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The level of patients’ satisfaction and perception on quality of nursing services in the Renal unit, Kenyatta National hospital nairobi, Kenya

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Open Journal of Nursing 2013年第2期3卷 186-194页

作者： James Ndambuki School of Nursing Sciences The University of Nairobi Nairobi Kenya

Introduction: Renal failure is on the increase and patients have to identify with renal services and centres where services for renal replacement therapies are rendered. This calls for health care workers to offer services that are perceived as quality and satisfying in order to meet the biophysical and psychological needs of the patients. Study design: This was a descriptive cross-sectional study undertaken at the Renal unit of Kenyatta National hospital (KNH). Purpose: The study aimed at determining the level of satisfaction and perception of the quality of nursing services in the Renal unit. Methodology: The study population included all patients who were seeking dialysis services during one month period of data collection. The sample size was 151 following data collection. Data collection tools consisted of semi-structured questionnaires which were administered with the aid of research assistants as well as checklists which were self administered. Data analysis and results: Analysis of data was performed using the statistical package of social sciences (SPSS) version 16. Results of data analysis were presented in form of descriptive statistics which included mean, standard deviation and percentages. Regression analysis, t-test and ANOVA were conducted to determine demographic predictors of patient satisfaction with the nursing services. The results of the study revealed that patients in the Renal unit were generally satisfied with the nursing services. The aggregate mean score for all patients on Likert scale was 71.2 out of 105, with a standard deviation of 16.8. Level of satisfaction was 67.8%. The findings also showed that there was no association between demographic characteristics with the levels of satisfaction with the nursing services. Recommendation: The hospital should keep the patients’ level of satisfaction high and maintain it through the provision of more dialysis machines and hiring more nurses.

关键词： Quality Health Care Patient Satisfaction Utilization of Nursing Services

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Prevalence of Disrespectful Maternity Care and Abuse among Women Seeking Maternity Care Services at the Kenyatta National hospital, nairobi: A Cross-Sectional Descriptive Study

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Open Journal of Obstetrics and Gynecology 2018年第6期8卷 610-629页

作者： Ondieki Peter Atai Hannah Inyama Sabina Wakasiaka Joyce Jebet Jennifer Oyieke Department of Midwifery and Obstetric Nursing School of Nursing Sciences University of Nairobi Nairobi Kenya

Background: Respectful Maternity Care (RMC) is a basic human right for every childbearing woman. Acts of disrespectful maternity care and abuse are commonly reported worldwide and are recognized as a powerful deterrence to facility based childbirth than the traditionally known accessibility. In Kenya, acts of disrespect and abuse are frequently reported. Objectives of the study: To assess the prevalence of disrespectful maternity care and abuse among women seeking maternity care services at the Kenyatta National hospital, nairobi. Methods: This study was conducted at the Kenyatta National hospital maternity wards. A descriptive study design was employed and targeted 164 respondents. The study utilized an interviewer administered questionnaire and an observational checklist to collect required data. Participants were sampled using simple random sampling method. Data was collected between July 15th and July 30th 2017 and was entered, cleaned and analyzed using SPSS 20. Results were presented in descriptive form, figures and tables. Results: Out of the targeted 164 participants, 152 (93%) women were interviewed during the study. The study found that women experienced at least some form of disrespect and abuse while seeking maternity care services at the Kenyatta National hospital. In general, prevalence of disrespectful maternity care and abuse ranged from 9% for discriminatory care to as high as 32% for non-privacy of care. Untimely care/abandonment of care was 22%, similar to non-consensual care (22%). Prevalence for non-confidential care was 28%. Majority of the women who experienced disrespect and abuse chose to resort to acquiescence whereby they just complied or kept quiet. The study found a strong association between marital status and physical abuse of women in labor 95% CI (P < 0.000) and level of education was found to be strongly associated with right to information 95% CI (P = 0.029). Conclusion: There are significant levels of disrespect and abuse among wo

关键词： Disrespect Abuse

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Levels of Polycyclic Aromatic Hydrocarbons (PAHs) in Healthcare Waste Incinerators’ Bottom Ash from Five County hospitals in Kenya

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Journal of Environmental Protection 2024年第3期15卷 318-337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 Public Health and Epidemiology Umma University Kajiado Kenya

Health-care waste contains potentially harmful microorganisms and compounds which can infect and affect hospital patients, healthcare workers, the general public and environment. Therefore, management of health care waste requires safe handling, treatment and disposal procedures. While incineration reduces the volume and quantity of waste for final disposal, it leads to the production of fly and bottom ashes laden with toxic incomplete combustion products such as Polycyclic Aromatic Hydrocarbons (PAHs), dioxins, furans and heavy metals. This exposes workers who handle and dispose the bottom ashes, hospital patients, the general public and environment. The goal of this study was to determine the total and individual levels of 16 most prevalent and toxic PAHs. Bottom ash samples were collected from incinerators in five county hospitals in Kenya, namely;Moi-Voi, Narok, Kitale, Makindu and Isiolo. Bottom ash samples were collected over a period of six months from the five hospitals. The samples were then sieved, homogenised and stored at 4°C in amber coloured glass containers. The PAHs were extracted using 30 ml of a hexane-acetone solvent (1:1) mixture by ultrasonication at room temperature (23°C) for 45 minutes. The PAHs were then analyzed with a GC-MS spectrophotometer model (Shimadzu GCMS-QP2010 SE) connected to a computer work station was used for the PAHs analysis. The GC-MS was equipped with an SGE BPX5 GC capillary column (30 m × 0.25 mm × 0.25 μm) for the separation of compounds. Helium was used as the carrier gas at a flow rate of 15.5 ml/minute and 14.5 psi. 1 μl of the sample was injected at 280°C, split mode (10:1). The oven programming was set for a total runtime of 40 minutes, which included: 100°C (2-minute hold);10°C /min rise to 200°C;7°C /min rise to 249°C;3°C /min rise to 300°C (2-minute hold). The interface temperature was set at 290°C. Analysis was done in Selected Ion Monitoring (SIM) mode and the peak areas of each of the PAHs were collected from

关键词： PAHs GC-MS Healthcare Wastes Disposal Incinerator Bottom Ash

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Urinary Tract Infection among Pregnant Women at Pumwani Maternity hospital, nairobi, Kenya: Bacterial Etiologic Agents, Antimicrobial Susceptibility Profiles and Associated Risk Factors

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Advances in Microbiology 2018年第3期8卷 175-187页

作者： Hellen A. Onyango Carolyne Ngugi John Maina John Kiiru Department of Medical Microbiology Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya Department of Medical Microbiology College of Health Sciences Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya Centre of Microbiology Research Kenya Medical Research Institute Nairobi Kenya

Urinary Tract Infections (UTIs) during pregnancy are among the most common infections worldwide and can lead to poor perinatal and maternal outcomes. This study determined the prevalence of UTIs during pregnancy, associated risk factors and antimicrobial susceptibility profiles of associated bacterial pathogens. A cross-sectional study was conducted among 210 pregnant women attending antenatal clinic at Pumwani Maternity hospital. Their social-demographic profiles were obtained using a structured questionnaire. Cultures were done from midstream urine and antimicrobial susceptibility testing determined using the disc diffusion test. The overall prevalence of UTI was 15.7% regardless of the women’s age, parity and stage of gestation. Prevalence of asymptomatic and symptomatic bacteriuria was 4.3% and 11.4% respectively. Material of undergarment and frequency of changing the undergarments were found to contribute significantly to the acquisition of UTI (P < 0.05). E. coli was the most predominant UTI organism at (44.5%) followed by K. pneumoniae (21.2%) and S. aureus (15.1%). Almost a half (over 49%) of all Gram-negative organisms showed resistance prevalence against third generation cephalosporins, fluoroquinolones, Sulfamethoxazole-Trimethoprim, Cefoxitin, Nitrofurantoin and Amoxicillin-clavulanic acid. Gram-positive strains were susceptible to Amoxicillin-clavulanic acid, Nitrofurantoin, Linezolid and Ofloxacin. The prevalence of multi-drug resistance (MDR) in all study isolates was 96%. Our data suggest a serious resistance trend among UTI strains and more should be done to slow down this trend. Pregnant women should be screened by urine culture and treatment be guided by the antimicrobial susceptibility data.

关键词： Urinary Tract Infection Pregnancy Risk Factors Antimicrobial Resistance ESBL MRSA MDR

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Prevalence and Predictors of Neonatal Sepsis among Neonates Admitted at the Newborn Unit of Kenyatta National hospital, nairobi, Kenya

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Open Journal of Obstetrics and Gynecology 2020年第9期10卷 1216-1232页

作者： Okubatsion Tekeste Okube Mercy Komen School of Nursing The Catholic University of Eastern Africa Nairobi Kenya

Background: Neonatal sepsis is one of the primary causes of neonatal morbidity and mortality especially in developing countries. Despite the availability of different preventive interventions, in Kenya, the burden of neonatal sepsis remains critically high. Aim: To determine the prevalence and predictors of neonatal sepsis among newborns admitted at the newborn unit of Kenyatta National Hospital, Kenya. Methods: This is a hospital-based, cross-sectional study design carried out among 196 neonates and their mothers at the new born unit of Kenyatta National Hospital. A systematic random sampling technique was employed to select the study subjects. Data on the possible contributing factors of neonatal sepsis was collected using a semi-structured questionnaire. Statistical analyses were performed using the statistical package for the Social Sciences (SPSS: version 22). Data were descriptively analyzed into frequencies and proportions. The chi-square test of independence and binary logistic regression were employed to determine associations between the dependent (neonatal sepsis) and various independents variables. A multiple logistic regression model was carried out to determine the variables independently contributed to the occurrence of neonatal sepsis. Results: Our study revealed that the prevalence of neonatal seps

关键词： Preterm Birth Neonatal Sepsis Predictors of Neonatal Sepsis Kenya

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Determinants of Preterm Birth at the Postnatal Ward of Kenyatta National hospital, nairobi, Kenya

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Open Journal of Obstetrics and Gynecology 2017年第9期7卷 973-988页

作者： Okubatsion Tekeste Okube Lillian Moraa Sambu Regina Pacis Institute of Health Sciences The Catholic University of Eastern Africa (CUEA) Nairobi Kenya

Background: Preterm birth, delivery prior to 37 completed weeks or 259 days gestation, is a worldwide maternal and perinatal challenge and is a leading cause of neonatal morbidity and mortality. Preterm birth remains the leading cause of perinatal and postnatal mortality and morbidity especially in developing countries where the health care services are suffering from limited resources. Premature babies usually suffer from both immediate and long term consequences. Right after birth, they have difficulties in breathing, temperature regulation, bleeding, infection and other problems due to organ immaturity. Their growth and developmental milestones will also be affected leading poor physical, mental, educational and psychosocial problems as a long term consequences. Preterm deliveries were responsible for 1 million out of the 6.3 million deaths of children under5 in2013 REF _Ref493689700 \r \h \* MERGEFORMAT [1]. In Kenyatta National hospital, few studies have been carried out to determine the prevalence and factors associated with preterm birth. Hence the aim of this study is to determine the prevalence and factors associated with preterm birth at Kenyatta national hospital (KNH), nairobi, Kenya. Materials and Methods: This was a hospital based descriptive cross-sectional study involving randomly selected respondents (N = 183) from post natal ward of Kenyatta National hospital. Systematic random sampling method was applied to recruit the study respondents. A pre-tested semi-structured questionnaire was employed to collect information on the possible determinants of Preterm birth. Data was analysed usingSPSSsoftware version 22.0. Descriptive analysis was done using mean and frequency proportion. Inferential analysis using chi-square test was used to establish association different variables. The ethical approval to conduct the study was obtained from KNH-University of nairobi Ethical Review Committee (KNH-UoN ERC). Permission to collect data was sought from the KNH a

关键词： Prevalence Preterm Birth Risk Factors

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Characteristic Radiological and Histological Patterns of Fibrous Dysplasia and Ossifying Fibroma of the Jaws at University of nairobi Dental Teaching hospital

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Surgical Science 2012年第4期3卷 189-193页

作者： Jeremiah Moshy Elizabeth Dimba Tom Ocholla Mark Chindia Department of Oral and Maxillofacial Surgery—Oral Pathology and Oral Medicine University of Nairobi Nairobi Kenya Department of Oral Surgery/Oral Pathology College of Health Sciences Muhimbili University Dar es Salaam Tanzania

Objective: To characterize the diagnostic features of ossifying fibroma (OF) and fibrous dysplasia (FD) of the jaw bones. Study Design: A histopathological and radiological analysis with full clinical documentation. Setting: University of nairobi Dental Teaching hospital (UNDH). Study Population: All archival cases diagnosed as FD and OF from 1992-2006 were retrieved from the UNDH Oral Pathology Laboratory records. New cases were included as they pre-sented over a 6-month period from January to June 2007. Methodology: Information regarding the histological type of a fibro-osseous lesion (FOL) including the clinical features, demographic and radiographic data was documented for analysis;and comparison between pathological parameters and the final diagnosis was evaluated with the chi-square test. Results: FD lesions constituted 40 (27.2%) cases while 107 (72.8%) were OF. The age ranged from 1 - 72 years (mean = 24.19 ± SD 13 years). The differences in the gender distribution were not statistically significant. Radiographic analyses showed statistically significant differences between the appearances of the body (p = 0.012) and the margins (p = 0.003) of FD and OF. The microscopic differences between the two lesions were not statistically significant. Conclusion: Differentiation between FD and OF is only possible after critically analyzing the clinical, radiological and histological criteria.

关键词： Diagnostic Ossifying-Fibroma Fibrous Dysplasia Jaws

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Estimation of Burden of Kidney Dysfunction in HIV-Infected Pediatrics and Adolescents by Use of Urinary Neutrophil Gelatinase-Associated Lipocalin: A Single Center Experience in Kenya

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Infectious Diseases & Immunity 2022年第1期2卷 9-14页

作者： Anne P.Lomole William M.Macharia Mary S.Limbe Doris W.Kinuthia Samuel K.Kabinga Aga Khan University Medical College East AfricaAga Khan University HospitalNairobiKenya University of nairobi East African Kidney InstituteNairobiKenya

Background:About 75%of patients infected with human immunodeficiency virus(HIV)live in sub-Saharan *** Kenya,about 1.5 million Kenyans are living with HIV,of whom almost 100,000 are children and *** active antiretroviral therapy(HAART)has converted HIV infection to a chronic illness with its attendant *** disease is a common complication of HIV infection and its *** disease in HIV-infected persons can be asymptomatic,insidious onset and may lack specific clinical *** can only be detected on active *** urine albumin-to-creatinine ratio and estimated glomerular filtration rate(eGFR)using serum creatinine are not sensitive in identification of early kidney *** neutrophil gelatinase-associated lipocalin(uNGAL)has been used as marker of early kidney ***:This cross-sectional study used uNGAL and serum creatinine to determine the prevalence of kidney dysfunction in HIVinfected children and adolescents with HAART at Gertrude’s Children’s hospital,nairobi,Kenya,from March 2016 to February *** samples were assayed for uNGAL using the Bio Porto®enzyme-linked immunosorbent *** creatinine was assayed using the Jaffe reaction in the Cobas®6000 biochemistry analyzer and eGFR calculated using the Schwartz *** plot of eGFR against log uNGAL levles was performed by Statistical Package for Social Sciences and Pearson correlation coefficeint between log uNGAL levles and eGFR was ***:Ninety-three patients were *** mean age was 11.8±3.6 years and the median duration on HAART was 72.6 *** were 47(50.5%).The prevalence of kidney dysfunction using uNGAL was 15.1%(95%CI 7.6%–22.5%)and 5.4%(95%CI 1.8%–12.1%)by *** mean eGFR was 131±25mL·min1·1.73m2 and median uNGAL was 10 ng/*** every one ng/mL increase in uNGAL value above the normal value,eGFR decreases by 4.8mL·min1·1.73m2(P=0.038).Patients with elevated uNGAL were older when co

关键词： HIV Estimated glomerular filtration rate Highly active antiretroviral therapy Kidney disease Serum creatinine uNGAL

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Overview of dyslipidemia and metabolic syndrome in myeloproliferative neoplasms

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World Journal of Clinical Oncology 2024年第6期15卷 717-729页

作者： Mihnea-Alexandru Găman Bahadar Singh Srichawla Yong-Feng Chen Poulami Roy Arkadeep Dhali Ahmed Nahian Muhammad Romail Manan Vincent Kipkorir Richard Christian Suteja Lakshmi Venkata Simhachalam Kutikuppala Amelia Maria Găman Camelia Cristina Diaconu Faculty of Medicine “Carol Davila”University of Medicine and PharmacyBucharest 050474Romania Department of Hematology Center of Hematolog Department of Cellular and Molecular Pathology Stefan S Nicolau Institute of VirologyRomanian AcademyBucharest 030304Romania Department of Neurology University of Massachusetts Chan Medical SchoolWorcesterMA 01655United States Department of Basic Medical Sciences School of Medicine of Taizhou UniversityTaizhou UniversityTaizhou 318000Zhejiang ProvinceChina Department of Medicine North Bengal Medical College and HospitalWest Bengal 734012India Academic Department of Gastroenterology Sheffield Teaching Hospitals NHS Foundation TrustSheffield S57AUUnited Kingdom Lecom at Seton Hill GreensburgPA 15601United States Faculty of Medicine Services HospitalLahore 54000Pakistan Department of Human Anatomy and Physiology University of NairobiNairobi 00100Kenya Faculty of Medicine Udayana UniversityDenpasarBali 80361Indonesia Department of General Surgery Dr.NTR University of Health SciencesVijayawada 520008Andhra PradeshIndia Department of Pathophysiology University of Medicine and Pharmacy of CraiovaCraiova 200349Romania Clinic of Hematology Filantropia City HospitalCraiova 200143Romania Department of Internal Medicine Faculty of Medicine“Carol Davila”University of Medicine and PharmacyBucharest 050474Romania Internal Medicine Clinic Clinical Emergency Hospital of BucharestBucharest 105402Romania

Myeloproliferative neoplasms(MPNs)occur due to the abnormal proliferation of one or more terminal myeloid cell lines in peripheral *** suffering from MPNs display a high burden of cardiovascular risk factors,and thrombotic events are often the cause of death in this population of ***,we provide a brief overview of dyslipidemia and metabolic syndrome and their epidemiology in MPNs and examine the common molecular mechanisms between dyslipidemia,metabolic syndrome,and MPNs,with a special focus on cardio-vascular risk,atherosclerosis,and thrombotic ***,we investigate the impact of dyslipidemia and metabolic syndrome on the occurrence and survival of thrombosis in MPN patients,as well as the management of dyslipidemia in MPNs,and the impact of MPN treatment on serum lipid concentrations,particularly as side/adverse effects reported in the context of clinical trials.

关键词： Polycythemia vera Essential thrombocythemia Myelofibrosis Cardiovascular disease Hypercholesterolemia Hypertriglyceridemia Obesity Diabetes Inflammation Oxidative stress

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Concordance between bio-impedance analysis and clinical score in fluid-status assessment of maintenance haemodialysis patients: A single centre experience

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World Journal of Nephrology 2022年第4期11卷 127-138页

作者： Kamiti Muchiri Joshua K Kayima Elijah N Ogola Seth McLigeyo Sally W Ndung’u Samuel K Kabinga Clinical Medicine and Therapeutics University of NairobiNairobi+254Kenya Department of Clinical Medicine and Therapeutics University of NairobiNairobi+254Kenya Department of Public Health University of NairobiNairobi+254Kenya East African Kidney Institute University of NairobiNairobi+254Kenya

BACKGROUND The burden of chronic kidney disease(CKD)is rising rapidly *** overload(FO),an independent predictor of mortality in CKD,should be accurately assessed to guide estimation of the volume of fluid to be removed during haemodialysis(HD).Clinical score(CS)and bio-impedance analysis(BIA)have been utilized in assessment of FO and BIA has demonstrated reproducibility and accuracy in determination of fluid status in patients on *** is need to determine the performance of locally-developed CSs in fluid status assessment when evaluated against *** To assess the hydration status of patients on maintenance HD using BIA and a CS,as well as to evaluate the performance of that CS against BIA in fluid status *** This was a single-centre,hospital-based cross-sectional study which recruited adult patients with CKD who were on maintenance HD at Kenyatta National *** patients were aged 18 years and above and had been on maintenance HD for at least 3 *** with pacemakers,metallic implants,or bilateral limbs amputations were *** on the patients’clinical history,physical examination,and chest radiograph findings were *** was performed on each of the study participants using the Quantum®II bio-impedance analyser manufactured by RJL Systems together with the BC 4®*** evaluating the performance of the CS,BIA was considered as the gold standard test.A 2-by-2 table of the participants’fluid status at each of the CS values obtained compared to their paired BIA results was constructed(either++,+-,--or-+for FO using the CS and BIA,respectively).The results from this 2-by-2 table were used to compute the sensitivity and specificity of the CS at the various reference points and subsequently plot a receiver operating characteristic(ROC)curve that was used to determine the best cut-off *** above and below the best CS cut-off point as determined by the ROC were classified as being positive and negative for FO

关键词： Bio-impedance analysis Clinical score Chronic kidney disease Maintenance haemodialysis Fluid overload Concordance

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