Browsing by Author "Kirira, Peter"

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    Association between Metabolic Syndrome and Substance Dependence: A Cross-Sectional Study in Kenya
    (European Journal of Medical and Health Sciences, 2022-06-28) Mbuguah, Samuel Mungai; Mecha, Ezekiel; Kirira, Peter; Njoroge, Margaret; Malala, Boniface; Gitaka, Jesse; Makokha, Francis; Mwenda, Catherine
    Metabolic syndrome and its defining components remain an understudied area of human health research in Kenya and Africa. Understanding the relationship between substance dependence and the occurrence of metabolic syndrome is critical in prevention and clinical management of the related complications. This was a cross-sectional study in 6 rehabilitative centers in 3 counties in Kenya with a conveniently selected sample size of 166 participants. A signed informed consent was obtained from each participant following which anthropometric and biochemical measurements were obtained. Descriptive statistics and chi-square test were used to describe the prevalence of metabolic syndrome and the relationship of the defining criteria with the substance of dependence. A quarter of the respondents were overweight and 6% obese. Fasting blood glucose was elevated in 62% of the sampled population with triglycerides having a significant variation with a mean of 216.95mg/ dL and a standard deviation of 151.107. A prevalence rate of 4.8% was established based on the Harmonized Joint Scientific Statement on Metabolic syndrome for the African region. 87.34% of the population showed at least one elevated defining criteria with alcohol as the most prevalent substance of dependence. There was statistical difference of fasting blood glucose and triglycerides with alcohol use. The findings indicate that alcohol use resulted to elevated levels of fasting blood glucose and triglycerides. There is need for emphasis on a multidisciplinary approach to substance dependence and metabolic syndrome management integrating physical activity interventions, dietary modifications and psychotherapeutic approaches.
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    Improving Access to Safe Water in Rural Schools of Kenya: Qualitative Multisectoral Insights
    (Cureus., 2023-11-21) Kirira, Peter; Oyatsi, Fiona; Waudo, Ashley; Mbugua, Samuel Mungai
    Background: Comprehensive strategies in water, sanitation, and appropriate hygiene behaviors can improve school enrollment and improve gender parity disparities. Lack of safe drinking water negatively impacts the social capital of people, especially school-going children in rural areas. In this study, we systematically evaluated and documented evidence on the barriers and facilitators in the access and adoption of safe water practices in rural schools in Laikipia County, Kenya. Methods: An ethnographic formative, collaborative implementation research design was used in an iterative and participatory process to evaluate community, socio-economic, and health system-related factors affecting water, hygiene, and sanitation strategies. Qualitative data was collected using key informant interviews (n=5) and focus groups (n=3) from various multisectoral participants. Directed content analysis was used to develop codes, categories, and themes from textual data. Data was organized according to the Promoting Action on Research Implementation in Health Services framework. Results: The findings were classified and described under three key elements: context, evidence, and facilitation. Contextual elements showed an association of diarrhea outbreaks with unsafe hygiene practices compounded by water scarcity. The evidence elements were indicative of the applicability of water backpacks in strengthening handwashing, storage, and transport of water. Facilitation elements indicated evidence of gaps in synergy between the school health and public health systems, necessitating multisectoral collaboration and social capital capacity building. Conclusion: The national and county governments play an imperative role in ensuring access and continuous supply of safe drinking water in schools. This is fundamental in efforts towards reducing social inequalities of health among school-going children and building their social capital. Participatory, collaborative, multisectoral interventions and decision-making are crucial, leveraging on creating local ownership, in meeting the water consumption needs of children and communities in water-scarce regions.