Hillary Rono - Academia.edu (original) (raw)

Papers by Hillary Rono

African Journal of Traditional, Complementary and Alternative Medicines, Mar 15, 2016

Background: An inventory of the medicinal plants used by herbalists to treat various ailments in ... more Background: An inventory of the medicinal plants used by herbalists to treat various ailments in Tindiret area of Nandi County, Kenya was conducted by a team comprising of medical researchers and botanists with a view to preserve indigenous ethnobotanical knowledge and potential research and development of new drugs. Materials and Methods: Data was collected from practicing herbalists through semi-structured interviews, group discussions and observations. The types of medical conditions treated, treatment methods as well as the plants used were recorded. Results and Conclusion: A total of 50 medicinal plants belonging to 28 families used for the treatment of 32 medical conditions were recorded. The disease conditions which were treated by the highest number of plants were abdominal/colic pains with 15 different plants recorded (13%), respiratory disorders 15(13%) and infertility14 (12%). The most widely used medicinal plants were Vernonia amygdalina 7(7%), Toddalia asiatica 6(6%), Aloe kedongensis 5(5%) and Zanthoxylum gilletii 5(5%); whereas the families with the highest number of plant usage were Fabaceae 8(14%), Lamiaceae 4(8%) and Solanaceae 4(8%) plants respectively. The study documents important ethno-medical knowledge on the plants used by herbalists in Tindiret sub-county.

Wellcome open research, May 4, 2022

Background: Attendance rates for eye clinics are low across low-and middle-income countries (LMIC... more Background: Attendance rates for eye clinics are low across low-and middle-income countries (LMICs) and exhibit marked sociodemographic (SD) inequalities. We aimed to quantify the association between a range of SD domains and attendance rates from vision screening in programmes launching in Botswana, Kenya and Nepal. Methods: We will develop a set of sociodemographic questions and introduce them into routine community-based eye screening programmes in Kenya, Botswana and Nepal, targeting children aged 5-18 years and adults. Our study design is a rolling survey, embedded within the Peek screening programme. The sociodemographic questions will be asked of 10% of all those presenting to be screened, and 100% of those identified with an eye problem. We will also collect data on whether people referred to ophthalmic clinic for treatment or further assessment attended, and we will use logistic regression to report odds ratios for this outcome attendance) for each

Objective: To assess the prevalence and distribution of trachoma and dirty faces prior to impleme... more Objective: To assess the prevalence and distribution of trachoma and dirty faces prior to implementation of the SAFE strategy (Surgery, Antibiotic treatment, Facial cleanliness and Environmental improvement) in the Upper Eastern Kenya region. Methods: A pre-survey trachoma risk assessment was conducted followed by division of the region into three geographical areas (survey segments). The sample size was 800 children aged 1-9 years old and 600 adults aged >40 years per segment. Results: A total of 2,400 children were examined. The prevalence of TF in the region was 9.2% (95%CI: 8.0%-10.4%) and Marsabit was the only segment with prevalence >10%. The prevalence of a dirty face in the region was 17.5% (95%CI: 16.0%-19.1%) and Masabit was the only segment with prevalence >20%. A child with a dirty face was more likely to have TF than one with a clean face. The Odd's ratios were: Marsabit 12.1(95%CI: 8.1-18.1), Isiolo 7.5(95%CI: 4.4-12.8) and Moyale 1.9 (95%CI: 0.7-5.6). A total of 1,797 adults were examined and 54 (3.0%, 95%CI: 2.2%-3.8%) had TT. Women had higher prevalence of TT than men. Ten out of 13 persons with CO were from Moyale. The backlog of TT in the region was 2,369 people and TT surgical services were poor. Moyale had the lowest prevalence of TF but the highest prevalence of TT. Conclusion: The survey methods used allowed differentiated interventions as follows: Marsabit needed full SAFE strategy; Moyale "S" component and Isiolo repeat sub-district surveys. A Knowledge Attitude and Practice (KAP) was needed to explain the distribution of trachoma in the region.

International Journal for Equity in Health

Background Health inequalities are ubiquitous, and as countries seek to expand service coverage, ... more Background Health inequalities are ubiquitous, and as countries seek to expand service coverage, they are at risk of exacerbating existing inequalities unless they adopt equity-focused approaches to service delivery. Main text Our team has developed an equity-focused continuous improvement model that reconciles prioritisation of disadvantaged groups with the expansion of service coverage. Our new approach is based on the foundations of routinely collecting sociodemographic data; identifying left-behind groups; engaging with these service users to elicit barriers and potential solutions; and then rigorously testing these solutions with pragmatic, embedded trials. This paper presents the rationale for the model, a holistic overview of how the different elements fit together, and potential applications. Future work will present findings as the model is operationalised in eye-health programmes in Botswana, India, Kenya, and Nepal. Conclusion There is a real paucity of approaches for ope...

African Journal of Disability, 2016

Background: Although the consequences of disability are magnified in humanitarian contexts, resea... more Background: Although the consequences of disability are magnified in humanitarian contexts, research into the difficulties of caring for children with a disability in such settings has received limited attention.Methods: Based on in-depth interviews with 31 families, key informants and focus group discussions in Turkana, Kenya, this article explores the lives of families caring for children with a range of impairments (hearing, vision, physical and intellectual) in a complex humanitarian context characterised by drought, flooding, armed conflict, poverty and historical marginalisation.Results: The challenging environmental and social conditions of Turkana magnified not only the impact of impairment on children, but also the burden of caregiving. The remoteness of Turkana, along with the paucity and fragmentation of health, rehabilitation and social services, posed major challenges and created opportunity costs for families. Disability-related stigma isolated mothers of children with...

Public Health Genomics, 2014

Background/Aims: Clinical cancer genetics is an integral part of cancer control and management, y... more Background/Aims: Clinical cancer genetics is an integral part of cancer control and management, yet its development as an essential medical service has been hindered in many low-and-middle-income countries. We report our experiences in developing a clinical cancer genetics service for retinoblastoma in Kenya. Methods: A genetics task force was created from within the membership of the existing Kenyan National Retinoblastoma Strategy group. The task force engaged in multiple in-person and telephone discussions, delineating experiences, opinions and suggestions for an evidence-based, culturally sensitive retinoblastoma genetics service. Discussions were recorded and thematically categorized to develop a strategy for the design and implementation of a national retinoblastoma clinical genetics service. Results: Discussion among the retinoblastoma genetics task force supported the development of a comprehensive genetics service that rests on 3 pillars: (1) patient and family counseling, ...

The Journal of Ophthalmology of Eastern, Central and Southern Africa, 2018

International Journal of Environmental Research and Public Health, 2019

Background: Eye care provision is currently insufficient to meet the population’s eye health need... more Background: Eye care provision is currently insufficient to meet the population’s eye health needs in Kenya. Many people remain unnecessarily visually impaired or at risk of becoming so due to treatable or preventable conditions. A lack of access and awareness of services are key barriers, in large part due to their being too few eye care providers in the health system for this unmet need. Methods: A hospital-based, retrospective analysis of patients who attended Kitale eye unit, Trans Nzoia County, Kenya from 1st January 2013 to 31st December 2015. Age and sex standardized hospital attendance rates by residence, age group, and sex were calculated for Trans Nzoia county and each subcounty. The changing trends in attendance rates were estimated by calculating the difference between base year and last year. Incidence rate ratios for attendance for each age-group, sex, and residence were estimated using a multivariable regression model. Results: 20,695 patients from the county were see...

Informed consent materials. (DOCX 112 kb)

Sub-group analysis among indirect presenters. (DOCX 18 kb)

Infectious agents and cancer, 2017

Oesophageal carcinoma (OC) is highly prevalent in Western Kenya especially among the members of t... more Oesophageal carcinoma (OC) is highly prevalent in Western Kenya especially among the members of the Kalenjin community who reside in the Northern and Southern areas of the Rift Valley. Previous authors have suggested potential association of environmental and genetic risk factors with this high prevalence. The environmental factors that have been suggested include contamination of food by mycotoxins and/or pesticides, consumption of traditional alcohol (locally referred to "Busaa" and "Chan'gaa"), use of fermented milk ("Mursik"), poor diet, tobacco use and genetic predisposition. The aim of this paper is to critically examine the potential contribution of each of the factors that have been postulated to be associated with the high prevalence of the disease in order to establish the most likely cause. We have done this by analyzing the trends, characteristics and behaviours that are specifically unique in the region, and corroborated this with the a...

Tropical Diseases, Travel Medicine and Vaccines, 2016

British Journal of Ophthalmology, 2011

A survey to determine the prevalence of trachomatous trichiasis (TT) requires a large sample size... more A survey to determine the prevalence of trachomatous trichiasis (TT) requires a large sample size and the recommended participant age is ≥15 years. This study sought to establish the appropriate age range of individuals to be included in TT surveys. Data from six previous surveys of adults ≥15 years old were reanalysed. Reanalysis indicated that 69.6-93.3% (average 87.0%) of untreated TT occurred in those aged 40+ years and 52.2-86.7% (average 73.1%) in those aged 50+ years (age ≥50 years is used in rapid assessment of avoidable blindness). Age ≥40 years was adopted in a TT survey conducted in Turkana district because it allowed a smaller sample size than age ≥15 years. The estimated backlog of untreated TT in people aged ≥40 years old in Turkana was 5932 and the overall TT backlog was likely to be 6358-8523. These findings cannot be generalised because all surveys were carried out in the same country.

Background: A combination of limited access to eye services and low numbers of eye care providers... more Background: A combination of limited access to eye services and low numbers of eye care providers in low and middle income (LMIC) populations results in high prevalence of avoidable visual impairment. Aim: To develop and evaluate a demonstration model of community volunteers and teachers using a novel mobile phone-based technology (Peek) in communities and schools, respectively, to identify and refer those with referable eye conditions and increase adherence to services so as to reduce avoidable visual impairment. Methods: This thesis comprises: (1) a three-year retrospective review of utilisation of hospital eye care services; (2) a cluster randomized trial (C-RCT) to determine the effectiveness of using of the mobile phone based, Peek School Eye Health System (Peek SEH) to increase identification and referral adherence to hospital of school pupils with visual impairment; (3) the development and validation of a smartphone based community screening decisionsupport algorithm (Peek Co...