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Correlates of HIV Infection among Men who have Sex with Men in Mvita Sub-County, Mombasa County, Kenya 肯尼亚蒙巴萨县Mvita县男男性行为者中HIV感染的相关因素
Pub Date : 2023-03-15 DOI: 10.47604/jhmn.1849
Wangui K, K. Ngure, A. Adem
Purpose: The broad objective of the study was to determine the correlates of HIV infection among men who have sex with men in Mvita sub-county, Mombasa County, by December 2020. Methodology: Descriptive cross-sectional study design using quantitative methods was used to collect data from a study population which included 121 HIV positive and 119 HIV negative MSM.  The respondent-driven sampling (RDS) was used to obtain the sample of respondents while chi-square and multivariable logistic regression were used to identify the variables which were associated with HIV infection. Data generated from the questionnaires was collected, cleaned, coded and analyzed using STATA software Version 17. Level of significance was fixed at p=0.05, with a 95% confidence interval. Findings: Majority of the MSM (51%) were between 19-29 years, were single (71%), were christian (60%) had attained primary education (45%), were working (63%), 55% had an income of less than Ksh. 5000 but only 38% were married to a female. Majority (91%) of HIV negative MSM accessed PEP/PrEP and only 70% used PEP/PrEP for HIV prevention. However, majority (60%) of HIV positive MSM had anal sex with multiple casual male partners, 49% sometimes had condomless insertive anal sex while 49% had condomless receptive anal sex. HIV positive MSM also had anal sex more than once while high on alcohol (41%), always used drugs before engaging in anal sex (33%) and were non-adherent to ARVs, PrEP/PEP due to lack of transport (66%), alcohol use (24%), and drug use (15%), among other factors. Unique Contribution to Theory, Practice and Policy: From the study findings, the Government/NGO must address the MSM issues for instance, by increasing the number of HIV programmes targeting MSM, adequately funding them and actively engaging the MSM in running the them. Also, by sensitizing the communities, human right groups, religious leaders, politicians and other stake holders on matters pertaining MSM and lobbying for the review of the laws that criminalizes same sex relationship.
目的:该研究的主要目的是在2020年12月之前确定蒙巴萨县Mvita副县男男性行为者中艾滋病毒感染的相关性。方法:采用定量方法的描述性横断面研究设计,从研究人群中收集数据,其中包括121名HIV阳性和119名HIV阴性的男男性行为者。采用被调查者驱动抽样(RDS)获得被调查者样本,采用卡方和多变量logistic回归识别与HIV感染相关的变量。从问卷中产生的数据被收集、清理、编码并使用STATA软件版本17进行分析。显著性水平固定为p=0.05,置信区间为95%。调查结果:大多数男男性行为者(51%)年龄在19-29岁之间,单身(71%),是基督徒(60%),接受过小学教育(45%),有工作(63%),55%的人收入低于5000肯尼亚先令,但只有38%的人与女性结婚。大多数(91%)艾滋病毒阴性男男性行为者获得PEP/PrEP,只有70%的人使用PEP/PrEP进行艾滋病毒预防。然而,大多数(60%)艾滋病毒阳性的男男性接触者与多个随意的男性伴侣进行肛交,49%的人有时进行无安全套插入性肛交,49%的人进行无安全套接受性肛交。艾滋病毒阳性的男男性行为者在酗酒时也有不止一次的肛交(41%),在肛交前总是使用药物(33%),由于缺乏运输(66%)、饮酒(24%)和吸毒(15%)等因素而没有坚持使用抗逆转录病毒药物、PrEP/PEP。对理论、实践和政策的独特贡献:从研究结果来看,政府/非政府组织必须解决男同性恋者问题,例如,通过增加针对男同性恋者的艾滋病毒项目的数量,充分资助这些项目,并积极让男同性恋者参与这些项目的运作。此外,通过使社区、人权团体、宗教领袖、政治家和其他利益相关者对有关男同性恋者的问题敏感,并游说对将同性关系定为犯罪的法律进行审查。
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引用次数: 0
Preparing Future Doctors for Palliative and End of Life Care in Kenya: Cross-sectional Survey 准备未来的医生在肯尼亚姑息治疗和临终关怀:横断面调查
Pub Date : 2023-03-01 DOI: 10.47604/jhmn.1798
David Mungara, W. Too
Purpose: The main aim of this study was to assess how prepared are Kenyan doctors in delivering palliative and end of life care to chronic and life-threatening conditions. Methodology: Cross-sectional survey was used to assess doctor’s palliative and end of life practices. Multi-center (three-mission referral and teaching hospitals in Kenya): Tenwek, Kijabe, and Chogoria were used to collect data from 96 medical practioners. Medical doctors with at least 6 months managing patients with chronic conditions (cancer, HIV/AIDS and other life-threatening conditions) were recruited into the study. The quantitative data was analysed using an independent t-test. All ethical considerations were addressed. Findings: Majority of doctors interviewed were generalists who had managed chronic diseases. Majority had basic concepts of palliative care and end of life care. Those who had received prior training in palliative care were better in performance’s score on knowledge questions regarding palliative care and end of life. Medical doctors were knowledgeable on psychological distress and opioids effects domains as compared to delirium and dyspnea domains. Among those who were knowledgeable in palliative care and end of life care were doctors trained outside Kenya, those who were senior with more experiences (>10 years), over 40 years and had further training after their undergraduate Unique Contribution to Theory, Practice and Policy: This study seeks to develop training tailored to Kenyan doctors and Physicians on end-of-life care practices in selected counties then roll-out to the rest of the counties in the country in collaboration with Ministry of Health Kenya and also provide opportunities for doctors to develop palliative and end-of-life care skills especially for resident and junior doctors. This study will also form basis for policy development on palliative and end-of-life care practices in Kenya, which currently is non-existent. End-of-life care Policy would aid in clinical application of good practices surrounding palliative and end-of-life care which should be implemented in Kenya. This study advocates inclusion of end-of-life care training modules in a standardized curriculum for undergraduate as part of training and preparing future Kenyan doctors. Further, this study can be considered as current Physician’s approach to end-of-life care practices in Kenya which then can be a basis to develop guidelines and standards addressing end-of-life which is fraught with ethical and medical dilemmas carried by healthcare professionals.
目的:本研究的主要目的是评估肯尼亚医生对慢性和危及生命的疾病提供姑息治疗和临终关怀的准备程度。方法:采用横断面调查评估医生的姑息治疗和临终实践。多中心(肯尼亚的三任务转诊和教学医院):Tenwek、Kijabe和Chogoria收集了96名医生的数据。研究招募了至少有6个月治疗慢性病(癌症、艾滋病毒/艾滋病和其他危及生命的疾病)患者经验的医生。定量资料采用独立t检验进行分析。所有的伦理考虑都得到了解决。调查结果:大多数受访医生是治疗过慢性病的全科医生。大多数人对姑息治疗和临终关怀有基本的概念。那些先前接受过姑息治疗培训的人在关于姑息治疗和生命终结的知识问题上的表现得分更高。与谵妄和呼吸困难领域相比,医生对心理困扰和阿片类药物影响领域了解较多。在了解姑息治疗和临终关怀的人中,有在肯尼亚以外接受过培训的医生,有经验丰富的资深医生(>10年),有40岁以上的医生,在本科毕业后接受了进一步的培训。本研究旨在开发针对肯尼亚医生和医生的临终关怀实践培训,然后与肯尼亚卫生部合作,在选定的县推广到该国其他县,并为医生提供发展姑息治疗和临终关怀技能的机会,特别是为住院医生和初级医生。这项研究还将为肯尼亚目前不存在的姑息治疗和临终关怀做法的政策制定奠定基础。临终关怀政策将有助于临床应用围绕姑息治疗和临终关怀的良好做法,这些做法应在肯尼亚实施。这项研究提倡将临终关怀培训模块纳入本科生的标准化课程,作为培训和准备未来肯尼亚医生的一部分。此外,这项研究可以被认为是肯尼亚目前医生临终关怀实践的方法,然后可以作为制定指导方针和标准的基础,解决医疗保健专业人员所面临的充满道德和医学困境的临终关怀问题。
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引用次数: 0
Clinical Profile of Pediatric Patients with Neural Tube Defects in a Tertiary Hospital in Davao City, Philippines: A Five-Year Retrospective Study 菲律宾达沃市一家三级医院小儿神经管缺损患者的临床概况:一项为期五年的回顾性研究
Pub Date : 2023-03-01 DOI: 10.7176/jhmn/106-04
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引用次数: 0
Determinant Analysis of Divorce in Wolaita Sodo Town: In Case of Wadu Kebele, Snnpr, Ethiopia Wolaita Sodo镇离婚的决定因素分析——以埃塞俄比亚南部Wadu Kebele为例
Pub Date : 2023-03-01 DOI: 10.7176/jhmn/106-01
Adinew Handiso Arficho
Marriage is the very beautiful gift which Allah given to his human being. It gives pleasure, security, peace, and family. In life there is happiness and worries which men or women...
婚姻是安拉赐予人类的最美丽的礼物。它带来快乐、安全、和平和家庭。生活中有快乐也有烦恼,男人或女人……
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引用次数: 1
Clinical Profile of Pediatric Extrapulmonary Tuberculosis in a Tertiary Hospital: A 10-year Retrospective Study 某三级医院小儿肺外结核临床分析:10年回顾性研究
Pub Date : 2023-03-01 DOI: 10.7176/jhmn/106-03
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引用次数: 0
Nurses Practice and Associated Factors towards Hemodialysis Care in Addis Ababa, Ethiopia 护士实践和相关因素对血液透析护理在亚的斯亚贝巴,埃塞俄比亚
Pub Date : 2023-03-01 DOI: 10.7176/jhmn/106-02
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引用次数: 0
Assessment of Covid-19 Management by Healthcare Providers in Busia County Referral Hospital, Busia County, Kenya 肯尼亚布西亚县布西亚县转诊医院医疗服务提供者Covid-19管理评估
Pub Date : 2022-12-24 DOI: 10.47604/jhmn.1725
Psusma Psusma, Tito Kwena, Mukhtar Mukhtar
Purpose: The main objective was to assess COVID-19 management by healthcare providers in Busia County Referral Hospital, Busia County, Kenya by November 2021. Materials and Methods: A sample size of 153 was considered to give the data from the different clustered cadres The data collection tools included a facility readiness assessment for COVID-19 observation checklist adopted from the World Health Organization, an Interview structured questionnaire, and a key informant guide for managers of every key cadre. Both qualitative and quantitative data collected were cleaned, coded, sorted, and analyzed using the statistical package for social sciences (SPSS) version 21. The data collected was presented in frequencies, pie charts, graphs, proportions, and tables. The associations of variables were tested using the Chi-square test, bivariate and multivariate. An association was considered significant when the p-value is less than 0.05 (p<0.05) with a confidence interval of 95% (CI 95). Findings: The study revealed a shorter duration of experience 1 to 3 years and a shorter training session 1 to 2 days had higher odds of 2.3 and 2.1 (p = 0.03) and p=0.04) respectively to report correct practice in the management of COVID-19, and was statistically significant. Furthermore, knowledge of five moments of hand hygiene (p=0.007), and audit (p=0.004) were statistically significant to report correct practice in the management of the pandemic. In addition, the availability of gloves, face masks, thermogun, screening checklist, and the designated focal person at triage reported higher odds >2.5 with p>0.05 to facilitate correct practice in the management of COVID-19. Respondents who reported the existence of an infection prevention and control committee had 5.2 odds with p=0.03 to adhere to correct practice in pandemic management. Unique contribution to theory, practice, and policy: The study revealed that updated policy documents, knowledge, skills, and Health Products and Technologies on the management of COVID-19 were paramount in the fight against the pandemic. Keywords: SARSCOV2; COVID-19; Hand hygiene; Personal Protective Equipment
目的:主要目标是在2021年11月之前评估肯尼亚布西亚县布西亚县转诊医院医疗保健提供者对COVID-19的管理情况。材料与方法:采用世界卫生组织新冠肺炎疫情监测设施准备情况评估表、访谈结构化问卷、各重点干部管理人员关键信息提供人指南等数据收集工具,样本量为153人。收集的定性和定量数据都被清洗、编码、排序,并使用社会科学统计软件包(SPSS)第21版进行分析。收集的数据以频率、饼状图、图形、比例和表格的形式呈现。变量间的相关性采用卡方检验、双变量检验和多变量检验。当p值小于0.05 (p2.5, p>0.05)时,认为相关性显著,以促进COVID-19管理的正确做法。报告存在感染预防和控制委员会的应答者在大流行管理中坚持正确做法的赔率为5.2 (p=0.03)。在理论、实践和政策方面的独特贡献:该研究表明,关于COVID-19管理的最新政策文件、知识、技能以及卫生产品和技术对抗击大流行至关重要。关键词:SARSCOV2;COVID-19;手卫生;个人防护装备
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引用次数: 0
Accessibility and Health Facility Factors Influencing Maternal and Fetal Outcomes among Mothers Referred with Obstetric Emergencies in Baringo County Referral Hospital, Kabarnet, Kenya 可及性和卫生设施因素对肯尼亚卡巴内特巴林戈县转诊医院产科急诊产妇和胎儿结局的影响
Pub Date : 2022-12-21 DOI: 10.47604/jhmn.1723
Phylis Kandie
Purpose: To determine the accessibility to a health facility and health facility factors influencing maternal and fetal outcomes among mothers referred with obstetric emergencies in Baringo County referral Hospital. Methodology: A descriptive cross-sectional study which employed a mixed method approach of data collection was adopted. Simple Random technique was used in selecting 284 respondents into the study. The study population also included nurses, gynaecologist and medical officers who were purposively sampled. Qualitative data collection was analysed through content analysis while descriptive and inferential statistics were used to analysed quantitative data.  Findings: results show that mothers who are accompanied by nurse are 4.3 times more likely to have complications than those accompanied by relatives (AOR:4.3;95% CI:1.2-16.1;p=0.03). Moreover, mothers who were coming from distant health facilities were 70% less likely to have experience complications than those who live closer to the referral hospital (AOR: 0.3; 95%CI: 0.1-1.1; p=0.07). Neonates whose mothers received treatment within 30 min (OR: 0.5; 95% CI: 0.3 – 0.8; p = 0.005) were 50% less likely to have had abnormal outcome. In contrast, the risk of abnormal outcome was higher for neonates whose mothers received treatment before referral (OR: 2.3; 95% CI: 1.4 – 3.8; p = 0. 001) suggesting possible delay in providing treatment as a possible cause of deteriorating condition of the foetus. Mothers who stated that nurses listened and explained things (3.9%) or those seen within less than 30 minutes to be attended to (p = 0.3) experienced complications. On the other hand, the odds of complications increased where the main reason for referral was lack of expertise and equipments at the referring health facility (p = 0.09) though the result was not statistically significant. Unique Contribution to Theory, Practice and Policy: This study has identified accessibility and health facility factors influencing the obstetric emergencies in a marginalized county. The study will provide insight to policy maker’s hence evident-based interventions will be made. No literature review has been published on this topic at the study site therefore, this study will form a basis for other researchers.
目的:确定在巴林戈县转诊医院接受产科急诊的母亲前往卫生设施的可及性和影响母婴结局的卫生设施因素。方法:采用描述性横断面研究,采用混合数据收集方法。采用简单随机抽样法,选取284名调查对象。研究人群还包括护士、妇科医生和医务人员,他们是有意抽样的。定性数据收集通过内容分析进行分析,定量数据采用描述统计和推理统计进行分析。结果显示,有护士陪同的产妇发生并发症的可能性是有亲属陪同的产妇的4.3倍(AOR:4.3;95% CI:1.2 ~ 16.1;p=0.03)。此外,来自偏远医疗机构的母亲比住在转诊医院附近的母亲出现并发症的可能性低70% (AOR: 0.3;95%置信区间:0.1—-1.1;p = 0.07)。母亲在30分钟内接受治疗的新生儿(OR: 0.5;95% ci: 0.3 - 0.8;P = 0.005)发生异常结果的可能性降低50%。相比之下,转诊前母亲接受过治疗的新生儿出现异常结局的风险更高(OR: 2.3;95% ci: 1.4 - 3.8;P = 0。001)表明可能延误提供治疗是导致胎儿状况恶化的可能原因。表示护士倾听并解释事情的母亲(3.9%)或在30分钟内就诊的母亲(p = 0.3)出现并发症。另一方面,当转诊的主要原因是转诊医疗机构缺乏专业知识和设备时,并发症的发生率增加(p = 0.09),尽管结果没有统计学意义。对理论、实践和政策的独特贡献:本研究确定了影响边缘化县产科急诊的可及性和卫生设施因素。该研究将为政策制定者提供见解,从而采取基于证据的干预措施。本研究尚未在研究现场发表相关的文献综述,因此本研究将为其他研究者提供研究基础。
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引用次数: 0
Risky Sexual Behaviour and Contraceptive Use Among Young Adults in Public Colleges of Education in Ogun State, Nigeria 尼日利亚奥贡州公立教育学院年轻人的危险性行为和避孕药具使用情况
Pub Date : 2022-11-01 DOI: 10.7176/jhmn/104-02
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引用次数: 0
Assessment of Knowledge, Attitude and Practices About Rabies Prevention and Associated Factors in Wolaita Sodo City, Southern Ethiopia 埃塞俄比亚南部Wolaita Sodo市关于狂犬病预防及其相关因素的知识、态度和行为评估
Pub Date : 2022-11-01 DOI: 10.7176/jhmn/104-01
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引用次数: 0
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Journal of Health, Medicine and Nursing
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