Susan Onyango - Academia.edu (original) (raw)

Papers by Susan Onyango

Updates on Renal Replacement Therapy [Working Title]

This chapter discusses Medical Nutrition Therapy in three modalities of renal replacement therapy... more This chapter discusses Medical Nutrition Therapy in three modalities of renal replacement therapy (RRT), outlining the nutrient requirements for patients on maintenance hemodialysis, peritoneal dialysis, and kidney transplant in acute and chronic phases. The chapter takes note of the drastic impact of RRT on the patient’s nutrition status and overall well-being, which puts them at high risk of morbidity and mortality, and thus emphasizes timely and regular comprehensive nutrition assessment to enable appropriate intervention. Recognizing that there are different modalities of RRT and that patients have different physiological characteristics as well as different laboratory test values, which may also vary for individual patients each time tests are run, nutrition therapy is individualized each time. The chapter takes a closer look at protein-energy wasting, a condition common among patients undergoing RRT, which is a predictor of mortality, discussing its prevention and treatment me...

DOAJ (DOAJ: Directory of Open Access Journals), Dec 1, 2020

Introduction Nutrition therapy is now strongly advocated to be integrated into Antiretroviral The... more Introduction Nutrition therapy is now strongly advocated to be integrated into Antiretroviral Therapy (ART). Nutrition interventions aim to prevent malnutrition and restore nutritional status to maintain PLHIV’s productivity. In Kenya, the Food by Prescription (FBP) program provides nutritional support to malnourished PLHIV. Homa Bay County has been implementing nutrition support services for PLHIV since the advent of devolution of counties. Purpose The purpose of this study was to assess selected nutrition indicators in the HIV response of Homa Bay County, Kenya between 2014 and 2018. Materials and methods Data were extracted from the Kenya Health Information System (KHIS), using a datasheet, analyzed, and studied. The indicators selected for this study included: the number of clients assessed for malnutrition, eligibility for food support, treatment outcomes for PLHIV on food support, reporting rates, and nutrition commodities stockouts. Data obtained from the survey were analyzed using descriptive statistics. Some of the results were also presented in tables as frequencies or frequencies and percentages. Results Results of the study indicated that 15% to 65% of adults attending the HIV/ AIDS clinics in public health facilities were malnourished, while 30% of children attending the clinic were also malnourished. The number of patients assessed for malnutrition increased from 1,742 in 2014 to 133,880 in 2018 while those who received food support increased from 2,702 to 17,116. Reporting rates for nutrition services and nutrition commodities increased from 12% and 16.3% respectively to 99% for both. Nutrition commodity stock out days reduced from 349 days and 200 days for therapeutic and supplementary foods respectively to 40 days and 20 days. Cure rates were still found to be low at 20% against the recommended 75%. Conclusion The county needs to strengthen the systems, including the channels through which they receive nutrition commodities.

DOAJ (DOAJ: Directory of Open Access Journals), Dec 1, 2020

Effective malaria control programs prevent transmission of malaria by promoting personal protecti... more Effective malaria control programs prevent transmission of malaria by promoting personal protective measures like the use of mosquito repellent creams, the use of mosquito net/coils, promoting effective vector control strategies like indoor residual spraying, and the provision of appropriate case management with early diagnosis and effective treatment. The Malaria vaccine is the proposed potential additional tool to complement the existing package of the WHO-recommended preventive, diagnostic, and treatment measures for malaria. Marindi Sub-County Hospital is one of the pilot sites where the Malaria Vaccine Program is being implemented in Kenya. Assessing the performance of the program is crucial in gauging the progress of the pilot program, identifying gaps/challenges, and formulating ways of addressing those challenges. We reviewed the records of children attending the Child Welfare Clinic (CWC) of the Marindi Sub-County Hospital and determined the number of children eligible for the malaria vaccine and those who got vaccinated between October 2019 and March 2020. 68.8% of the eligible children was vaccinated during this period. The malaria vaccine program is yet to pick up well due to various challenges and is expected to take shape as the implementation continues if the proposed measures are put in place. To improve the situation, there is the need for more sensitization (using the local language and through some contextually relevant channels), on the job training for healthcare workers, the astute dissemination of relevant information to all and sundry and to make more vaccines available to the program and localities

DOAJ (DOAJ: Directory of Open Access Journals), Dec 10, 2020

Re-use permitted under CC BY-NC. No commercial re-use or duplication.

Orapuh, 2020

Introduction Nutrition therapy is now strongly advocated to be integrated into Antiretroviral The... more Introduction
Nutrition therapy is now strongly advocated to be integrated into Antiretroviral
Therapy (ART). Nutrition interventions aim to prevent malnutrition and restore
nutritional status to maintain PLHIV’s productivity. In Kenya, the Food by
Prescription (FBP) program provides nutritional support to malnourished PLHIV.
Homa Bay County has been implementing nutrition support services for PLHIV
since the advent of devolution of counties.
Purpose
The purpose of this study was to assess selected nutrition indicators in the HIV
response of Homa Bay County, Kenya between 2014 and 2018.
Materials and methods
Data were extracted from the Kenya Health Information System (KHIS), using a
datasheet, analyzed, and studied. The indicators selected for this study included:
the number of clients assessed for malnutrition, eligibility for food support, treatment
outcomes for PLHIV on food support, reporting rates, and nutrition commodities
stockouts. Data obtained from the survey were analyzed using descriptive
statistics. Some of the results were also presented in tables as frequencies or
frequencies and percentages.
Results
Results of the study indicated that 15% to 65% of adults attending the HIV/ AIDS
clinics in public health facilities were malnourished, while 30% of children
attending the clinic were also malnourished. The number of patients assessed for
malnutrition increased from 1,742 in 2014 to 133,880 in 2018 while those who
received food support increased from 2,702 to 17,116. Reporting rates for nutrition
services and nutrition commodities increased from 12% and 16.3% respectively to
99% for both. Nutrition commodity stock out days reduced from 349 days and 200
days for therapeutic and supplementary foods respectively to 40 days and 20 days.
Cure rates were still found to be low at 20% against the recommended 75%.
Conclusion
The county needs to strengthen the systems, including the channels through which
they receive nutrition commodities.

Orapuh, 2020

Effective malaria control programs prevent transmission of malaria by promoting personal protecti... more Effective malaria control programs prevent transmission of malaria by promoting
personal protective measures like the use of mosquito repellent creams, the use of
mosquito net/coils, promoting effective vector control strategies like indoor
residual spraying, and the provision of appropriate case management with early
diagnosis and effective treatment. The Malaria vaccine is the proposed potential
additional tool to complement the existing package of the WHO-recommended
preventive, diagnostic, and treatment measures for malaria. Marindi Sub-County
Hospital is one of the pilot sites where the Malaria Vaccine Program is being
implemented in Kenya. Assessing the performance of the program is crucial in
gauging the progress of the pilot program, identifying gaps/challenges, and
formulating ways of addressing those challenges. We reviewed the records of
children attending the Child Welfare Clinic (CWC) of the Marindi Sub-County
Hospital and determined the number of children eligible for the malaria vaccine
and those who got vaccinated between October 2019 and March 2020. 68.8% of the
eligible children was vaccinated during this period. The malaria vaccine program
is yet to pick up well due to various challenges and is expected to take shape as the
implementation continues if the proposed measures are put in place. To improve
the situation, there is the need for more sensitization (using the local language and
through some contextually relevant channels), on the job training for healthcare
workers, the astute dissemination of relevant information to all and sundry and to
make more vaccines available to the program and localities

ORAPUH, 2020

Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) is an epidemic that t... more Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome
(HIV/AIDS) is an epidemic that the world still grapples with. In 2014, The Joint
United Nations Program on HIV/AIDS (UNAIDS) set fast-track targets for 2020 to
accelerate HIV response to end the HIV/AIDS epidemic by 2030. Ending the AIDS
epidemic will motivate the development and public health efforts, indicating what
global solidarity, multi-sectoral partnerships, and evidence-based actions can be
achieved. The 'ambitious' targets state that by 2020, 90% of all people living with
HIV will know their HIV status, 90% of all people with diagnosed HIV infection
will receive sustained antiretroviral therapy, and 90% of all people receiving
antiretroviral therapy will have viral load suppression. The purpose of this study
was to assess the progress of the Marindi Sub-County Hospital towards achieving
the 2020 United Nations' AIDS 'ambitious' 90-90-90 targets towards HIV testing,
antiretroviral therapy, and viral load suppression. At the time of this review, 1,823
people receiving ART at the hospital have been tested, representing 73 percent of
people who know their HIV status, giving the second 90 percent health outcome
target a 100 percent score. The viral load suppression rate in the hospital was 93.3
percent. Marindi Sub-County Hospital has achieved the second and the third 90
but is yet to fully achieve the first 90. Achieving the second and third 90 may be
right, but without achieving the first 90, it still means that many people who are
HIV positive are not accessing treatment, which can lead to an increase in HIV-related morbidities, mortalities, and new HIV infections. Believably, the '90–90–90
targets' remain a powerful tool to assess progress towards HIV elimination and
drive standards in care for PLHIV. From these results, 90-90-90 is not only feasible
but also achievable.

Books by Susan Onyango

This chapter discusses Medical Nutrition Therapy in three modalities of renal replacement therapy... more This chapter discusses Medical Nutrition Therapy in three modalities of renal replacement therapy (RRT), outlining the nutrient requirements for patients on maintenance hemodialysis, peritoneal dialysis, and kidney transplant in acute and chronic phases. The chapter takes note of the drastic impact of RRT on the patient's nutrition status and overall well-being, which puts them at high risk of morbidity and mortality, and thus emphasizes timely and regular comprehensive nutrition assessment to enable appropriate intervention. Recognizing that there are different modalities of RRT and that patients have different physiological characteristics as well as different laboratory test values, which may also vary for individual patients each time tests are run, nutrition therapy is individualized each time. The chapter takes a closer look at protein-energy wasting, a condition common among patients undergoing RRT, which is a predictor of mortality, discussing its prevention and treatment measures. Finally, the chapter takes a closer look at electrolytes, specifically potassium, sodium, calcium, and phosphorous, in relation to mineral bone disease.

Updates on Renal Replacement Therapy [Working Title]

DOAJ (DOAJ: Directory of Open Access Journals), Dec 1, 2020

DOAJ (DOAJ: Directory of Open Access Journals), Dec 10, 2020

Re-use permitted under CC BY-NC. No commercial re-use or duplication.

Orapuh, 2020

Introduction Nutrition therapy is now strongly advocated to be integrated into Antiretroviral The... more Introduction
Nutrition therapy is now strongly advocated to be integrated into Antiretroviral
Therapy (ART). Nutrition interventions aim to prevent malnutrition and restore
nutritional status to maintain PLHIV’s productivity. In Kenya, the Food by
Prescription (FBP) program provides nutritional support to malnourished PLHIV.
Homa Bay County has been implementing nutrition support services for PLHIV
since the advent of devolution of counties.
Purpose
The purpose of this study was to assess selected nutrition indicators in the HIV
response of Homa Bay County, Kenya between 2014 and 2018.
Materials and methods
Data were extracted from the Kenya Health Information System (KHIS), using a
datasheet, analyzed, and studied. The indicators selected for this study included:
the number of clients assessed for malnutrition, eligibility for food support, treatment
outcomes for PLHIV on food support, reporting rates, and nutrition commodities
stockouts. Data obtained from the survey were analyzed using descriptive
statistics. Some of the results were also presented in tables as frequencies or
frequencies and percentages.
Results
Results of the study indicated that 15% to 65% of adults attending the HIV/ AIDS
clinics in public health facilities were malnourished, while 30% of children
attending the clinic were also malnourished. The number of patients assessed for
malnutrition increased from 1,742 in 2014 to 133,880 in 2018 while those who
received food support increased from 2,702 to 17,116. Reporting rates for nutrition
services and nutrition commodities increased from 12% and 16.3% respectively to
99% for both. Nutrition commodity stock out days reduced from 349 days and 200
days for therapeutic and supplementary foods respectively to 40 days and 20 days.
Cure rates were still found to be low at 20% against the recommended 75%.
Conclusion
The county needs to strengthen the systems, including the channels through which
they receive nutrition commodities.

Orapuh, 2020

Effective malaria control programs prevent transmission of malaria by promoting personal protecti... more Effective malaria control programs prevent transmission of malaria by promoting
personal protective measures like the use of mosquito repellent creams, the use of
mosquito net/coils, promoting effective vector control strategies like indoor
residual spraying, and the provision of appropriate case management with early
diagnosis and effective treatment. The Malaria vaccine is the proposed potential
additional tool to complement the existing package of the WHO-recommended
preventive, diagnostic, and treatment measures for malaria. Marindi Sub-County
Hospital is one of the pilot sites where the Malaria Vaccine Program is being
implemented in Kenya. Assessing the performance of the program is crucial in
gauging the progress of the pilot program, identifying gaps/challenges, and
formulating ways of addressing those challenges. We reviewed the records of
children attending the Child Welfare Clinic (CWC) of the Marindi Sub-County
Hospital and determined the number of children eligible for the malaria vaccine
and those who got vaccinated between October 2019 and March 2020. 68.8% of the
eligible children was vaccinated during this period. The malaria vaccine program
is yet to pick up well due to various challenges and is expected to take shape as the
implementation continues if the proposed measures are put in place. To improve
the situation, there is the need for more sensitization (using the local language and
through some contextually relevant channels), on the job training for healthcare
workers, the astute dissemination of relevant information to all and sundry and to
make more vaccines available to the program and localities

ORAPUH, 2020

This chapter discusses Medical Nutrition Therapy in three modalities of renal replacement therapy... more This chapter discusses Medical Nutrition Therapy in three modalities of renal replacement therapy (RRT), outlining the nutrient requirements for patients on maintenance hemodialysis, peritoneal dialysis, and kidney transplant in acute and chronic phases. The chapter takes note of the drastic impact of RRT on the patient's nutrition status and overall well-being, which puts them at high risk of morbidity and mortality, and thus emphasizes timely and regular comprehensive nutrition assessment to enable appropriate intervention. Recognizing that there are different modalities of RRT and that patients have different physiological characteristics as well as different laboratory test values, which may also vary for individual patients each time tests are run, nutrition therapy is individualized each time. The chapter takes a closer look at protein-energy wasting, a condition common among patients undergoing RRT, which is a predictor of mortality, discussing its prevention and treatment measures. Finally, the chapter takes a closer look at electrolytes, specifically potassium, sodium, calcium, and phosphorous, in relation to mineral bone disease.