Medical/Surgical Nursing

Permanent URI for this collectionhttp://erepository.kibu.ac.ke/handle/123456789/690

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Devolution of healthcare system in Kenya: Progress and challenges
(Elsevier, 2020) Masaba, Brian Barasa; Moturi, John Kennedy; Mmusi-Phetoe, Rose
The healthcare system and client failures contributing to maternal mortality in rural Kenya
(BMC Pregnancy and Childbirth, 2022) Masaba, Brian Barasa; Mmusi-Phetoe, Rose; Moturi, John Kennedy; Kabo, Jane Wamuyu
The global maternal mortality ratio is estimated at 211/100 000 live births in 2017. In Kenya, progress on reducing maternal mortality appears to be slow and persistently higher than the global average, despite eforts by the government’s provision of free maternity services in both private and public facilities in 2013. We aimed to explore and describe the experiences of midwives on maternal deaths that are associated with the healthcare system and client failures in Migori, Kenya.
Drivers of early marriage and teenage pregnancy in Kenya and Uganda during COVID‑19 lockdown period: A systematic review
(Journal of Integrative Nursing, 2023-01-06) Masaba, Brian Barasa; Mmusi-Phetoe, Rose; Kabo, Jane Wamuyu; Moturi, John Kennedy
The present study aimed to explore the drivers of early marriage and teenage pregnancy in Kenya and Uganda during COVID‑19 lockdown period. A systematic review design was adopted. The major online databases utilized were PubMed, Google Scholar, Uganda and Kenya Ministry of Health repositories, ScienceDirect, and Scopus. Studies that were originating from Kenya and Uganda that were publicly available in electronic format published from March 2020 to March 2022 were used. The thematic analysis identified major concepts that were drivers to the present research problem which were as follows: (1) school closure and (2) loss of income by parents. The COVID‑19 containment measures introduced in the two countries were noted as major contributing factors. During the pandemic, lockdown led to school closures which meant the teenagers being idle at home with an increased opportunity to indulge in sexual risk behaviors. Schools have been noted to be a safe place protecting this vulnerable population. However, with their prolonged closure, the teenagers were exposed to sexual predators. Parents lost income, and this might have contributed to early marriages and teenagers’ dependency on their sexual partners. Based on the reviewed evidence, the present study furthers the advocacy for the reduction of early marriages and teenage pregnancy, especially in the current COVID‑19 pandemic era. The study calls upon the governments to intensify efforts toward the present research problem as the COVID‑19 pandemic is eroding the earlier gains made within the region.
Sociodemographic factors associated with mothers’ experiences of psychosocial care and communication by midwives during childbirth in Nairobi, Kenya
(KIBU, 2019-08-05) Kabo, Jane; Holroyd, Eleanor; Edwards, Grace; Sarki, Ahmed
Purpose: To clarify sociodemographic and socioeconomic factors associated with mothers’ experiences of psychosocial care and communication by midwives during childbirth in Nairobi, Kenya. Design: A descriptive cross-sectional study conducted in a government national referral hospital. Respondents were 109 systematically sampled mothers who delivered in the study hospital. Mothers’ experiences of intrapartum care were assessed using three subscales from the Experience of Psychosocial Care and Communication during Childbirth Questionnaire (effective communication; emotional support; and respect, care and dignity). Simple and multivariable logistic regression analyses were used to assess associations between sociodemographic factors, socioeconomic factors and mothers’ experiences of intrapartum care. Findings: The majority of respondents were aged 20–24 years (45.9%), married (71.6%), had primary school education (48.6%) and were self-employed (45%). The majority reported positive experiences of communication, respect, dignity and emotional support from their midwives. Being an older mother was significantly associated with a positive experience of intrapartum care (adjusted odds ratio [AOR] 7.32; 95% Confidence Interval (CI): 1.17–45.9). The odds of having a positive intrapartum care experience was significantly lower among women with parity of four or more (AOR 0.09; 95% CI: 0.01–0.56) and tertiary education (AOR 0.11; 95% CI: 0.01–0.91). Conclusion: Attention to the use of respectful language and adherence to clear communication must be an integral part of quality improvement for midwifery care in Kenya.
Experiences and associated factors in quality of delivery care at the Kenyatta National Hospital
(KIBU, 2013-08) Kabo, Jane
The fifth Millennium Development Goal calls for a reduction in the maternal mortality ratio by 75% between 1990 and 2015, with a key indicator being the proportion of births attended to by skilled health personnel (United Nations 2007). In Sub-Saharan Africa approximately 40% of women deliver with a skilled attendant. In Sub-Saharan Africa, little research has been carried out on the experience of quality in facility-based delivery care and factors associated with delivery care. This was a cross sectional descriptive study that focuses on experience and associated factors of delivery care by postnatal mothers in the Kenyatta National Referral Hospital in Nairobi, Kenya. The main objective was to describe the experience of quality in delivery care among women who delivered in the health facility; and their perception of the care. Systematic sampling was employed to recruit post-natal mothers who delivered in KNH labour ward and four postnatal wards. A total of 109 participants were recruited into the study, postnatal wards were purposely selected. Training of research assistant was done before data collection. Data was collected using structured and semi-structured questionnaires to respondents within 48 hours after delivery. Qualitative data was collected by use of case studies and key informant interviews. Data was analyzed using ANOVA. Research results were presented in frequency distribution tables, graphs and charts. P-values were used to calculate the statistical significance of the results obtained The average age of the participants was 26 years (SD 4.5), close to thirty eight percent (37.6%) of the participants had a parity of three. Most (95.4%) of the deliveries were uncomplicated and five (4.6%) participants had complicated births. Views and experiences of recently delivered women were elicited using a five-point Likert scale questionnaire focusing on four dimensions of participants’ intrapartum experience. The participants attending KNH for second delivery viewed providers as respectful (p = 0.043), effective in explaining labor and delivery (p = 0.019) and seeking patient consent before procedures (p = 0.008). Most participants (87.7%) agreed that they were treated respectfully, accorded privacy and asked to consent to procedures, prior to the initiation of these procedures. Ninety percent of participants agreed that the health providers explained what to expect during labor, listened to participants concerns and clearly explained to clients their condition. However 8% of the respondents disagreed with this statement. Most participants (n = 102, 93.6%) said they would recommend delivery services at KNH to friends or family, although 6% of them said they would not recommend. In conclusion, the study showed majority of the participants rated most of the delivery care aspects highly and therefore had a good experience of delivery care though few aspects were rated poorly. There is need for the hospital management to increase the staff patient ratios in labour ward to care for women in labour especially with the increase in numbers of mothers delivering in the institution following provision of free maternity services by the government. The management also needs to plan on increasing the number of beds in labour rooms and also delivery rooms as well provision of privacy in these rooms.
Factors influencing high prevalence of Fresh Still Births in Mbagathi County Hospital, Nairobi - Kenya
(KIBU, 2018-01) Kabo, Jane; Ongeso, Abednego; Lukorito, Magdalene
The annual global burden of stillbirths is approximately 2.6 million, 98% of which occur in Sub Saharan Africa. In 2016, approximately 24 still births per month occurred in Mbagathi County Hospital (MCH) representing a 33.3% increase from 2015. A third of these were Fresh Still Births (FSBs).
Experiences in Care Given During Child Birth at a Referral Hospital in Kenya
(KIBU, 2016-01) Kabo, Jane; Karani, A; Oyieke, J; Wakoli, B. A.; Cheruiyot, B
The fifth Millennium development Goal (MDG) calls for a reduction in the maternal mortality ratio (MMR) by 75% between 1990 and 2015, with a key indicator being the proportion of births attended to by skilled health personnel, (United Nations, 2007). In Kenya the MMR is 400 and has made insufficient progress towards improving maternal health, (UNICEF, WHO, World Bank, 2013). According to KDHS (2014), the proportion of skilled birth attendance is 46.5%, while in Kenya it is 62% against an MDG target of 90%. According to Zaers S., et al., (2008), prior experience in delivery care by skilled attendants affects their subsequent use of these services. In Africa little research has been carried out on the experiences of mothers in facility-based delivery care. This study was therefore set to describe the experiences of women during labour and delivery at a referral hospital in Kenya This was a cross sectional descriptive study that focused on experiences of delivery care by postnatal mothers at a referral hospital in Kenya. Systematic random sampling from a sampling frame of 327 was employed to recruit post-natal mothers who delivered in labour ward and four postnatal wards. A total of 109 participants were recruited into the study. Views and experiences of recently delivered women were elicited using a five-point Likert scale questionnaire focusing on four dimensions of participants’ intrapartum experience. Data was analyzed using ANOVA. Research results were presented in frequency distribution tables, graphs and charts. P-values were used to determine the statistical significance of the results obtained. Most participants (87.7%) agreed that they were treated with respect, accorded privacy and asked to consent, prior to the initiation of the procedures. A single aspect of communication, namely health provider explanation of health status with understandable terms was poorly rated (mean 1.8 to 2.2) as was the level of genuine interest in patient well-being (mean = 1.7 to 2.0) which was significant in the study. Most participant (n = 102(93.6%) said they would recommend delivery services at KNH to friends or family, although 6% of them said they would not recommend. Majority of the participants had a positive experience of quality in delivery care. This was evidenced by the fact that majority of then stated that they would come to deliver in the same institution again or recommend a relative or friend. Aspects of care such as health providers communicating to clients in understandable terms and showing genuine interest in patients wellbeing was rated poorly. Institutional factors such as inadequate space and shortage of staff were also noted to be significantly contributing to negative experience of delivery care in the study
High-Impact Low-Cost Interventions Implemented to Enhance the Quality of Care Given to Preterm Babies in Kilifi County, Kenya
(KIBU, 2019-02-24) Kabo, Jane
The main objective of this study was to explore and describe the implementation of national policies/guidelines regarding low-cost high-impact interventions to enhance health outcomes for preterm babies among health professionals in Kilifi County. A mixed method approach, with a convergent parallel design was used. Seventeen public health facilities were chosen purposively for the study. Census sampling for the nurses and midwives was utilized with a sampling frame of 146 nurses and midwives. Data was collected using semi structured questionnaires to the nurses and midwives (n=102); A health facility assessment tool with facility leaders (n=16); focus group discussions were held among with nurses and midwives (n=7); in-depth interviews with key informants n=seven and unstructured observation. Analysis of quantitative data was done using the Statistical Package for Social Sciences (SPSS) version 23. Descriptive statistics (i.e. mean and standard deviation for continuous variables, frequencies and percentages for discrete variables) and inferential statistics were used to answer the research questions. Qualitative data was coded and analysed thematically. The results provided rich information from several data sources highlighting a need to improve the implementation of four evidence-based practices that would enhance health outcomes for preterm babies. Guidelines/policies, important equipment and medications were not always available, which caused frustration among healthcare workers in their efforts to provide care for preterm babies. Despite common recognition of their key function, guidelines are not always adhered to, as shown in this study. Inadequate use of guidelines reflects the omission of beneficial treatments, possible avoidable harms, and suboptimal patient care. This study also established that there were associations between participants’ gender and percentage scores for knowledge and practice and implementation. The study also highlights barriers and enablers to implementation of clinical guidelines and possible strategies to effective implementation.
Knowledge, Understanding and Utilisation of High-impact Low-cost Evidenced-based Interventions for Preterm Carein Rural Kenya
(KIBU, 2019-07-25) Kabo, Jane
Approximately 25% of 4 million neonatal deaths globally are due to prematurity (WHO 2015; Gondwe et al 2017). A majority of the preterm babies deaths occurs within the the first week of life (Penfold et al 2013). 60% of the preterm births occur in sub-Saharan Africa (Baker et al 2017). Preterm birth rate in Kenya is 12.3% with some rural counties having higher rates (KDHS, 2014). International consensus exists on effectiveness of high-impact low-cost evidence-based interventions to improve preterm outcomes (WHO 2016). • Kenya has adopted and contextualised the following preterm care guidelines: – Immediate and exclusive breastfeeding – Thermal protection of the new-born: a practical guide – Kangaroo Mother Care: Clinical Implementation Guidelines – Basic paediatric protocols (Resuscitation) – Use of chlorhexidine for new-born umbilical cord care • Despite development of these guidelines, there is paucity of literature on availability and effective implementation by health professionals
Birth outcome associated with ntient linked mutlfactorialetilogy amongst HIV+ mothers attending ANC in Eastlands, Nairobi county Kenya
(KIBU, 2019-06-12) Muriuki, Joe M.
The main objective of this study was to assess to what extent insufficient nutritional intake amongst HIV+ pregnant mothers is associated with the increased risk of multiple birth outcomes. Insufficient nutritional intake leads to foetal IUGR, a direct cause of SGA, pre-term birth and LBW outcomes. Infants born with SGA, pre-term birth or LBW risk contracting neonatal infections and HIV.LBW contributes 60% to 80% of all neonatal deaths, 96.5% of which are in developing countries. 33% results from SGA and 5%-10% from preterm births. Weakened HIV+ mother’s body due to low caloric intake impairs metabolism resulting to 50% reduced effects and 33% total failures of ARV and other drugs. Poor access to sufficient food intake and unpredictability lead to increase in none adherence causing a rise in viral load and reduced CD4 counts and vulnerability to OI. Exposed HIV+ pregnant mothers were followed from the 1st trimester through the nine months and six weeks after birth and compared with experience of none exposed at ratio of 1:2. Using multistage sampling technique data was collected from 124 pregnant mothers in 18 of the 115 ANCs in Eastland’s. Closed questionnaires were used to collect socio demographic. Chi2 test of homogeneity was used for analysis of difference between exposed and none exposed risks while association was established through RR for each outcome and located within 100(1-α) % CI = RR1± z α / √ Chi 2 at 95% CL. Margin of error provided for random errors while proper selecting of subjects, gathering of information and analysis reduced systematic errors. Keyfinding was that birth outcomes were associated with insufficient nutrients. The study concluded that lack of enough nutrients during the pregnancy is a major challenge for HIV+ mothers with no or inadequate family support.
The impact of co-morbidity and treatment characteristics on adherence to tuberculosis treatment in Kisumu East Sub County, Kenya
(IOSR: Journal of Nursing and Health Science, 2017-10-01) Senghor, Morris Shisanya; Arudo, John; Oloo, James Aggrey
Despite the great strides made in TB diagnosis and highly effective shorter periods of treatment, there are still poor treatment outcomes in a significant proportion of the patients. Poor adherence to TB treatment is one of the leading causes of poor outcomes of treatment. Kisumu East Sub county in Kenya records some of the highest adverse outcomes of care. Therefore a cross sectional descriptive study was conducted in the Sub county to establish the impact of co-morbidity and treatment characteristics on TB treatment adherence among tuberculosis patients above 18 years attending TB clinics in Kisumu East Sub county. The data was analyzed using SPSS version 21. Descriptive statistics, bivariate analysis and binary logistic regression were used in the analysis and data presented in contingency tables and figures. Significance was assumed at P value ≤0.05. Belief that TB treatment affects other treatments; (OR: 0.03; 95% CI:5. 0-0.1 ;P<0.001), retreatment (OR: 11; 95% CI: 4.2-29.6 ;P<0.001), not completing previous treatments (OR:19; 95% CI:6-73 ;P<0.001) self-discontinuation (OR:0.1; 95% CI: 0.01-1 ;P<0.049) were significant in predicting adherence. These aspects can serve as a guide for flagging some patient as having potential for non-adherence thus appropriate follow-up measures instituted in time. It is important to establish the effects of socio-demographic aspects on adherence in every TB care setting for appropriate follow-up.
Effects of socio-demographic factors on regimen adherence among tuberculosis patients in Kisumu Region, Kenya
(Kenyan Journal of Nursing & Midwifery, 2018-01-01) Senghor, Morris Shisanya
Introduction: Efforts to diagnose TB and patients on treatment have been very successful as per WHO targets for Kenya. However, there are still poor treatment outcomes in a significant number of the patients. These poor treatment outcomes have been significantly linked to poor adherence to TB treatment. Methods: This was a cross sectional descriptive study that was conducted in Kisumu East District to establish the effects of socio-demographic factors on regimen adherence among tuberculosis patients aged above 18 years attending TB clinics in Kisumu region, in Western Kenya. The data was analyzed using descriptive statistics and bivariate analysis and binary logistic regression. P values, Adjusted Odds Ratios with 95% confidence interval (CI) were used to demonstrate significance and strength of association between the socio-demographic factors and adherence. Significance was assumed at P value ≤0.05. Findings: Residence; (OR:21.8; 95% CI:5.4-87.5 ;P<0.001), number of family members(OR:5.7; 95% CI:1.7-19.1 ;P=0.005) and sex of the patient (OR:0.2; 95% CI: 0.0-0.9 ;P<0.036) were the significant socio-demographic aspects that predicted adherence. Conclusion: Therefore some socio-demographic aspects of TB patients key predictors of adherence. These aspects can serve as a guide for flagging some patient as having potential for non-adherence thus appropriate follow-up measures instituted in time. It is important to establish the effects of socio-demographic aspects on adherence in every TB care setting for appropriate follow-up.
Determinants of maternal satisfaction with spinal anaesthesia care for caesarian delivery at the Kisumu County Hospital
(IOSR Journal of Nursing and Health Science, 2017-02-01) Senghor, Morris Shisanya; Morema, Everlyne Nyanchera
Elective and emergency caesarean sections are increasing in the low income countries. Over the last fifteen years or so, spinal anaesthesia has been gradually escalated in Kenyan Hospitals. In Kisumu County Hospital (KCH), the cases of caesarean sections done under spinal anaesthesia have increased tremendously from one in every ten to seven in every ten cases in a span of 7 years. Despite documented safety for the procedure, complications can highly influence the mother’s perception of quality of care. This study was therefore undertaken to evaluate patient satisfaction after spinal anaesthesia for caesarean section. A crosssectional study of patients who underwent caesarean section under spinal anaesthesia in the operating rooms of KCH was conducted. Post-operative survey of patients on the day after surgery was conducted by collecting pre-operative and intra-operative data on a structured questionnaire. Post-operative data, including satisfaction and understanding the anaesthetist’s explanation regarding anaesthesia and satisfaction in receiving spinal anaesthesia were inquired by trained data personnel. A total of 99 pregnant patients, with age ranging from 17 to 40 years, were surveyed: Overall, 85 (85%) of the mothers interviewed were satisfied and 15 (15%) were dissatisfied the anaesthesia care they received. Income range (OR: 23.1; 95% CI: 2.77-192; P<0.001) and marital status (OR: 4.42; 95% CI 1.32-14.9; P<0.011) were significant demographic determinant of satisfaction with maternal satisfaction with anaesthesia care. Neonatal outcomes were also demonstrated to be associated with satisfaction were; neonate’s birth weight (OR: 3.29; 95% CI: 1.01-10.71; P:0.04) and APGAR score at 10 minutes (OR:4.74; 95% CI: 1.24-18.03; P:0.02). In comparison to studies elsewhere, maternal satisfaction in the surveyed population was low. Structured communication by anaesthesia team, exceptional clinical skill of the anaesthesia practitioners and prevention of side effects might improve patient satisfaction.
Characteristics of injuries among children attending public primary schools in Kisumu Municipality, Kenya.
(Donnish Journal of Nursing and Midwifery, 2015-05-18) Nyangahu, Drusilla N.; Odero, Wilson; Ogonda, Lilian; Senghor, Morris Shisanya; Morema, Everlyne Nyanchera
Injuries remain a major killer of children throughout the world. On average, for children in the age group 5-14 years, injury accounts for more than a quarter (27 %) of all deaths worldwide. In addition to these deaths, many other children sustain injuries that require hospitalization, outpatient treatment and sometimes result in disability. In Kenya, injuries are the third leading cause of mortality after malaria and HIV/AIDS and are the fifth leading cause of morbidity among patients attending health care facilities. Approximately 16.8 % of reported injury cases in Kisumu occur among children less than 15 years of age and accounting for 28.7 % of the total injury admissions. Although children less than 15 years of age fall within the primary school age, not much is known about the nature and factors that contribute to the occurrence of injuries among primary school children in Kisumu and programs focusing on their prevention are lacking. Methods: This was a cross-sectional study that aimed to describe the characteristics of injuries among primary school children in Kisumu Municipality. A random sample of 492 pupils aged 11 to 18 years; from 18 schools was interviewed using a structured questionnaire to collect information on the incidence of injuries during the three month period prior to the interview. Results: The most common cause of these injuries was due to falls on the same level (33.9 %). Majority of these pupils were injured while playing (48.8 %), at home (40.9 %) with cuts or open wounds being the most common injury that was sustained (42.1 %). However, injuries caused by fire / hot fluids were associated with gender (P < 0.002) with 76% of the pupils who reported having sustained these injuries being girls. Furthermore, gender was associated with occurrences of injuries at home (P < 0.001) with 115 out of the 201 (57.2%) children who reported having been injured while at home being girls. Almost half of the pupils sought medical care and a quarter of the pupils were hospitalized. Two-thirds of the pupils (66.5 %) received first aid which was mostly administered by a friend or family. More than half (56.7 %) of the pupils were absent from school due to the injury. Although 95.7 % of the pupils reported being taught about road safety in school, only 24 % of the pupils demonstrated a high level of awareness regarding road safety by being able to give a correct response regarding traffic lights and zebra crossing. The information obtained from this study will shed more light on the extent and characteristics of injuries occurring among primary school children and can be used to develop and implement injury prevention and safety promotion policies in primary schools. Conclusion: These findings suggest that most children in primary schools are affected by injuries sustained while playing at home; and girls are at a higher risk of burn injuries than boys. Moreover, there is a low level of awareness of road safety rules and regulations among the primary school pupils. Interventions such as adequate supervision by caregivers while children are playing and review of teaching strategies for road safety education for schools could aid in the reduction of injuries among the pupils.
Relationship between health care system setup and adherence to tuberculosis treatment in Western Kenya
(Quest Journals : Journal of Medical and Dental Science Research, 2017-02-12) Morema, Everlyne Nyanchera; Senghor, Morris Shisanya
Despite the concerted effort to detect and treat TB, there are still poor treatment outcomes in a significant number of the patients. These poor treatment outcomes have been significantly linked to poor adherence to TB treatment. Therefore, a cross sectional descriptive study was conducted in Kisumu East District to establish the relationship between health care system factors and TB treatment adherence among patients aged above 18 years attending TB clinics in Kisumu East District, in Western Kenya. A total sample of 250 respondents was surveyed. An interviewer administered structured questionnaire was used to collect data from the respondents on the social, demographic aspects of the patients and structural aspects of TB care. The data was analyzed using descriptive statistics for socio-demographic variables and bivariate analysis to determine the health care system factors that significantly predicted treatment adherence. P values, Odds Ratios with 95% confidence interval (CI) were used to demonstrate significance of association between the health system related predictors and adherence. Significance was assumed at P value ≤0.05. Behaviour of the health care workers (OR: 3.6; 95% CI1.1-12.1; P=0.031) and waiting time (OR: 7; 95%CI: 3-18; P<0.001) were the significant determinants of adherence related to health care set up. Health care system setup has a number of immediate modifiable predictors of adherence like waiting time and staff behaviour. It is important to establish the key predictors of adherence that are linked to health care system for quality TB treatment and care services in every TB care setting.
Women’s persistent utilisation of unskilled birth attendants in Kakamega County, Kenya
(AJOL, 2016-01-01) Namusonge, Lucy; Kabue, P.N.; Sharma, R.R.
Background: Minority of births in sub-Saharan Africa are conducted by skilled birth attendants. Having the highest world maternal mortality ratios and most deaths being associated with lack of trained supervision at delivery. Changing delivery practices is a major priority in this region. Objective: To determine the factors that contribute to persistent utilisation of unskilled birth attendance by women in Kakamega County. Design: A descriptive cross-sectional study . Setting: Kakamega County, Kenya Subjects: Post-natal mothers with children aged less than six months who delivered without skilled attendance. Results: Antenatal attendance rate of 92.7% while proportion of skilled birth attendance was at 48.6%. The following factors were found to influence utilisation of UBAs in the Study area: age (X2=8.65, df=3, P= 0.013), occupation (X2=10.04, df=3, P=0.006), religion (X2=19.73, df=5, P=0.0001), monthly income (X2=7.59, df=2, P=0.002), marital status (X2=10.10424, df=2, P=0.005) and education level (X2=9.472, df=4, P=0.002). Negative attitude of healthcare providers, socio-cultural practices and insecurity also enhanced utilisation of unskilled birth attendance. Conclusion: Birth preparedness should be advocated for every pregnant woman and health facilities to address the discrepancy between antenatal attendance and delivery by skilled birth attendance. We hope that the information generated from this study will be used by the policy makers leading to appropriate interventions or strategies which will reduce the number of home deliveries and maternal deaths.
A study of common causes of mortality among Fishermen in Lake Victoria, Kenya
(KEMRI : AJHS, 2014-01-01) Opemo, Damian Otieno; ALoo, Peninah A.; Arudo, John A.; Mbithi, John N.
The fishing industry in Kenya plays an integral role in the socio-economic development of Kenya. However, the working environment of fishermen is characterized by a wide variety of occupational hazards and mortality attributed to work related diseases or accidents and injuries, which, are poorly reported. Most of the reported cases are in the formal sector, while the informal sector such as fishing, where most people are employed, are largely ignored. The objective of this study was to determine the causes of mortality and identify factors that influence mortality among fishermen in Lake Victoria. A two-year retrospective mortality survey using verbal autopsy was carried out among fishermen in eight riparian districts of Lake Victoria in Kenya. The study successfully followed up a total of 3058 deceased fishermen. The mean age at death was 33 years (SD: ± 9.5) and a median of 32 years ranging between 15 – 54 years. Peak mortality reported among fishermen aged 25 - 29 years (19.8%) and 30 – 34 years (19.3%) was comparable. The findings revealed that the major causes of death were HIV – related infections (33.8%) followed by drowning (14.3%), pulmonary tuberculosis (12.4%), and malaria (10.4%). Results of this study show that there is an urgent need to identify strategies that would prevent HIV – related infections and drowning among the fishing community.
Early mobilization and physical activity improve stroke recovery: a cohort study of stroke inpatients in Kisumu County referral hospitals, Kenya
(Science and education publishing ; AJPHR, 2016-01-01) Ogolla, Maurice M.; Opemo, Damian Otieno; Asweto, collins otieno
Early mobilization in acute stroke care is highly recommended in a range of developed countries policy; however, in developing countries like Kenya, lack of evidence seems to hinder formulation and implementation of policy guideline on early mobilization in acute stroke care. Therefore, to estimate the safe optimal time for early mobilization of stroke patients in Kenya, we conducted a prospective cohort study in two purposively selected health facilities in Kisumu County, Kenya. About 100 stroke patients admitted in medical wards (mean age 59.1±2.3 years, females 61%) were recruited. Barthel Index’ tool was used to assess recovery and physical activity levels. It comprised of scoring scale ranging from 0-100. The participants were categorized as follows: Patients who score between 0 – 30 were considered as mildly recovered, 31 - 60 as moderately recovered and patients who score from 61 – 100 were regarded as fully recovered. Multiple logistic regression model was used to compute adjusted ORs (AOR) of early mobilization and Barthel Index variable, adjusting for age, gender and type of stroke. Early mobilization improves patient recovery. Participants in early mobilization group were more like to independently feed, groom, dress, use toilet, use wheel chair and climb stairs with help compared to late mobilization (p <0.05). Most (76%) participants who were exposed to high physical activity had full recovery than the (5%) bones in low physical activity (p< 0.001). This study provides evidence that early mobilization and high physical activity improves stroke patient recovery.
Logistic regression analysis of mortality among fishermen in the riperian counties of Lake Victoria, Kenya
(Science Publishing Group, 2019-01-21) Opemo, Damian Otieno; shem, Godfrey Juma

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