Peter karimi - Academia.edu (original) (raw)
Papers by Peter karimi
Research Square (Research Square), Apr 3, 2024
Background: Tanzania has a relatively high unmet need and low use of family planning methods. Thi... more Background: Tanzania has a relatively high unmet need and low use of family planning methods. Thirty-eight per cent of reproductive-aged women currently use modern contraceptive methods, and 22% have an unmet need for family planning. Objectives: To determine the factors in uencing the uptake of modern contraceptives among women attending public health facilities in Dodoma City Council. Methods An analytical cross-sectional study using a quantitative approach was conducted among 362 women of reproductive age who attended public health facilities in Dodoma City and 32 healthcare workers. The participants were selected using simple random sampling. Data was collected from 6 September to 15 October 2021. A structured questionnaire was used. Data was analyzed using descriptive and inferential statistics at the 0.05 level of signi cance. The strength of association was determined using a logistic regression model. Results Of the 362 participants, 46.6% were between 24 and 34 years old. Most (60.2%) were married, and 48.9% had completed secondary education. About a third (32.6%) had a monthly income of 300,000 to 399,999 TZS. A statistically signi cant association at 0.05 was observed between uptake of contraceptives and education (p = 0.043), marital status (p = 0.024), partner's support (p = 0.001), awareness, preference, and satisfaction (p = 0.000). Conclusion The study revealed that education, marital status, awareness, preference, and satisfaction of the respondents have a positive signi cant effect on the uptake of modern contraceptives.
Journal of Pharmaceutical Policy and Practice, Feb 21, 2023
Background Vaccines require cold chain storage conditions, and good distribution practices throug... more Background Vaccines require cold chain storage conditions, and good distribution practices throughout the supply chain to maintain their quality and potency. However, in the last mile of the vaccines supply chain, these requirements may not be guaranteed resulting in reduced effectiveness which could lead to an upsurge in vaccine preventable morbidity and mortality. The aim of this research was to evaluate vaccine storage and distribution practices in the last mile of vaccine supply chain in Turkana County. Methods A descriptive cross-sectional study was conducted from January 2022 to February 2022 across seven subcounties in Turkana County, Kenya, to assess vaccine storage and distribution practices. The study sample size was 128 county health professionals across 4 hospitals, 9 health centers, and 115 dispensaries. The respondents were selected using simple random sampling within the facilities strata. Data were collected using a structured questionnaire, adapted, and adopted from a standardized WHO questionnaire on effective vaccines management and administered to one healthcare personnel working in the immunization supply chain per facility. Data were analyzed using excel and presented as percentages in table forms. Results A total of 122 health care workers participated in the study. Most respondents (89%, n = 109) had utilized a vaccine forecasting sheet, but only 81% did have an established maximum-minimum level inventory control system. Many of the respondents had sufficient knowledge of ice pack conditioning although 72% had adequate vaccine carriers and ice packs. Only 67% of respondents had a complete set of twice-daily manual temperature records at the facility. Most refrigerators complied with the WHO specifications but only 80% of them had functional fridge-tags. The number of facilities that had a routine maintenance plan was below average while only 65% had an adequate contingency plan. Conclusion Rural health facilities have suboptimal supply of vaccine carriers and icepacks for effective storage and distribution of vaccines. In addition, some vaccine fridges lack functional fridge-tags for proper temperature monitoring. Routine maintenance and contingency plans remain a challenge to ensure optimal service delivery.
East and Central African Journal of Pharmaceutical Sciences, 2008
A retrospective descriptive study was carried out from June to November 2004 in a retail pharmacy... more A retrospective descriptive study was carried out from June to November 2004 in a retail pharmacy situated at the School of Pharmacy, University of Nairobi within the Kenyatta National Hospital complex. The objective was to evaluate prescribing habits and to determine the frequency of prescribing of commonly used drug classes in a hospital. The average number of drugs per prescription was 2.20 1.16. The prevalence of prescribing was 28.6% anti-infective drugs, 21.1% musculoskeletal agents, 16.6% respiratory system drugs, 8.1% cardiovascular system drugs, 7.2% central nervous system drugs, 7.1% gastrointestinal system drugs, 4.3% minerals and vitamins, 2.1% ear, nose and throat drugs, 1.1% endocrine drugs, 2% skin preparations, 0.9% anticancer drugs and 0.74% eye preparations. The prescribing habits evaluated were compared to the legal requirements in Kenya and to recommended international practice. The information gathered may serve as a basis for rational use of drugs.
The African Journal of Pharmacology and Therapeutics, 2016
Background: Severe pre-eclampsia is one of the major causes of high maternal mortality rate in bo... more Background: Severe pre-eclampsia is one of the major causes of high maternal mortality rate in both developed and developing countries. The goals of management are to prevent progression to eclampsia thus preventing convulsions, to control the blood pressure and to prevent untoward effects in the foetus. The first-line option for the treatment and prevention of eclamptic seizures is magnesium sulphate. Objective: To determine the serum magnesium, urea and electrolyte levels in neonates of mothers treated with magnesium sulphate and compare the findings with the levels in non-exposed neonates. Methodology: A quasi experimental design was adopted where test s ubjects were neonates of mothers suffering from preeclampsia and severe eclampsia and were being treated with magnesium sulphate just before delivery at Pumwani Maternity hospital. The control group comprised neonates of hypertensive mothers without preeclampsia being treated using other drugs. Blood samples were obtained from th...
Journal of Pharmaceutical Policy and Practice
Background Family planning involves the use of traditional or modern methods to prevent maternal ... more Background Family planning involves the use of traditional or modern methods to prevent maternal and infant mortality associated with unintended pregnancies and negative economic outcomes. In sub-Saharan Africa, the unmet need for modern family planning is approximately 66%. However, information on factors affecting utilization of female family planning commodities is limited. Therefore, this research was conducted to bridge this gap. Methods Health facility-based descriptive cross-sectional research design was conducted and involved the public health facilities offering family planning, targeting respondents who handle the commodities and service providers themselves. A semi-structured questionnaire was used to collect data about availability of the commodities, knowledge of service providers and barriers affecting provision of the service. Data were coded and analyzed via Microsoft Excel 2019 and SPSS version 20. Results The study showed that shorter term methods were more readily...
The African Journal of Pharmacology and Therapeutics, 2016
Background: Hypertension is a common non-communicable illness that can occur either alone or in c... more Background: Hypertension is a common non-communicable illness that can occur either alone or in combination with diabetes and other diseases. Diabetic hypertensive patients are more vulnerable to cardiovascular and renal complications compared to non-diabetic hypertensive patients. Target blood pressures in these two patient populations are different; nevertheless, optimal blood pressure control is paramount in both groups. Objective: To evaluate the management of hypertension among diabetic and non-diabetic outpatients at the medical outpatient clinic in Kenyatta National Hospital, Nairobi, Kenya. Methodology: A tertiary hospital based cross-sectional study was carried out at the medical outpatient clinic in Kenyatta National Hospital. This study comprised of two study groups: 48 diabetic hypertensive patients and 48 non-diabetic hypertensive patients. Face to face interviews were conducted and additional data was extracted from the patient’s file. The main outcomes of interests we...
Prevalence and Determinants of Medication Related Problems in AcuteKidney Injury Patients at Tertiary Teaching and Referral Hospital inKenya
Journal of Pharmaceutical Care & Health Systems, 2021
Background: Acute Kidney Injury (AKI) is a common illness especially among critically ill patient... more Background: Acute Kidney Injury (AKI) is a common illness especially among critically ill patients. The incidence is 2-3 cases per 1000. Seventy percent of the cases are found in the Sub-Sahara African. The proportion of drug- induced AKI is about 25%. Hence there is a need to identify the medication related problems in AKI patients which will facilitate identification, prevention and improved patient outcomes. Objective: To establish the prevalence and determinants of medication related problems in patients with AKI at Kenyatta National Hospital. Methods: This study was a cross-sectional survey that was conducted among patients with AKI at Kenyatta National Hospital. Consecutive random sampling was used to select 92 participants. Data was collected using researcher administered questionnaire and analyzed using STATA version 15. The level of significance was set at p ≤ 0.05. Results: The average age of the participants was 51(± 15.96) years. Medication related problems (57, 62%) ide...
The African Journal of Pharmacology and Therapeutics, 2016
Background : Chronic Heart Failure is a major health problem with a prevalence of between 1 and 1... more Background : Chronic Heart Failure is a major health problem with a prevalence of between 1 and 12% in USA and Europe, and approximately 5.7% in Sub-Saharan Africa, and has socio-economic relevance owing to its high prevalence, mortality and impact on young economically active individuals. In 1999 chronic heart failure constituted 3.3% of all medical admissions at Kenyatta National Hospital. Objective: The purpose of the current study was to determine factors that affect adherence to treatment among patients with Chronic Heart Failure at Kenyatta National Hospital and assess any association between any such factors Methodology: This was a descriptive cross-sectional study involving patients >18 years diagnosed with Chronic Heart Failure at Kenyatta National Hospital. Eighty three eligible and consenting study participants were recruited into the study using a convenient sampling technique. Data were collected by means of an interviewer administered questionnaire adapted from the ...
Introduction over 1.5 million children die from vaccine-preventable diseases yearly. To avert the... more Introduction over 1.5 million children die from vaccine-preventable diseases yearly. To avert these deaths and improve their livelihood, vaccine availability is important. The study assessed the availability of the vaccine, injection accessories and the associated factors in public health facilities in Nairobi City County and provided valuable data to contribute to improving healthcare infrastructure, stock management and vaccine distribution. Methods a descriptive cross-sectional study was conducted in 68 randomly selected public health facilities at Nairobi City County in Kenya. Data was collected using a researcher-administered structured questionnaire and more information abstracted from the Vaccines management tools. The analysis was carried out using STATA version 14. Results most facilities had experienced vaccines and accessories stock out at the time of the study and in the preceding twelve months. The most affected vaccines were tetanus (88%), measles-rubella (81%) and ora...
Background: The effectiveness of antihypertensive medicines depends on whether the patient uses t... more Background: The effectiveness of antihypertensive medicines depends on whether the patient uses the drugs as instructed by the health care provider. Failure to adhere to therapy may lead to uncontrolled blood pressure and possibly preventable complications. The factors which may impact on adherence to medicines among patients in rural health facilities have not been adequately documented. Objective: To determine the predictors of non- adherence to antihypertensive therapy in Murang’a South Sub-county Hospital. Methods: A descriptive cross-sectional study design was used. One hundred and sixty-seven adult hypertensive patients who were on therapy at Murang’a South Sub-county Hospital were included. Participants who satisfied the inclusion criteria were selected using simple random sampling. Data was collected using a researcher administered questionnaire. Analysis was carried out using STATA version 14 statistical software and p</=0.05 was considered statistically significant. Per...
The African Journal of Pharmacology and Therapeutics, 2016
Background : Patients’ factors such as knowledge on warfarin use are important in achieving desir... more Background : Patients’ factors such as knowledge on warfarin use are important in achieving desirable anticoagulation outcomes. Objective : To assess the patient factors impacting on oral anticoagulation control among adult outpatients taking warfarin at Kenyatta National Hospital. Methodology : A cross-sectional survey of 147out-patients on warfarin at Kenyatta National Hospital was carried out between March and April 2015. Data were collected using a pre-designed interviewer administered questionnaire. The data included patient characteristics such as indication and duration of anticoagulation; knowledge on anticoagulation; and international normalized ratio tests. The Oral Anticoagulation Knowledge test was used with a score of ≥75% indicating sufficient knowledge. Logistic regression was used to determine independent variables associated with anticoagulation control. Results : Females were majority (74.9%) while optimal anticoagulation control was at 43.5%. Only 10.1% had suffic...
Effect of Pesticide Exposure on Serum Cholinesterase Levels among Asthmatic Children in Naivasha Sub-County, Kenya
Background: Pesticide exposure is a risk factor for asthma exacerbations in flower farm regions i... more Background: Pesticide exposure is a risk factor for asthma exacerbations in flower farm regions in the world. Data on levels of serum cholinesterase among asthmatic children exposed to pesticides in Kenya is scanty. Objectives: To compare and identify variables which affect the concentration of serum cholinesterases in children who are exposed and unexposed to pesticides. Methodology: The design was a comparative cross-sectional study that involved exposed and unexposed children. The study was conducted between May and July, 2014 in Naivasha, Kenya. Patients were interviewed and serum samples were analysed for cholinesterase levels. Multi-linear regression was done to identify variables that affected cholinesterase activity. Results: Children who were exposed to pesticides had a lower median ChE activity of 5828 [IQR 4863, 6443] compared to the unexposed arm whose median was 7133 [IQR 6063, 8179]. Five predictor variables were found to be significantly associated with depressio...
Etiology, risk factors and management of infectious diarrhoea in children at Kenyatta National Hospital
Rwanda Journal of Medicine and Health Sciences
BackgroundStock outs of medicines and unaffordable cost are two major barriers of access to healt... more BackgroundStock outs of medicines and unaffordable cost are two major barriers of access to healthcare. Universal Health Coverage (UHC) seeks to ensure that all people have access to quality essential health services without suffering financial hardship.ObjectiveThe main objective of the study was to determine the effect and challenges of UHC program on the availability of medicines in public health facilities in Kisumu County.MethodologyThe study used a Pretest - posttest research design. The study was carried out in twenty-nine health facilities that were selected using stratified random sampling. Data was collected using key informant interviews with a health worker in each facility. Participants also involved four hundred and forty-four patients selected from the chosen facilities using consecutive sampling. Data from patients was collected using researcher administered questionnaires.ResultsThe availability of medicines improved by 3.4% for 20 tracer medicines since the introdu...
Gynecologic Oncology Research and Practice
Background: Although cervical cancer is preventable, it is still the second leading cause of canc... more Background: Although cervical cancer is preventable, it is still the second leading cause of cancer deaths among women in the world. Further, it is estimated that around 5-10% of hospital admissions are due to drug related problems (DRPs), of which 50% are avoidable. In cancer therapy, there is an immense potential for DRPs due to the high toxicity of most chemotherapeutic regimens. Hence, this study sought to assess DRPs among patients with cervical cancer at Kenyatta National Hospital (KNH). Methods: A cross-sectional study was conducted at the oncology units of KNH. A total of 81 study participants were recruited through simple random sampling. Data were collected from medical records and interviewing patients. The appropriateness of medical therapy was evaluated by comparing with National Compressive Cancer Network and European Society for Medical Oncology practice guideline of cervical cancer treatment protocol. The degree of adherence was determined using eight-item Morisky medication adherence scale. The likelihood of drug interaction was assessed using Medscape, Micromedex and Epocrates drug interaction checkers. The data were entered in Microsoft Excel and analysed using statistical software STATA version 13.0. Descriptive statistics such as mean, percent and frequency were used to summarise patients' characteristics. Univariable and multivariable binary logistic regression were used to investigate the potential predictors of DRPs. Result: A total of 215 DRPs were identified from 76 patients, translating to a prevalence of 93.8% and a mean of 2. 65 ± 1.22 DRPs. The predominant proportion of DRPs (48.2%) was identified in patients who had been treated with chemoradiation regimens. Adverse drug reactions 56(69.1%) and drug interactions 38(46.9%) were the most prevalent DRPs. Majority (67.9%) of the study population were adherent to their treatment regimens. Forgetfulness 18(69.2%), expensive medications 4(15.4%) and side effects of medications 4(15.4%) were the main reasons for medication non-adherence. Patients with advanced stage cervical cancer were 15.4 times (AOR = 15.4, 95% CI = 1. 3-185.87, p = 0.031) more likely to have DRPs as compared to patients with early stage disease. Conclusion: Adverse drug reactions, drug interactions, and need of additional drug therapy were the most common DRPs identified among cervical cancer patients. Advanced stage cervical cancer was the only predictor of DRPs.
Antihypertensive therapy and adequacy of blood pressure control among adult hypertensive diabetic patients with chronic kidney disease in a tertiary referral hospital
Hospital Practice
Determinants of Adherence to Anticonvulsants Therapy among Outpatient Epileptic Children in a Kenyan Referral Hospital
African Journal of Pharmacology and Therapeutics, Nov 5, 2015
Effect of Pesticide Exposure on Serum Cholinesterase Levels among Asthmatic Children in Naivasha Sub-County, Kenya
African Journal of Pharmacology and Therapeutics, Mar 4, 2015
Introduction of Mortgage backed securities in Kenya Capital Market
Research Square (Research Square), Apr 3, 2024
Background: Tanzania has a relatively high unmet need and low use of family planning methods. Thi... more Background: Tanzania has a relatively high unmet need and low use of family planning methods. Thirty-eight per cent of reproductive-aged women currently use modern contraceptive methods, and 22% have an unmet need for family planning. Objectives: To determine the factors in uencing the uptake of modern contraceptives among women attending public health facilities in Dodoma City Council. Methods An analytical cross-sectional study using a quantitative approach was conducted among 362 women of reproductive age who attended public health facilities in Dodoma City and 32 healthcare workers. The participants were selected using simple random sampling. Data was collected from 6 September to 15 October 2021. A structured questionnaire was used. Data was analyzed using descriptive and inferential statistics at the 0.05 level of signi cance. The strength of association was determined using a logistic regression model. Results Of the 362 participants, 46.6% were between 24 and 34 years old. Most (60.2%) were married, and 48.9% had completed secondary education. About a third (32.6%) had a monthly income of 300,000 to 399,999 TZS. A statistically signi cant association at 0.05 was observed between uptake of contraceptives and education (p = 0.043), marital status (p = 0.024), partner's support (p = 0.001), awareness, preference, and satisfaction (p = 0.000). Conclusion The study revealed that education, marital status, awareness, preference, and satisfaction of the respondents have a positive signi cant effect on the uptake of modern contraceptives.
Journal of Pharmaceutical Policy and Practice, Feb 21, 2023
Background Vaccines require cold chain storage conditions, and good distribution practices throug... more Background Vaccines require cold chain storage conditions, and good distribution practices throughout the supply chain to maintain their quality and potency. However, in the last mile of the vaccines supply chain, these requirements may not be guaranteed resulting in reduced effectiveness which could lead to an upsurge in vaccine preventable morbidity and mortality. The aim of this research was to evaluate vaccine storage and distribution practices in the last mile of vaccine supply chain in Turkana County. Methods A descriptive cross-sectional study was conducted from January 2022 to February 2022 across seven subcounties in Turkana County, Kenya, to assess vaccine storage and distribution practices. The study sample size was 128 county health professionals across 4 hospitals, 9 health centers, and 115 dispensaries. The respondents were selected using simple random sampling within the facilities strata. Data were collected using a structured questionnaire, adapted, and adopted from a standardized WHO questionnaire on effective vaccines management and administered to one healthcare personnel working in the immunization supply chain per facility. Data were analyzed using excel and presented as percentages in table forms. Results A total of 122 health care workers participated in the study. Most respondents (89%, n = 109) had utilized a vaccine forecasting sheet, but only 81% did have an established maximum-minimum level inventory control system. Many of the respondents had sufficient knowledge of ice pack conditioning although 72% had adequate vaccine carriers and ice packs. Only 67% of respondents had a complete set of twice-daily manual temperature records at the facility. Most refrigerators complied with the WHO specifications but only 80% of them had functional fridge-tags. The number of facilities that had a routine maintenance plan was below average while only 65% had an adequate contingency plan. Conclusion Rural health facilities have suboptimal supply of vaccine carriers and icepacks for effective storage and distribution of vaccines. In addition, some vaccine fridges lack functional fridge-tags for proper temperature monitoring. Routine maintenance and contingency plans remain a challenge to ensure optimal service delivery.
East and Central African Journal of Pharmaceutical Sciences, 2008
A retrospective descriptive study was carried out from June to November 2004 in a retail pharmacy... more A retrospective descriptive study was carried out from June to November 2004 in a retail pharmacy situated at the School of Pharmacy, University of Nairobi within the Kenyatta National Hospital complex. The objective was to evaluate prescribing habits and to determine the frequency of prescribing of commonly used drug classes in a hospital. The average number of drugs per prescription was 2.20 1.16. The prevalence of prescribing was 28.6% anti-infective drugs, 21.1% musculoskeletal agents, 16.6% respiratory system drugs, 8.1% cardiovascular system drugs, 7.2% central nervous system drugs, 7.1% gastrointestinal system drugs, 4.3% minerals and vitamins, 2.1% ear, nose and throat drugs, 1.1% endocrine drugs, 2% skin preparations, 0.9% anticancer drugs and 0.74% eye preparations. The prescribing habits evaluated were compared to the legal requirements in Kenya and to recommended international practice. The information gathered may serve as a basis for rational use of drugs.
The African Journal of Pharmacology and Therapeutics, 2016
Background: Severe pre-eclampsia is one of the major causes of high maternal mortality rate in bo... more Background: Severe pre-eclampsia is one of the major causes of high maternal mortality rate in both developed and developing countries. The goals of management are to prevent progression to eclampsia thus preventing convulsions, to control the blood pressure and to prevent untoward effects in the foetus. The first-line option for the treatment and prevention of eclamptic seizures is magnesium sulphate. Objective: To determine the serum magnesium, urea and electrolyte levels in neonates of mothers treated with magnesium sulphate and compare the findings with the levels in non-exposed neonates. Methodology: A quasi experimental design was adopted where test s ubjects were neonates of mothers suffering from preeclampsia and severe eclampsia and were being treated with magnesium sulphate just before delivery at Pumwani Maternity hospital. The control group comprised neonates of hypertensive mothers without preeclampsia being treated using other drugs. Blood samples were obtained from th...
Journal of Pharmaceutical Policy and Practice
Background Family planning involves the use of traditional or modern methods to prevent maternal ... more Background Family planning involves the use of traditional or modern methods to prevent maternal and infant mortality associated with unintended pregnancies and negative economic outcomes. In sub-Saharan Africa, the unmet need for modern family planning is approximately 66%. However, information on factors affecting utilization of female family planning commodities is limited. Therefore, this research was conducted to bridge this gap. Methods Health facility-based descriptive cross-sectional research design was conducted and involved the public health facilities offering family planning, targeting respondents who handle the commodities and service providers themselves. A semi-structured questionnaire was used to collect data about availability of the commodities, knowledge of service providers and barriers affecting provision of the service. Data were coded and analyzed via Microsoft Excel 2019 and SPSS version 20. Results The study showed that shorter term methods were more readily...
The African Journal of Pharmacology and Therapeutics, 2016
Background: Hypertension is a common non-communicable illness that can occur either alone or in c... more Background: Hypertension is a common non-communicable illness that can occur either alone or in combination with diabetes and other diseases. Diabetic hypertensive patients are more vulnerable to cardiovascular and renal complications compared to non-diabetic hypertensive patients. Target blood pressures in these two patient populations are different; nevertheless, optimal blood pressure control is paramount in both groups. Objective: To evaluate the management of hypertension among diabetic and non-diabetic outpatients at the medical outpatient clinic in Kenyatta National Hospital, Nairobi, Kenya. Methodology: A tertiary hospital based cross-sectional study was carried out at the medical outpatient clinic in Kenyatta National Hospital. This study comprised of two study groups: 48 diabetic hypertensive patients and 48 non-diabetic hypertensive patients. Face to face interviews were conducted and additional data was extracted from the patient’s file. The main outcomes of interests we...
Prevalence and Determinants of Medication Related Problems in AcuteKidney Injury Patients at Tertiary Teaching and Referral Hospital inKenya
Journal of Pharmaceutical Care & Health Systems, 2021
Background: Acute Kidney Injury (AKI) is a common illness especially among critically ill patient... more Background: Acute Kidney Injury (AKI) is a common illness especially among critically ill patients. The incidence is 2-3 cases per 1000. Seventy percent of the cases are found in the Sub-Sahara African. The proportion of drug- induced AKI is about 25%. Hence there is a need to identify the medication related problems in AKI patients which will facilitate identification, prevention and improved patient outcomes. Objective: To establish the prevalence and determinants of medication related problems in patients with AKI at Kenyatta National Hospital. Methods: This study was a cross-sectional survey that was conducted among patients with AKI at Kenyatta National Hospital. Consecutive random sampling was used to select 92 participants. Data was collected using researcher administered questionnaire and analyzed using STATA version 15. The level of significance was set at p ≤ 0.05. Results: The average age of the participants was 51(± 15.96) years. Medication related problems (57, 62%) ide...
The African Journal of Pharmacology and Therapeutics, 2016
Background : Chronic Heart Failure is a major health problem with a prevalence of between 1 and 1... more Background : Chronic Heart Failure is a major health problem with a prevalence of between 1 and 12% in USA and Europe, and approximately 5.7% in Sub-Saharan Africa, and has socio-economic relevance owing to its high prevalence, mortality and impact on young economically active individuals. In 1999 chronic heart failure constituted 3.3% of all medical admissions at Kenyatta National Hospital. Objective: The purpose of the current study was to determine factors that affect adherence to treatment among patients with Chronic Heart Failure at Kenyatta National Hospital and assess any association between any such factors Methodology: This was a descriptive cross-sectional study involving patients >18 years diagnosed with Chronic Heart Failure at Kenyatta National Hospital. Eighty three eligible and consenting study participants were recruited into the study using a convenient sampling technique. Data were collected by means of an interviewer administered questionnaire adapted from the ...
Introduction over 1.5 million children die from vaccine-preventable diseases yearly. To avert the... more Introduction over 1.5 million children die from vaccine-preventable diseases yearly. To avert these deaths and improve their livelihood, vaccine availability is important. The study assessed the availability of the vaccine, injection accessories and the associated factors in public health facilities in Nairobi City County and provided valuable data to contribute to improving healthcare infrastructure, stock management and vaccine distribution. Methods a descriptive cross-sectional study was conducted in 68 randomly selected public health facilities at Nairobi City County in Kenya. Data was collected using a researcher-administered structured questionnaire and more information abstracted from the Vaccines management tools. The analysis was carried out using STATA version 14. Results most facilities had experienced vaccines and accessories stock out at the time of the study and in the preceding twelve months. The most affected vaccines were tetanus (88%), measles-rubella (81%) and ora...
Background: The effectiveness of antihypertensive medicines depends on whether the patient uses t... more Background: The effectiveness of antihypertensive medicines depends on whether the patient uses the drugs as instructed by the health care provider. Failure to adhere to therapy may lead to uncontrolled blood pressure and possibly preventable complications. The factors which may impact on adherence to medicines among patients in rural health facilities have not been adequately documented. Objective: To determine the predictors of non- adherence to antihypertensive therapy in Murang’a South Sub-county Hospital. Methods: A descriptive cross-sectional study design was used. One hundred and sixty-seven adult hypertensive patients who were on therapy at Murang’a South Sub-county Hospital were included. Participants who satisfied the inclusion criteria were selected using simple random sampling. Data was collected using a researcher administered questionnaire. Analysis was carried out using STATA version 14 statistical software and p</=0.05 was considered statistically significant. Per...
The African Journal of Pharmacology and Therapeutics, 2016
Background : Patients’ factors such as knowledge on warfarin use are important in achieving desir... more Background : Patients’ factors such as knowledge on warfarin use are important in achieving desirable anticoagulation outcomes. Objective : To assess the patient factors impacting on oral anticoagulation control among adult outpatients taking warfarin at Kenyatta National Hospital. Methodology : A cross-sectional survey of 147out-patients on warfarin at Kenyatta National Hospital was carried out between March and April 2015. Data were collected using a pre-designed interviewer administered questionnaire. The data included patient characteristics such as indication and duration of anticoagulation; knowledge on anticoagulation; and international normalized ratio tests. The Oral Anticoagulation Knowledge test was used with a score of ≥75% indicating sufficient knowledge. Logistic regression was used to determine independent variables associated with anticoagulation control. Results : Females were majority (74.9%) while optimal anticoagulation control was at 43.5%. Only 10.1% had suffic...
Effect of Pesticide Exposure on Serum Cholinesterase Levels among Asthmatic Children in Naivasha Sub-County, Kenya
Background: Pesticide exposure is a risk factor for asthma exacerbations in flower farm regions i... more Background: Pesticide exposure is a risk factor for asthma exacerbations in flower farm regions in the world. Data on levels of serum cholinesterase among asthmatic children exposed to pesticides in Kenya is scanty. Objectives: To compare and identify variables which affect the concentration of serum cholinesterases in children who are exposed and unexposed to pesticides. Methodology: The design was a comparative cross-sectional study that involved exposed and unexposed children. The study was conducted between May and July, 2014 in Naivasha, Kenya. Patients were interviewed and serum samples were analysed for cholinesterase levels. Multi-linear regression was done to identify variables that affected cholinesterase activity. Results: Children who were exposed to pesticides had a lower median ChE activity of 5828 [IQR 4863, 6443] compared to the unexposed arm whose median was 7133 [IQR 6063, 8179]. Five predictor variables were found to be significantly associated with depressio...
Etiology, risk factors and management of infectious diarrhoea in children at Kenyatta National Hospital
Rwanda Journal of Medicine and Health Sciences
BackgroundStock outs of medicines and unaffordable cost are two major barriers of access to healt... more BackgroundStock outs of medicines and unaffordable cost are two major barriers of access to healthcare. Universal Health Coverage (UHC) seeks to ensure that all people have access to quality essential health services without suffering financial hardship.ObjectiveThe main objective of the study was to determine the effect and challenges of UHC program on the availability of medicines in public health facilities in Kisumu County.MethodologyThe study used a Pretest - posttest research design. The study was carried out in twenty-nine health facilities that were selected using stratified random sampling. Data was collected using key informant interviews with a health worker in each facility. Participants also involved four hundred and forty-four patients selected from the chosen facilities using consecutive sampling. Data from patients was collected using researcher administered questionnaires.ResultsThe availability of medicines improved by 3.4% for 20 tracer medicines since the introdu...
Gynecologic Oncology Research and Practice
Background: Although cervical cancer is preventable, it is still the second leading cause of canc... more Background: Although cervical cancer is preventable, it is still the second leading cause of cancer deaths among women in the world. Further, it is estimated that around 5-10% of hospital admissions are due to drug related problems (DRPs), of which 50% are avoidable. In cancer therapy, there is an immense potential for DRPs due to the high toxicity of most chemotherapeutic regimens. Hence, this study sought to assess DRPs among patients with cervical cancer at Kenyatta National Hospital (KNH). Methods: A cross-sectional study was conducted at the oncology units of KNH. A total of 81 study participants were recruited through simple random sampling. Data were collected from medical records and interviewing patients. The appropriateness of medical therapy was evaluated by comparing with National Compressive Cancer Network and European Society for Medical Oncology practice guideline of cervical cancer treatment protocol. The degree of adherence was determined using eight-item Morisky medication adherence scale. The likelihood of drug interaction was assessed using Medscape, Micromedex and Epocrates drug interaction checkers. The data were entered in Microsoft Excel and analysed using statistical software STATA version 13.0. Descriptive statistics such as mean, percent and frequency were used to summarise patients' characteristics. Univariable and multivariable binary logistic regression were used to investigate the potential predictors of DRPs. Result: A total of 215 DRPs were identified from 76 patients, translating to a prevalence of 93.8% and a mean of 2. 65 ± 1.22 DRPs. The predominant proportion of DRPs (48.2%) was identified in patients who had been treated with chemoradiation regimens. Adverse drug reactions 56(69.1%) and drug interactions 38(46.9%) were the most prevalent DRPs. Majority (67.9%) of the study population were adherent to their treatment regimens. Forgetfulness 18(69.2%), expensive medications 4(15.4%) and side effects of medications 4(15.4%) were the main reasons for medication non-adherence. Patients with advanced stage cervical cancer were 15.4 times (AOR = 15.4, 95% CI = 1. 3-185.87, p = 0.031) more likely to have DRPs as compared to patients with early stage disease. Conclusion: Adverse drug reactions, drug interactions, and need of additional drug therapy were the most common DRPs identified among cervical cancer patients. Advanced stage cervical cancer was the only predictor of DRPs.
Antihypertensive therapy and adequacy of blood pressure control among adult hypertensive diabetic patients with chronic kidney disease in a tertiary referral hospital
Hospital Practice
Determinants of Adherence to Anticonvulsants Therapy among Outpatient Epileptic Children in a Kenyan Referral Hospital
African Journal of Pharmacology and Therapeutics, Nov 5, 2015
Effect of Pesticide Exposure on Serum Cholinesterase Levels among Asthmatic Children in Naivasha Sub-County, Kenya
African Journal of Pharmacology and Therapeutics, Mar 4, 2015
Introduction of Mortgage backed securities in Kenya Capital Market