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5-year audit of the range and volume of diagnostic radiographic services at the University of nairobi Dental hospital

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Open Journal of Stomatology 2012年第3期2卷 234-236页

作者： Eunice N. Kihara Florence Opondo Tom J. Ocholla Mark L. Chindia Evelyn Wagaiyu Department of Oral & Maxillofacial Surgery Oral Pathology & Medicine University of Nairobi Nairobi Kenya Department of Periodontology University of Nairobi Nairobi Kenya Radiology Division Department of Oral & Maxillofacial Surgery Oral Pathology & Medicine University of Nairobi Nairobi Kenya

Background: Dental and cranio-maxillofacial diagnostic imaging constitutes an invaluable tool in the accurate diagnosis and management of a diverse range of conditions and diseases that afflict the oral and cranio-maxillofacial region. In order to improve on any existing facility, periodic audit evaluation is paramount. In this way proper and relevant service delivery can be achieved. Objective: To evaluate the range and volume of dental and cranio-maxillofacial diagnostic radiographic services offered at the University of nairobi Dental hospital (UNDH) in Kenya over a 5-year period (2006-2010). Methods: Retro-spective survey involving manual examination of patient records at the Division of Dental and cra-nio-maxillofacial Radiology registry of the UNDH. Results: Over the study period, the range of diagnostic radiographic services offered comprised of both intra- and extra- oral examinations. The total volume of radiographs taken was 48,874 among which 41,980 (86%) were intraoral and 6894 (14%) extraoral views. Among the intraoral views, 74% were bitewing, 25% periapical and only 1% were occlusal diagnostic views. The majority (95%) of the extraoral projections consisted of panoramic views and only 5% constituted other techniques. The volume of radiographs was high from January to September while November and December had the lowest number of examination requests. Conclusion: Intraoral radiography was the commonest examination with bitewings having been the majority while the panoramic tomography was the commonest extraoral examination performed.

关键词： Audit Radiographs

Pattern of occurrence of jaw cysts and cyst-like lesions at the University of nairobi Dental hospital: A 10-year histopathologic audit

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Open Journal of Stomatology 2012年第2期2卷 140-145页

作者： Cyrus S. Micha Mark L. Chindia David O. Awange Elizabeth Dimba Tom M. Osundwa Josiah G. Otwoma Department of Oral & Maxillofacial Surgery and Oral medicine Oral Pathology School of Dental Sciences University of Nairobi Kenya

Background: Jaw cysts and cyst-like lesions cause facial deformity, destruction of dental tissues and affect masticatory and phonation functions. These ad-versely erode patients’ psycho-social status;create low self-esteem and may change one’s facial identity and appearance. Objective: To determine the histo-pathologic characteristics, variants and demographic pattern of jaw cysts and cyst-like lesions at the University of nairobi Dental hospital. Material and Me-thod: This was an analytical and verification study that involved microscopic re-examination of all available incisional/excisional biopsy samples from January 2000 to December 2009 for histo-pathological diagnosis at the University of nairobi Dental hospital. Results: 187 jaw cysts and cyst-like lesions were diagnosed at the University of nairobi Dental hospital over the ten-year period. Keratocystic odontogenic tumours constituted 28%, dentigerous cysts 25%, nasopalatine duct cysts 19%, radicular cysts 15%, while calcifying odontogenic cysts comprised 4% of all the lesions. The rest of the lesions were between 1% and 3% of all the lesion entities. Conclusion: Keratocystic odontogenic tumours and dentigerous cysts were the most common developmental odontogenic cysts diagnosed in the ten-year period.

关键词： Jaw Cysts Odontogenic Cyst Non-Odontogenic Cysts Dentigerous Cyst and Cyst-Like Lesions

Socio-Demographic and Economic Factors Associated with Uptake of COVID-19 Vaccine among Pregnant Women at Pumwani Maternity hospital in nairobi County, Kenya

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Open Journal of Epidemiology 2024年第2期14卷 221-237页

作者： Nyawela S. Nyibil Gideon Kikuvi Isabel Kazanga Chiumia Jomo Kenyatta University of Agriculture and Technology School of Public Health Department of Environmental Health and Disease Control Nairobi Kenya Department of Health Systems and Policy Kamuzu University of Health Sciences Lilongwe The Republic of Malawi

Introduction: Pregnant women are a highly vulnerable population for COVID-19 with increased risk of hospitalization, intensive-care unit admission, invasive ventilation support, and mortality. Objective: This study determined the socio-demographic and economic factors associated with the uptake of COVID-19 vaccine among pregnant women utilizing antenatal care services in Pumwani Maternity hospital, nairobi County-Kenya. Methods: The study was carried out from 15 June to 23 July 2023. Systematic sampling was used to select 302 women from whom data was collected through face-to-face interviews using a pre-tested semi-structured questionnaire. Data was analyzed using SPSS software in which bivariate and multivariate logistic regression analyses were done at a significance level of p Results: A total of 302 pregnant women participated in the study. Of these, 105 (34.8%) were aged between twenty-six (26) and thirty (30) years. The mean age of the women was 28.60 ± (SD = 5.297). The uptake of the COVID-19 vaccine was 41.1%. The common side effects reported to be associated with the vaccines were fever, headache, joint pain, vomiting and skin rash. Uptake of the COVID-19 vaccine was significantly associated with being married (AOR = 3.65, 95% CI: 0.62 - 1.80, p = 0.001), having a secondary level of education (AOR = 3.78, 95% CI: 0.99 - 2.88, p = 0.001) and being employed (COR = 2.66, 95% CI: 1.31 - 3.06, p = 0.001). Conclusion: COVID-19 vaccination uptake remains low among pregnant women in seeking ANC in nairobi. The individual factors associated with the uptake of COVID-19 vaccine among pregnant Women at Pumwani maternity hospital in nairobi County were being married, having secondary level of education and being employed. Integration of the COVID-19 vaccine with other routine vaccinations as per the national immunization program in Kenya and the enhancement of education regarding the safety and efficacy of the COVID-19 vaccine in pregnancy and breastfeeding and economic

关键词： COVID-19 Vaccine Uptake Associated Factors Pregnant Women

Effectiveness of Short Message Service Support on Adherence to Chemotherapy Treatment among Patients Attending Cancer Treatment Facilities in Kenya

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Open Journal of Nursing 2024年第3期14卷 93-113页

作者： Nebert Kiguhe Mchidi John P. Oyore Gordon Ogweno Department of Specialized Surgery . Kenyatta National Hospital Nairobi Kenya Department of Community Health and Epidemiology School of Public Health Kenyatta University Nairobi Kenya Department of Medical Physiology School of Medicine Kenyatta University Nairobi Kenya

Introduction: Cancer is a chronic debilitating disease that unnerves patients, communities, and nations. At some point in cancer patient’s disease experience, chemotherapy is used, and the patient is expected to adhere to treatment to improve survival and quality of life. Methods: This multisite Cluster Randomized Trial (CRT) evaluated the effectiveness of mobile phone Short Message Service (SMS) support on the adherence to treatment schedules among adult cancer patients in Kenya. Data was collected using questionnaires. Ethical approvals were obtained from relevant Ethical Review Boards (ERBs). Results: The mean adherence was 83%. There was a significant difference between treatment arms in relation to the adherence. The intervention arm had a higher mean adherence difference, M = 3.913, 95% CI 2.632-5.193, t (402) = 6.006, p ≤ 0.001), with Cohen’s d = 0.60. Although not significant, (χ2dd = 0.151, df = 1, p = 2.064), more women were perfect adheres than males. Perfect adherers were satisfied with SMS support (χ2dd = 7.620, df = 1, p = 0.06), were in the intervention arm (χ2dd = 22.942, df = 1, p ≤ 0.001), and had trust in the care provider (χ2dd = 10.591 p ≤ 0.001). SMS support was not significant in the multivariate analysis but had an estimated effect size of 0.958 (z = 1.424, p = 0.154, CI = 0.242-3.781), indicating that mean adherence was slightly better in the presence of the intervention. Conclusions: SMS-support intervention has demonstrated superiority in influencing adherence. Further, health system-related factors have a significant influence on the adherence to chemotherapy treatment. Interventions to re-design health systems that are responsive to unmet care needs of cancer patients must be explored. .

关键词： Adherence Cancer Symptom Distress Quality of Life Medication Posses-sion Ratio Short Message Service Survivorship

Characterization of Extended Spectrum Beta-lactamase and Carbapenamase Producing Enterobacteriaceae Causing Urinary Tract Infection among Children in Kenya: A Cross-Sectional Study

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Advances in Microbiology 2024年第7期14卷 351-365页

作者： Rachael Wangeci Waithaka Janet Kerubo Maranga Celestine Khalechi Makobe Department of Microbiology Jomo Kenyatta University of Agriculture and Technology Juja Kenya Gertrudes Childrens hospital Nairobi Kenya

Introduction: Enterobacteriaceae causing urinary tract infections (UTI) have developed resistance to the commonly used antibiotics due to emergence of Extended Spectrum Beta-Lactamases (ESBLs) and Carbapenamase producing Enterobactericeae which are a public health problem worldwide. This study aims to determine the prevalence and characterize ESBLs and carbapenamase producing Enterobactericeae. Method: A cross-sectional study was carried out in Gertrude’s Children’s hospital, nairobi. 238 urine samples were collected from patients with urinary symptoms attending the outpatient department within the period 2020-2021. The urine were examined macroscopically and microscopically. Identification and antimicrobial susceptibility testing were done using VITEK® 2 Compact system (BioMérieux). Double disc synergy test and modified hodge tests were done as confirmatory tests for ESBLs and Carbapenamase phenotypes respectively. Polymerase Chain Reaction was used for the detection of blaCTX-M, blaTEM, blaSHV, blaKPC and blaOXA-48 genes. Results: From the 238 children sampled the prevalence of UTI caused by Enterobactericeae was 22.3%. The Enterobacteriaceae species isolated were Escherichia coli (84.9%), Klebsiella pneumoniae (5.66%), Proteus mirabillis (5.66%), Enterobacter aerogenes (1.89%) and Morganella morganii (1.89%). The isolated species were resistant to ampicillin. Meropenem had the highest susceptibility. Only E. coli species had the ESBLs (26.4%) and carbapenamase (1.9%) phenotypes. 100% had BlaCTX-M while 50% had blaTEM resistant gene. There was a significant association (p Conclusion: Ampicillin resistance resulted to use of alternative drugs and Meropenem was the drug of choice where increased resistance to the recommended drugs was noted. Further research on resistant genes is recommended.

关键词： Enterobactericeae Urinary Tract Infection Prevalence Beta Lactamases Polymerase Chain Reaction Children Outpatient Antimicrobial Resistance Phenotypes Escherichia coli

Assessment of Occupational Radiation Exposure for Radiotherapy Healthcare Workers at Kenyatta National hospital Using Thermoluminescence Dosimeter LiF:Mg,Ti

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Journal of Geoscience and Environment Protection 2024年第7期12卷 14-24页

作者： Collins Omondi Margaret Chege Samson Omondi Department of Physics Kenyatta University Nairobi Kenya College of Health Physics Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya

Kenyatta National hospital (KNH) is the largest public referral hospital with a comprehensive cancer treatment facility in East and Central Africa. Occupational radiation monitoring is a significant technique for demonstrating compliance of radiation regulatory limits. The objective of the study was to carry out assessment of occupational radiation exposure among radiotherapy personnel at KNH using thermoluminescence dosimeter, TLD. KNH staff were monitored using dosimeter type TLD-100 made of LiF:Mg,Ti, on monthly basis. The reader system used for analysis was Harshaw 8800. The measurement established the average monthly accumulated occupational personnel dose for KNH to be 0.21 mSv and 0.29 mSv for Hp (10) and Hp (0.07) respectively. The accumulated dose results were within the maximum acceptable dose of 1.67 mSv/month and 41.6 mSv/month for Hp (10) and Hp (0.07) respectively. The investigation results were higher than the acceptable public limit of 0.08 mSv/month. Moreover, incidences were noted where the fetus dose limit 0.42 was also exceeded. Evaluation of statistical dose exposure among doctors, nurses and radiographers’ measurement results were within ±0.02 mSv. The study established the average KNH occupational radiation exposure levels for both Hp (10) and Hp (0.07) were within the ICRU recommendation, validating radiation protection safe practice. Data analysis of healthcare workers did not indicate exposure trend biased to any healthcare profession. Hence radiation risk cut across all professional categories. It is recommended that Radiation Monitoring program be reviewed to include non-clinical staff who access the facility. Radiation reporting should not be limited to one facility, but reflect cases where workers are involved in multiple multiple jobs.

关键词： Occupational Monitoring Exposure Thermoluminescence Dosimeter and Radiotherapy

Characteristics of Archived Coagulase Negative <i>Staphylococci</i>Isolates at a University hospital, nairobi, Kenya

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Open Journal of Medical Microbiology 2014年第4期4卷 236-241页

作者： Shivachi Patricia Ingato Andrew Nyerere Kimang’a Geoffrey Omuse Samuel Kariuki Revathi Gunturu Victor Dinda Jomo Kenyatta University of Agriculture and Technology Itromid KEMRI Nairobi Kenya Aga Khan University hospital Nairobi Kenya Centres for Microbiology Research KEMRI Nairobi Kenya Masinde Muliro University of Science and Technology Nairobi Kenya

Background: Coagulase negative Staphylococci (CoNS) are normal inhabitants of the skin and mucous membranes and thus have been dismissed for a long time as culture contaminants even if they have been isolated from sterile specimens. The risk factors for CoNS infections include patients who are immunocompromised, implanted with foreign bodies or with indwelling devices. The aim of this study was to determine the antimicrobial susceptibility patterns and presence of mecA gene in methicillin resistant CoNS isolated in a teaching and referral hospital in Kenya. Methodology: This was a cross sectional retrospective study. Archived isolates were sub-cultured on 5% sheep blood agar. Speciation and antimicrobial susceptibility patterns were performed by Vitek2 technique. The presence of mecA gene was determined by (PCR). Results: A total of seven species were identified with Staphylococcus epidermidis having the highest percentage at 45.4% and Staphylococcus warneri with the lowest at 2.6%. High resistance to antibiotics that were tested was observed regardless of the source of the isolate. MecA gene was found in 90% of the isolates. Conclusion: Coagulase negative Staphylococci exhibited high levels of resistance generally. Most of the isolates carried the mecA gene. Despite some of the isolates being resistant to Cefoxitin, the mecA gene was not found. There is a possibility that methicillin resistance in these isolates is mediated using a different mechanism.

关键词： Coagulase Negative Staphylococcus (CoNS) Antimicrobial Susceptibility Patterns Methicillin Resistance

Development and Application of Integrated Indicators for Assessing Healthcare Waste Management Systems in Kenyan hospitals

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Open Journal of Applied Sciences 2024年第4期14卷 1080-1120页

作者： Muriithi Jackson Githinji Paul Mwangi Njogu Zipporah Nganga Mohamed Karama Institute of Tropical Medicine and Infectious Diseases (ITROMID) Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya Institute of Energy and Environmental Technology Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya Academic Research and Student Affairs South Eastern Kenya University Kitui Kenya School of Public Health Amref International University Nairobi Kenya

Healthcare waste management (HCWM) is an important aspect of healthcare delivery globally because of its hazardous and infectious components that have potential for adverse health and environmental impacts. The paper introduces a set of indicators for assessing HCWM systems in hospitals. These indicators are: HCWM policies and standard operating procedures, management and oversight, logistics and budget support, training and occupational health and safety, and treatment, disposal and waste treatment equipment housing. By plotting a mark on a continuum which is defined as good and poor on the extremes and is connected with all other marks in a spoke arrangement, it’s possible to describe a baseline for HCWM in any specific hospital. This baseline can be used to improve awareness of the actors and policy-makers, compare the same hospital at a different point in time, to compare observations by different evaluators and to track improvements. Results suggest that in Kenya, the application of such indicators is useful for evaluating which priorities should be addressed to improve outcomes in HCWM systems. Systematic sampling technique was used to identify and collect data by use of observational checklist, interviews, visual verification and review of documents and a HCWM assessment tool. The objective is to suggest an integrated management tool as a method to identify prevailing problems with a HCWM system. The method can be replicated in other contexts worldwide, with a focus on the developing world. The integrated indicators focus on management of HCW and not its potential impact on human health and environment, an area recognized to be critical for future research.

关键词： Developing Countries HCW Management Indicators Management Tools

A 19-year audit of benign jaw tumours and tumour-like lesions in a teaching hospital in nairobi, Kenya

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Open Journal of Stomatology 2012年第1期2卷 54-59页

作者： Fawzia M. Afrid Butt Julius Ogengo Jyoti Bahra Mark L. Chindia Elizabeth A. O. Dimba Evelyn Wagaiyu Dental Surgeon Nairobi Kenya Department of Periodontology University of Nairobi Nairobi Kenya Department Oral & Maxillofacial Surgery Oral Pathology & Medicine University of Nairobi Nairobi Kenya Dept. Oral & Maxillofacial Surgery University of Nairobi Nairobi Kenya Human Anatomy University of nairobi Nairobi Kenya

Background: The diversity of benign jaw tumours may cause difficulty in a correct diagnosis and insti-tution of an appropriate treatment. Data on the prevalence of these tumours is scarce from the Afri-can continent. We present a 19-year audit of benign jaw tumours and tumour-like lesions at a University teaching hospital in nairobi, Kenya. Methods: Histo-pathological records were retrieved and re-examined from the Department of Oral and Maxillofacial pathology, University of nairobi from 1992 to 2011. The jaw tumours were classified according to the latest WHO classification. Results: During the 19-year audit, 4257 biopsies were processed of which 597 (14.02%) were jaw tumours within an age range of between 4 to 86 years. There was greater number of odontogenic tumours 417 (69.85%) than the bone related lesions 180 (30.15%). Of the odontogenic tumours, the epithetlial and in the bone related types, the fibro-osseous lesions were frequent. Conclusion: Ameloblastoma and ossifying fibroma were the most frequent tumours reported in this audit. The information regarding the prevalence of these tumours is scarce from the continent and can be useful in early detection and management before they cause facial deformity.

关键词： Benign Jaw Tumours Odontogenic Tumours Bone Related Lesions