 had infection rate of 23.3%, with patients who received perioperative transfusion having infection rate of 6.6%. Conclusion: Overall incidence of SSI is high, majority of patients were male who were young with ASA score of one had highest rate of infection. Prolonged preoperative and intraoperative duration, dirty wounds and perioperative transfusion was associated with increased rate of SSI. Surveillance on SSI by surgical team, public health education on alcohol and cigarettes consumption, prompt surgical intervention and judicial use of blood could reduce incidence of SSI.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70522867","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}
A P Adrawa, D Opi, E Candia, E Vukoni, I Kimera, I Sule, G Adokorach, T O Aliku, E Ovuga
Background: Despite national policy guidelines advocating exclusive breastfeeding for the first six months of life to promote and accelerate child survival, the proportion of women exclusively breastfeeding for the first six months has remained small.
Objective: To describe the knowledge and practices of mothers regarding exclusive breastfeeding in a semi-urban Ugandan population.
Design: A descriptive cross-sectional study.
Setting: Semi-urban Ugandan population in four parishes in Adjumani District, the West Nile region of Uganda.
Subjects: The breastfeeding mothers with infants aged 3-12 months.
Results: Of the 385 breastfeeding mothers surveyed, 62.6% (241/385) and 53.5% (206/385) knew the exact meaning and the recommended duration of exclusive breastfeeding respectively. Nearly 68.6% (264/385) initiated breastfeeding within one hour after delivery and only 42.1% (162/385) exclusively breastfed their babies in the first six months of life. For the mothers who initiated non-breast milk feeds before the first six months of birth, most stated the following reasons: 'advice from the home', 'did not know the appropriate time', baby got thirsty and baby was crying at the sight of food'.
Conclusion: This study revealed low levels of knowledge and practice of the recommended duration of exclusive breastfeeding among the breastfeeding mothers. Continuous breastfeeding awareness campaigns are needed to improve knowledge and practice of exclusive breastfeeding among breastfeeding mothers.
{"title":"ASSESSMENT OF THE KNOWLEDGE AND PRACTICES OF EXCLUSIVE BREASTFEEDING AMONGST THE BREASTFEEDING MOTHERS IN ADJUMANI DISTRICT, WEST NILE.","authors":"A P Adrawa, D Opi, E Candia, E Vukoni, I Kimera, I Sule, G Adokorach, T O Aliku, E Ovuga","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Despite national policy guidelines advocating exclusive breastfeeding for the first six months of life to promote and accelerate child survival, the proportion of women exclusively breastfeeding for the first six months has remained small.</p><p><strong>Objective: </strong>To describe the knowledge and practices of mothers regarding exclusive breastfeeding in a semi-urban Ugandan population.</p><p><strong>Design: </strong>A descriptive cross-sectional study.</p><p><strong>Setting: </strong>Semi-urban Ugandan population in four parishes in Adjumani District, the West Nile region of Uganda.</p><p><strong>Subjects: </strong>The breastfeeding mothers with infants aged 3-12 months.</p><p><strong>Results: </strong>Of the 385 breastfeeding mothers surveyed, 62.6% (241/385) and 53.5% (206/385) knew the exact meaning and the recommended duration of exclusive breastfeeding respectively. Nearly 68.6% (264/385) initiated breastfeeding within one hour after delivery and only 42.1% (162/385) exclusively breastfed their babies in the first six months of life. For the mothers who initiated non-breast milk feeds before the first six months of birth, most stated the following reasons: 'advice from the home', 'did not know the appropriate time', baby got thirsty and baby was crying at the sight of food'.</p><p><strong>Conclusion: </strong>This study revealed low levels of knowledge and practice of the recommended duration of exclusive breastfeeding among the breastfeeding mothers. Continuous breastfeeding awareness campaigns are needed to improve knowledge and practice of exclusive breastfeeding among breastfeeding mothers.</p>","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5945216/pdf/nihms907671.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36092878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Diarrhoea remains a major public health problem among children and adults in developing nations such as Kenya. The risk of infection is higher in children due to their developing immunity, relatively poor hygiene and habits especially those living in informal settlements where water supply and sanitation are inadequate. Objectives: To determine the prevalence of selected enteric pathogens from children without diarrhoea attending two clinics in Mukuru as well as the anti-microbial resistance patterns, and pathogenicity of E. coli isolated. Design: A cross sectional study. Setting: Mukuru slum, Nairobi County. Subjects: Three hundred and twenty two children of ages five and below. Results: Mukuru Kwa Njenga; E. coli 34.6%, Salmonella spp. 1.3%, Shigella 0.7%, Citrobacter spp. 2.3%, Klebsiella spp. 5.3%, Proteus spp. 7.0%, No growth 2.3%. Mukuru Kwa Reuben; E. coli 63.4%, Salmonella 0.6%, Shigella 0.6%, Citrobacter spp. 1.2% ,Klebsiella spp. 14.3%, Proteus spp. 16.1%, No growth 3.7%. No significant difference among the organisms isolated in both clinics (p = 0.982). Ampicillin, Amoxycillin/ Clavulanic, cefoxitin had high resistance, while gentamicin was 100% susceptible. 46.6% E. coli isolates were positive for at least one of the eight virulence genes tested. Conclusion: Salmonella , Shigella and pathogenic E.coli associated with diarrhoea and presence of resistance genes were identified in foecal samples of children without diarrhoea living in Mukuru informal settlements in Nairobi. The major concern from the findings of this study was the emerging high resistance of E.coli that was observed to cephamycin (Cefoxitin).
背景:腹泻仍然是肯尼亚等发展中国家儿童和成人的一个主要公共卫生问题。儿童感染的风险较高,因为他们的免疫力正在发育,个人卫生和习惯相对较差,特别是那些生活在供水和卫生设施不足的非正式住区的儿童。目的:确定在穆库鲁两家诊所就诊的无腹泻儿童中选定肠道病原体的流行情况,以及分离出的大肠杆菌的抗微生物耐药性模式和致病性。设计:横断面研究。背景:内罗毕县穆库鲁贫民窟。研究对象:322名5岁及以下的儿童。结果:Mukuru Kwa Njenga;大肠杆菌34.6%,沙门氏菌1.3%,志贺氏菌0.7%,柠檬酸杆菌2.3%,克雷伯氏菌5.3%,变形杆菌7.0%,无增长2.3%。Mukuru Kwa Reuben;大肠杆菌63.4%,沙门氏菌0.6%,志贺氏菌0.6%,柠檬酸杆菌1.2%,克雷伯氏菌14.3%,变形杆菌16.1%,无增长3.7%。两家诊所分离的微生物无显著差异(p = 0.982)。氨苄西林、阿莫西林/克拉维兰、头孢西丁耐药较高,庆大霉素100%敏感。46.6%的大肠杆菌分离株在8种毒力基因中至少1种呈阳性。结论:在内罗毕穆库鲁非正式住区无腹泻儿童的粪便样本中发现了与腹泻相关的沙门氏菌、志贺氏菌和致病性大肠杆菌,并发现了耐药基因。本研究结果的主要担忧是观察到大肠杆菌对头孢霉素(头孢西丁)出现高耐药性。
{"title":"Pathogenic E.coli and other pathogenic gram negative enteric strains from foecal samples of children without diarrhoea living in Mukuru slums, Nairobi","authors":"P. Impwi, Peris Wambugu, A. Kimang’a, S. Kariuki","doi":"10.4314/eamj.v93i7","DOIUrl":"https://doi.org/10.4314/eamj.v93i7","url":null,"abstract":"Background: Diarrhoea remains a major public health problem among children and adults in developing nations such as Kenya. The risk of infection is higher in children due to their developing immunity, relatively poor hygiene and habits especially those living in informal settlements where water supply and sanitation are inadequate. Objectives: To determine the prevalence of selected enteric pathogens from children without diarrhoea attending two clinics in Mukuru as well as the anti-microbial resistance patterns, and pathogenicity of E. coli isolated. Design: A cross sectional study. Setting: Mukuru slum, Nairobi County. Subjects: Three hundred and twenty two children of ages five and below. Results: Mukuru Kwa Njenga; E. coli 34.6%, Salmonella spp. 1.3%, Shigella 0.7%, Citrobacter spp. 2.3%, Klebsiella spp. 5.3%, Proteus spp. 7.0%, No growth 2.3%. Mukuru Kwa Reuben; E. coli 63.4%, Salmonella 0.6%, Shigella 0.6%, Citrobacter spp. 1.2% ,Klebsiella spp. 14.3%, Proteus spp. 16.1%, No growth 3.7%. No significant difference among the organisms isolated in both clinics (p = 0.982). Ampicillin, Amoxycillin/ Clavulanic, cefoxitin had high resistance, while gentamicin was 100% susceptible. 46.6% E. coli isolates were positive for at least one of the eight virulence genes tested. Conclusion: Salmonella , Shigella and pathogenic E.coli associated with diarrhoea and presence of resistance genes were identified in foecal samples of children without diarrhoea living in Mukuru informal settlements in Nairobi. The major concern from the findings of this study was the emerging high resistance of E.coli that was observed to cephamycin (Cefoxitin).","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70522623","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}
E. Omesa, I. Kathure, E. Masini, R. Mulwa, A. Maritim, P. Owiti, K. Takarinda, O. Ogutu, R. Kosgei, T. Galgalo
Background: Chronic myeloid leukemia is a clonal myeloproliferative disorder caused by reciprocal translocation t(9;22) that induces tyrosin kinase protein. Imatinib is a selective inhibitor of this protein. Objectives: To assess responses to imatinib and outcome of Congolese patients with chronic phase chronic myeloid leukemia. Design: retrospective study. Settings: Clinical Haematology unit of Teaching Hospital in Brazzaville, Congo Subjects: Newly diagnosed patients with chronic phase chronic myeloid leukemia treated with imatinib. Results: A total of 25 males and 14 females with a mean age of 36 years at time of the diagnosis were enrolled in the study. The mean duration of the illness was 11.4 months. Imatinib induced complete hematologic response at 3 months in 100%. Major cytogenetic response was noticed in 87.18%. After a median follow up of 12 months, chronic myeloid leukemia had not progressed to the accelerated or blastic phase in an estimated 91.8% of patients and 86.6% were alive. Conclusion: Imatinib is effective in newly chronic phase chronic myeloid leukemia patient even though cytogenetic response rate are lower in Africa than western countries populations
{"title":"Imatinib mesylate in chronic myelogenous leukemia: a Congolese experience","authors":"E. Omesa, I. Kathure, E. Masini, R. Mulwa, A. Maritim, P. Owiti, K. Takarinda, O. Ogutu, R. Kosgei, T. Galgalo","doi":"10.4314/EAMJ.V93I10","DOIUrl":"https://doi.org/10.4314/EAMJ.V93I10","url":null,"abstract":"Background: Chronic myeloid leukemia is a clonal myeloproliferative disorder caused by reciprocal translocation t(9;22) that induces tyrosin kinase protein. Imatinib is a selective inhibitor of this protein. Objectives: To assess responses to imatinib and outcome of Congolese patients with chronic phase chronic myeloid leukemia. Design: retrospective study. Settings: Clinical Haematology unit of Teaching Hospital in Brazzaville, Congo Subjects: Newly diagnosed patients with chronic phase chronic myeloid leukemia treated with imatinib. Results: A total of 25 males and 14 females with a mean age of 36 years at time of the diagnosis were enrolled in the study. The mean duration of the illness was 11.4 months. Imatinib induced complete hematologic response at 3 months in 100%. Major cytogenetic response was noticed in 87.18%. After a median follow up of 12 months, chronic myeloid leukemia had not progressed to the accelerated or blastic phase in an estimated 91.8% of patients and 86.6% were alive. Conclusion: Imatinib is effective in newly chronic phase chronic myeloid leukemia patient even though cytogenetic response rate are lower in Africa than western countries populations","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70522137","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}
Adeniji Ka, D. Hugo, G. Rahman, T. Akande, S. Olatoke, H. Akande, K. Durowade, A. O. Durojaiye, G. Ayilara, O. Olopade
Objective : To study the relationship of histopathological characteristics, molecular subtypes of breast cancer and survival in a low resource setting. Design : Tumours from prospectively ascertained patients newly diagnosed with breast cancer were analyzed. Formalin-fixed and paraffin-embedded sections were constructed into tissue micro-arrays and immunostained with five anti-bodies. Five molecular subtypes were determined. Settings : The study was conducted jointly in the Department of Pathology of University of Ilorin Teaching Hospital, Ilorin in Nigeria and at the University of Chicago in the United States. Subjects : The study included a total of 203 histologically confirmed breast cancer patients whose pathological specimens were processed in the Department of Pathology of University of Ilorin Teaching Hospital, Ilorin, Nigeria between January 2003 and December 2007. Results : Mean age at diagnosis was 49.2 (SO ±11.9) years. Median time from symptom onset to cancer diagnosis was six months. Median follow-up time was 8.3 months. Median tumour size at diagnosis was 6cm. The proportion of ER+, PR+, HER2+ tumours were 27%, 16% and 30%, respectively. The most common molecular subtype was basal-like (25.1%) followed by unclassified (24.0%), luminal A (20.5%), HER2+/ER( 19.3%) and luminal B (11.1 %). Luminal A and B had best prognosis while basal-like and unclassified had worst prognosis. ER+ patients had longer duration of symptoms to diagnosis (median 8 months) than ER- patients (5 months) but ER+ patients had smaller tumours (median 5cm) than ER-patients (6cm, p=0.02). Recurrence-free survival was best for stage 1 and worst for stage 4 tumours. About 32.6% of patients had locoregional and/or metastatic recurrence. Conclusions : In consecutive breast cancer cases in Nigeria, almost half of patients were triple negative. Luminal A and B subtypes had best prognosis while triple negative had worst prognosis. The delay in breast cancer diagnosis and higher proportion of late stage of breast cancer underscores need for prompt diagnosis and initiation of treatment, especially hormonal therapy for ER positive patients.
{"title":"Survivorship patterns of histopathological variants and molecular subtypes of breast cancer in a teaching hospital in Nigeria","authors":"Adeniji Ka, D. Hugo, G. Rahman, T. Akande, S. Olatoke, H. Akande, K. Durowade, A. O. Durojaiye, G. Ayilara, O. Olopade","doi":"10.4314/EAMJ.V93I9","DOIUrl":"https://doi.org/10.4314/EAMJ.V93I9","url":null,"abstract":"Objective : To study the relationship of histopathological characteristics, molecular subtypes of breast cancer and survival in a low resource setting. Design : Tumours from prospectively ascertained patients newly diagnosed with breast cancer were analyzed. Formalin-fixed and paraffin-embedded sections were constructed into tissue micro-arrays and immunostained with five anti-bodies. Five molecular subtypes were determined. Settings : The study was conducted jointly in the Department of Pathology of University of Ilorin Teaching Hospital, Ilorin in Nigeria and at the University of Chicago in the United States. Subjects : The study included a total of 203 histologically confirmed breast cancer patients whose pathological specimens were processed in the Department of Pathology of University of Ilorin Teaching Hospital, Ilorin, Nigeria between January 2003 and December 2007. Results : Mean age at diagnosis was 49.2 (SO ±11.9) years. Median time from symptom onset to cancer diagnosis was six months. Median follow-up time was 8.3 months. Median tumour size at diagnosis was 6cm. The proportion of ER+, PR+, HER2+ tumours were 27%, 16% and 30%, respectively. The most common molecular subtype was basal-like (25.1%) followed by unclassified (24.0%), luminal A (20.5%), HER2+/ER( 19.3%) and luminal B (11.1 %). Luminal A and B had best prognosis while basal-like and unclassified had worst prognosis. ER+ patients had longer duration of symptoms to diagnosis (median 8 months) than ER- patients (5 months) but ER+ patients had smaller tumours (median 5cm) than ER-patients (6cm, p=0.02). Recurrence-free survival was best for stage 1 and worst for stage 4 tumours. About 32.6% of patients had locoregional and/or metastatic recurrence. Conclusions : In consecutive breast cancer cases in Nigeria, almost half of patients were triple negative. Luminal A and B subtypes had best prognosis while triple negative had worst prognosis. The delay in breast cancer diagnosis and higher proportion of late stage of breast cancer underscores need for prompt diagnosis and initiation of treatment, especially hormonal therapy for ER positive patients.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70522977","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}