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Jul 2025 DOI 10.14302/issn.2577-137X.ji-25-5581
Muthee Waweru EdmondCorresponding author
Coronavirus Disease 2019 (COVID-19) placed significant pressure on global health systems, necessitating rapid and widespread immunization, especially among healthcare workers (HCWs). Despite being prioritized in immunization programs, variations in vaccine uptake among HCWs have been reported across different settings. This study aimed to investigate the predictors of COVID-19 vaccine uptake among HCWs in Kiambu County, Kenya. An analytical cross-sectional study design was employed, involving 112 HCWs sampled using stratified random sampling from Level 2 to Level 5 healthcare facilities. Data were collected through a pre-tested and validated 18-item questionnaire and analyzed using SPSS version 29.0. Statistical methods included descriptive analysis, chi-square tests, logistic regression, and ANOVA. The overall COVID-19 vaccine uptake was 88.9%. Significant predictors of uptake included age (p = 0.048), cadre (p = 0.015), and facility level (p = 0.031). Knowledge of COVID-19 vaccines emerged as the strongest predictor, with HCWs demonstrating good-to-excellent knowledge being 14.97 times more likely to be vaccinated (p < 0.001). Confidence in vaccine safety and effectiveness was also significantly associated with uptake (p < 0.001). Uptake was highest in Level 5 hospitals and lowest in dispensaries. The study reveals high vaccine uptake among HCWs in Kiambu County, but disparities persist due to individual and systemic factors. Strengthening vaccine education, institutional support, and deploying mobile vaccine education units in lower-level facilities could help close these gaps, offering practical strategies for improving HCW vaccine coverage in Kenya and other low- and middle-income countries.
Sep 2024 DOI 10.14302/issn.2690-4721.ijcm-24-5195
Mutile Kavai SusanCorresponding author
The persistence of multidrug-resistant (MDR) Salmonella Typhi (S. Typhi) is a challenge especially in regions where typhoid is endemic. Surveillance of circulating genotypes of MDR S. Typhi is crucial in typhoid acute cases and carriers. This study aimed to investigate genotypic diversity of S. Typhi from symptomatic and asymptomatic children in endemic settings in Nairobi, Kenya. Symptomatic and asymptomatic individuals’ ≤ 16 years were recruited at four health facilities and tested for typhoid through stool cultures. The S. Typhi isolates were subjected to antibiotic susceptibility testing to investigate multidrug resistance. The MDR S. Typhi isolates’ DNA was extracted and illumina sequenced. Raw reads were de novo assembled and analyzed by pathogen-watch. From the 90 sequenced isolates, 60 (67%) were confirmed to be S. Typhi (sequence Type 1 and genotype 4.3.1). Out of the 60 S. Typhi strains; 39 (65%) had plasmids, from these 38 (97%) had IncHI1 plasmids alone. Out of the 60, 59 (98%) S. Typhi isolates had blaTEM-1D. Point mutations conferring reduced susceptibility to quinolones were detected in 42 (70%) of S. Typhi isolates, from these; 14 (33%) had gyrA S83Y , and 28 (67%) gyrB S464F genes, respectively. This study reports 4.3.1 (H58) as the most dominant S. Typhi genotype responsible for spread of MDR phenotypes carried on IncHI1 plasmids. Presence of MDR S. Typhi with resistance genes such as blaTEM-1Dand reduced susceptibility to ciprofloxacin especially among asymptomatic individuals, reiterates the need for use of typhoid conjugate vaccine among vulnerable children as a control and prevention measure against typhoid.
Apr 2024 DOI 10.14302/issn.2690-4721.ijcm-24-5030
S. Gunn* JohnCorresponding author
Typhoid fever, caused by the human restricted pathogen Salmonella Typhi, remains a major global public health concern. Even after successful treatment, approximately 3-5% of patients with typhoid fail to clear the bacteria within one year and become chronic carriers. Most typhoid carriers have gallstones in their gallbladder, and biofilm formation on gallstones is highly correlated with chronic carriage. This study’s goal was to identify asymptomatic typhoid carriers in an endemic setting in Kenya, and to compare acute versus chronic isolates. A cohort of typhoid fever patients identified through blood and/or stool culture, and their household contacts, were followed up after treatment to detect longitudinal S. Typhi stool shedding. An abdominal ultrasound scan was used to identify individuals with gallstones. A total of 32 index patients and 32 household contacts were successfully followed-up. Gallstones were detected in 4 cases and 1 household contact. The duration of S. Typhi shedding was significantly longer in individuals with gallstones compared to those without, P<0.001. Eighty-three (83) S. Typhi strains were tested for susceptibility to commonly used antimicrobials and examined by in vitro biofilm formation assays. Out of 37 infected individuals, 32.4% had infections caused by multidrug resistant (MDR) S. Typhi strains and only 18.9% were infected by susceptible strains. Non-MDR strains formed significantly better biofilms in vitro than the MDR strains (P<0.001). This study provides data on S. Typhi chronic carriage that will influence public health approaches aimed at reducing typhoid transmission and the burden of infection.
Oct 2020 DOI 10.14302/issn.2379-7835.ijn-20-3377
Amanya Mutuli LucyCorresponding author
PhD of Masinde Muliro University of Science and Technology 190-50100
Introduction Sub-optimal dietary intake patterns have a major detrimental impact on the nutritional status of an alcoholic. These patterns exacerbate the status of alcoholism and the functioning of the alcoholic’s body. Objective This study aimed to examine alcoholic’s dietary intake patterns. Methods A cross-sectional study was conducted on 204 alcoholics undergoing alcohol rehabilitation in selected rehabilitation centers. A 24 hour food recall and food frequency questionnaire was used to assess dietary intake of the respondents. Factor analysis of food items and groups, cluster analysis of dietary intake patterns, and multivariate regressions were carried out. Results Three dietary intake patterns were identified among alcoholics namely a low calorie intake (described mainly by consumption of plant-based foods); a composite intake (distinguished by adequate consumption of both plant-based and animal-based foods) and a high calorie intake (characterized by high consumption of animal-based foods). Conclusion Optimal dietary intake promotion programs are needed to address the dietary intakes of recuperating alcoholics under rehabilitation to help prevent malnutrition and other associated comorbidities.
Jun 2018
Mwai JCorresponding author
Kenya Medical Research Institute.
Background: Tungiasis is a parasitic tropical disease caused by female Tungapenetranswhich has remained an important public health problem and it affects resource-poor communities causing different health disabilities hence the need for behavior change. Main objective of the study was to determine factors influencing prevention and control of tungiasis infestation among school age children in Ugenya Sub County, Kenya. Methods: A descriptive cross sectional design and utilizing quantitative data collection method. Simple random sampling technique was applied to select the participants. Quantitative data was collected through a pretested structured questionnaire. The data was keyed-into excel and analyzed using SPSS version 23. Results: Study findings indicate that majority of the pupils infested with tungiasis were in classes 5 – 6 at 191(49%). Male participants were 200 (51%), while 185(49%) were female. Gender of pupils (χ2=4.383a, df=1, P<0.005) and household head occupation (χ2=44.729, df = 28, P<0.005) had a statistical significance with tungiasis infestation. Further significance was noted between participants who had ever heard of jiggers (χ2=6.361, df=1, P<0.005), Knowledge on important causes of jiggers (χ2=36.482, df = 9, P<0.005), mode of disease transmission (χ2=17.215, df = 5, P<0.005), signs and symptoms (χ2=4.088, df = 1, P<0.005), seriousness of jiggers in the area (χ2=13.175, df = 1, P<0.005) as well as pupil’s wearing of shoes (χ2=3.934, df = 1, P<0.005) and tungiasis infestation. Conclusions: Study concludes that tungiasis is still a big problem in rural settings and knowledge on tungiasis infestation does not translate to prevention and control in the areas. More emphasis should be given to improving practices touching on personal hygiene and health education to increase awareness both at school and in the households.
Feb 2014 DOI 10.14302/issn.2324-7339.jcrhap-13-211
Gust D.Corresponding author
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
Recruitment of couples is important for study success. The multi-centered HPTN 052 clinical trial was designed to evaluate whether immediate versus delayed use of ART by HIV-infected individuals would reduce transmission of HIV to their HIV-uninfected partners. The objective of this study was to retrospectively compare several approaches for community recruitment at our site in Kisumu, Kenya based on a) feedback from recruitment staff, b) associated cost, and c) number of eligible couples enrolled. A secondary objective was to assess the discordant couples’ acceptability of the community recruitment approaches relative to the a) main recruitment venues, b) educational materials, and c) local language best suited for explaining the trial. 241 couples were screened for eligibility using nine recruitment approaches. We compared the approaches used for the 60 couples found to be eligible to those used for the 56 ineligible couples for whom that information was available. Analyses for association were carried out. In-depth interviews were conducted with 20 staff and 29 discordant couples. Records were kept of the costs associated with each approach. Overall, staff interviews revealed that acceptability of the approaches was high. Challenges were present with all approaches ranging from one member of the couple not wanting to reveal their positive HIV status to their partner (Patient Support Center or PSC approach), to not finding people at home (home based counseling and testing or HBCT approach). The PSC and the HBCT recruitment approaches were the most effective in terms of recruiting eligible participants. There was an overall significant difference between the proportion of eligible and ineligible participants among the 9 approaches (χ2 (8) =33.5; p<0.0001). Analyses for association showed that the PSC approach resulted in attracting a greater proportion of couples who were eligible than ineligible (χ2 (1) =6.6; p=0.016). The cost for the PSC approach was less than one-third that of the HBCT approach. All discordant couples interviewed found the two main recruitment venues (PSC and their home) acceptable. Among couples who saw the educational materials, the majority found them useful (poster 72.7%; pamphlet 90.9%; flyer 88.9%). All couples found the language they were told about the study acceptable. The evaluation of recruitment approaches indicated that working with local partners, specifically the PSC staff and HBCT staff, was the most effective way to recruit eligible discordant couples. A focus on collaborations and partnerships between research and clinical organizations will help study recruitment efforts. Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of their respective institutions. Funding for this substudy was provided by the Kenya Medical Research Institute (KEMRI) through a cooperative agreement with the U.S. Centers for Disease Control and Prevention.
Jan 2014 DOI 10.14302/issn.2324-7339.jcrhap-13-187
Gust D.A.Corresponding author
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
Retention of sufficient numbers of participants in longitudinal research studies is a serious methodological concern, as retention influences the validity of the research findings. An assessment of participant retention or attending all study visits was made quarterly during a 12 month follow-up of an HIV incident cohort in Kisumu, Kenya. The study objectives were to determine 1) the proportion of participants attending all study visits and 2) demographic and behavioral factors associated with missing ≥ 1 visit. The Kisumu Incidence Cohort Study (KICoS) was initiated in January 2007 (N=831). Detailed contact information was collected from each participant to enhance retention. Bivariate and multivariable analyses were used to determine factors associated with missing ≥ 1 visit. Overall retention was 90%. Of those enrolled, 46.4% were females. The adjusted odds of missing ≥ 1 study visit were greater for participants who were female (AOR=2.85; CI=1.90-4.28) and who had technical training (AOR=2.51; CI=1.20-5.25) or college/university education (AOR=1.89; CI=1.10-3.24) compared to having no or only primary education. Retention was high in this HIV prevention cohort study. However, studies could benefit by tailoring retention strategies for women. Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of their respective institutions.
Apr 2024 DOI 10.14302/issn.2692-5257.ijgp-24-5041
Muendo NicholasCorresponding author
Introduction Globally, 36.7 million individuals live with HIV/AIDS, with 2.5 million new cases annually. Youth (14-25 years) account for 45% of these new infections. Those aged 15-24 years are less likely to be aware of their HIV status and engage in HIV care compared to older adults. This study explores the use of HIV self-testing to improve access to HIV care among Kenyatta University undergraduates. Objective To identify barriers and facilitators to HIV self-testing in this group. Methodology Employing multistage cluster sampling, 398 students were surveyed using a self-administered questionnaire. Results Of the participants (median age 21 years, 1:1.03 male-to-female ratio), 91.7% understood HIV's seriousness, with sexual intercourse as the primary transmission mode. Self-testing usage was 28.8%. Key barriers included fear of partner reaction, stigma, and lack of confidence. Significant facilitators were being female, knowledgeable about HIV, and sexually active. Conclusion Only 24% had prior HIV testing experience. The study highlights the importance of addressing fears and misconceptions while leveraging knowledge and sexual activity awareness to promote HIV self-testing.
Oct 2022 DOI 10.14302/issn.2641-4538.jphi-22-4325
Rutayisire ErigeneCorresponding author
Department of public Health, Mount Kenya University Rwanda Kigali Rwanda
The aim of this study is determine the prevalence and factors associated with caesarean section among women delivered at Kirehe District Hospital. A retrospective study was conducted among women delivered at Kirehe District Hospital from January 2018 to December 2019. The medical files of all women delivered at the hospital who meet the inclusion criteria were reviewed. Data were checked for completeness, cleaned, coded and entered into excel sheet, and then exported to SPSS version 22.0 for further analysis. Descriptive statistics was used to estimate the prevalence and description of study participants. Multivariable logistic regression models were used to estimate risk for CS with 95% confidence intervals (CIs). The study was conducted in accordance with the research protocol Mount Kenya University Rwanda research ethical committee. The majority 806 (69.9%) of women who delivered at Kirehe district hospital from January 2018 to December 2019 were aged 22-35 years old. The prevalence of C-section at Kirehe District Hospital was 23.1%. Demographic and economic factors associated with Caesaren section in bivariate and multivariate analysis was respondent’s type of health insurance where women who used private health insurance were 3 times more likely to deliver by C-section. The findings from multivariate analysis revealed that women who experienced eclampisa had 45% risk of C-Setion compared to those without Eclampsia. Women in rural area of Rwanda seem to have increased access to and use of CS. However, the significant increase in the rate of CS is of concern due to the potential of unnecessary CS.
Oct 2022 DOI 10.14302/issn.2641-4538.jphi-22-4333
Hezagira EmeryCorresponding author
Public Health Department, Mount Kenya University Rwanda
The motivations and barriers experienced by community health workers (CHWs) during the delivery of maternal and child health (MCH) services are less documented in Rwanda. This study aimed to explore the barriers and facilitators of implementing MCH care as perceived by CHWs. A descriptive qualitative study was conducted, and Semi-structured interviews with flow-up probing questions were used to collect data. A number of 24 interviews were conducted with CHWs from three selected sectors of the Gicumbi district including four supervisors of CHWs from each selected health center and one at the district hospital. Three focus group discussions with CHWs from each site were also conducted. Ethical approval was obtained from Mount Kenya University and permission to collect data from the study sites was granted. NVIVO software was used for analysis, and then the content analysis was adopted to identify themes merging from the interviews and focus group discussions. The study findings revealed emerged factors that facilitate the CHWs to deliver MCH services to their communities: liking their work, trust by the community, respect from the community, the willingness to help, desire to gain knowledge, being human, and sacrifice for the wellness of the community. On another hand, the findings indicated that the work of CHW has various barriers including working many hours, lack of equipment, lack of knowledge, unsatisfactory salary, heavy workload, lack of working space, lack of facilitation for communication, family conflicts, lack of specified working time, and believes.
May 2022 DOI 10.14302/issn.2641-4538.jphi-22-4185
Rutayisire ErigeneCorresponding author
Department of public Health, Mount Kenya University Rwanda Kigali Rwanda
This study aims to assess reproductive health knowledge and services utilization among adolescents from Rwamagana District. A community based cross-sectional study was carried out in Rwamagana district. A sample of 392 adolescent aged 15-19 participated in the study. Simple random sampling was used to select respondents. Data was collected by using a questionnaire adopted from previous studies. Data was checked for completeness, cleaned, coded and entered into excel sheet, and then exported to SPSS version 22.0 for further analysis. Frequencies and percentage was used to summarize descriptive statistics. To determine the association between different factors associated with reproductive health knowledge and services utilization, a logistic regression model was employed. Ethical clearance was obtained from the Ethical committee of Mount Kenya University. It was observed that the majority of adolescents in Rwamagana District knew the sign of maturity. Overall the majority of adolescents 91.8% in Rwamagana District had good knowledge about reproductive health services. The majority of adolescents in Rwamagana District (66.8%) had ever utilized reproductive health services at health facility. It was observed that adolescents who live with their parents were more likely to use reproductive health services compared to those who do not live with parents (aOR=2.161, 95%CI: 1.162-4.021, p=0.015). Moderate reproductive health services utilization was observed among adolescents. There is a need to increase adolescent’s awareness on the available services at health facilities.
May 2020 DOI 10.14302/issn.2641-4538.jphi-20-3324
Rutayisire ErigeneCorresponding author
Department of public Health, Mount Kenya University Rwanda Kigali Rwanda
Knowledge of tuberculosis has been shown to influence health seeking behaviour. The study aim was to assess knowledge of tuberculosis and identify the associated factors. This study was a cross sectional descriptive research design with quantitative approach. The target population was the TB patients visited health facilities in Gakenke District. A sample of 376 TB patients was randomly selected from three health centers. Interview-administrated structured questionnaire was used to collect data from 376 TB patients. Data was analyzed with SPSS-version 22. The study protocol was approved by Mount Kenya University Rwanda. The majority of respondents 71.0% were male, 51.6% were aged 45 years and above, 81.9% were married, and 65.2% had completed primary education. Few respondents identified a germ as the cause of TB (24.7%). This study revealed that 54.3% of TB patients had good knowledge about TB. The findings from multivariate analysis show that male were three times more likely to have good knowledge about TB compared to female (AOR=3.31, 95%CI: 1.98-5.53, p<0.001). Compared to TB patients aged 45 years and above, respondents aged 25-34 years old were more likely to have good knowledge about TB (AOR=38.71, 95%CI: 9.22-162.48, p<0.001). TB patients who live between 2-5 km from nearest health facility were more likely to have good knowledge about TB compared to those who live at more than 5 km (AOR=33.58, 95%CI: 14.95-74.40, p<0.001). The ministry of health and other stakeholders in health sector need to continue the interventions that aim to reduce TB infection.
Jun 2019 DOI 10.14302/issn.2768-5209.ijen-19-2712
Bridget. O BobadoyeCorresponding author
International Centre of Insect Physiology and Ecology (), P.O. Box 30772-00100 Nairobi, Kenya.
A field study was undertaken along six diverse habitat gradients of Kenya to evaluate the occurrence and underlining drivers that shape meliponine bee species diversity. These gradients ranged from continuous forest habitats (Indigenous forests, mixed forests and exotic forest patch) representing unfragmented habitats to dispersed habitats (Mixed deciduous woodlands, Grasslands dominated by perennial grasses such as Cenchrus ciliaris, Chloris roxburghiana and Acacia dominated bush lands) representing fragmented habitats respectively. A total of four different species of meliponine bees were encountered with Hypotrigona gribodoi being the most abundant species, followed by Meliponula ferruginea (black), Plebeina hildebrandti and Hypotrigona ruspolii in descending order. Occurrence and diversity of Hypotrigona gribodoi, Melipona ferruginea (black), Plebeina hildebrandti and Hypotrigonaruspolii was significantly influenced by the degree of fragmentation (vegetation type) and floral diversity (P = 0.0056); the mean number of colonies recorded per study site ranged from 2.3 in dispersed habitats in the lowlands to 1.0 in continuous forest landscapes in the highlands, whereas the mean population density ranged from 2.0 to 172 colonies/25 ha-transects. The results provide substantial support to better understand interactions between habitat structure and the degree of fragmentation in linking species diversity to habitat loss.