Peter Itsura | Moi University (original) (raw)

Papers by Peter Itsura

Research paper thumbnail of Survival of cervical cancer patients at Moi teaching and Referral Hospital, Eldoret in western Kenya

BMC Cancer

Background Cervical cancer is a major health burden and the second most common cancer after breas... more Background Cervical cancer is a major health burden and the second most common cancer after breast cancer among women in Kenya. Worldwide cervical cancer constitutes 3.1% of all cancer cases. Mortality rates are greatest among the low-income countries because of lack of awareness, screening and early-detection programs and adequate treatment facilities. The main aim was to estimate survival and determine survival predictors of women with cervical cancer and limited resources in western Kenya. Methods Retrospective charts review of women diagnosed with cervical cancer and follow-up for two years from the date of the histologic diagnosis. The outcome of interest was death or survival at two years. Kaplan Meier estimates of survival, log-rank test and Cox proportional hazards regression were used in the survival analysis. Results One hundred and sixty-two (162) participants were included in the review. The median duration was 0.8 (interquartile range (IQR) 0.3, 1.6) years. The mean age...

Research paper thumbnail of Mortality factors in high and ultra-high-risk gestational trophoblastic neoplasia at moi teaching & referral hospital: A decade-long observation in kenya

Gynecologic oncology reports, Apr 1, 2024

Research paper thumbnail of Colposcopic and Histopathologic Comparative Interpretations Among Patients Undergoing Evaluation for Cervical Dysplasia in Western Kenya

European medical journal. Reproductive health, Apr 9, 2024

Research paper thumbnail of 411 Cervical cancer management in a low resource setting: a 10-year review in a tertiary care hospital in Kenya

Research paper thumbnail of Loop Electrosurgical Excision Procedure is More Effective than Cryotherapy as Treatment for Cervical Intraepithelial Neoplasia in Women with HIV in Western Kenya

Research paper thumbnail of LEEP more effective than cryotherapy as effective treatment for CIN lesions in women living with HIV and without HIV in western Kenya (2129)

Research paper thumbnail of #636 Palliative care attitude and knowledge of clinicians attending to cervical cancer patients in moi teaching and referral hospital, Kenya

Research paper thumbnail of Case Records and Commentaries

In part fulfillment for examination of Masters Of Medicine In Obstetrics and Gynaecology Of the U... more In part fulfillment for examination of Masters Of Medicine In Obstetrics and Gynaecology Of the University Of Nairobi

Research paper thumbnail of Human Immunodeficiency Virus Type 1 RNA Genital Tract Shedding After Cryotherapy for Cervical Intraepithelial Neoplasia in Western Kenya

Open Forum Infectious Diseases

This prospective study of 39 women living with human immunodeficiency virus (HIV) on antiretrovir... more This prospective study of 39 women living with human immunodeficiency virus (HIV) on antiretroviral therapy in Western Kenya aimed to quantify genital tract HIV-1 RNA (GT-HIV RNA) shedding before and after cryotherapy for cervical intraepithelial neoplasia. Most GT-HIV RNA shedding was detected precryotherapy, suggesting that cryotherapy was not the primary cause of shedding.

Research paper thumbnail of Bethune Round Table 2012: 12th Annual Conference: Filling the GapImpact of international collaboration on surgical services in a Nigerian tertiary centreSurgeons OverSeas Assessment of Surgical Needs (SOSAS) Rwanda: a useful rural health experience for medical studentsPreinternship Nigerian medic...

Canadian Journal of Surgery, 2012

Research paper thumbnail of Knowledge of Cervical Cancer and Acceptability of Prevention Strategies Among Human Papillomavirus-Vaccinated and Human Papillomavirus-Unvaccinated Adolescent Women in Eldoret, Kenya

Cervical cancer is a critical public health concern in sub-Saharan Africa. Adolescents are key ta... more Cervical cancer is a critical public health concern in sub-Saharan Africa. Adolescents are key targets in primary prevention strategies. Following a human papillomavirus (HPV) vaccination initiative (Gardasil) in Eldoret, Kenya, the knowledge and source of information of cervical cancer and acceptance of prevention strategies among vaccinated and unvaccinated adolescents were evaluated. A cross-sectional comparative study enrolled 60 vaccinated and 120 unvaccinated adolescent women. Institutional ethical approval was obtained and signed consent was obtained from the parents. Data collection was performed using interviewer-administered questionnaires derived from factual statements based on information from print material used for community sensitization on cervical cancer. The median age of the participants was 14.0 years (interquartile range [IQR] = 13.0-15.0). Of 60 vaccinated adolescents, 56 (93.3%) had heard of the HPV vaccine compared with 6 (5%) of unvaccinated participants (p < 0.001). Of 60 vaccinated participants, 58 (96.7%) had heard of cervical cancer compared with 61 (50.8%) unvaccinated participants (p < 0.001). Both cohorts identified the school as the main source of information for cervical cancer. The two groups also showed similarity in their selection of cervical cancer prevention strategies acceptable to them such as delaying sexual debut, limiting number of sexual partners, and use of condoms for protection against sexually transmitted infections. Of 120 unvaccinated participants, 63.7% expressed willingness to be vaccinated. Exposure to the HPV vaccine was associated with a higher knowledge of cervical cancer. The adolescents predominantly rely on the school for health information. Both cohorts of adolescents showed remarkable acceptability for cervical cancer prevention strategies.

Research paper thumbnail of EP338/#105 Epidemiological profile and clinico-pathological features of pediatric gynecological cancers at moi teaching & referral hospital, Kenya

Research paper thumbnail of The East Africa Consortium for human papillomavirus and cervical cancer in women living with HIV/AIDS

Research paper thumbnail of Epidemiological profile and clinico-pathological features of pediatric gynecological cancers at Moi Teaching & Referral Hospital, Kenya

Gynecologic Oncology Reports, 2022

Highlights • Fertility-sparing surgery for pediatric gynecological cancers should be the primary ... more Highlights • Fertility-sparing surgery for pediatric gynecological cancers should be the primary management.• Dysgerminomas are the commonest ovarian germ cell tumors.• Neo-adjuvant chemotherapy is feasible in advanced germ cell tumors.• Pediatric gynecological cancers can have excellent prognosis.• Early diagnosis and treatment can improve prognosis for germ cell tumors in LMICs.

Research paper thumbnail of EP033/#52 A qualitative exploration of perceived causes of breast cancer in Busia and Trans Nzoia, Western Kenya

Research paper thumbnail of Survival of Patients With Cervical Cancer at Moi Teaching and Referral Hospital in Eldoret, Western Kenya

Background Cervical cancer is a major health burden and the second most common cancer after breas... more Background Cervical cancer is a major health burden and the second most common cancer after breast cancer among women in Kenya. Worldwide, cervical cancer constitutes 3.1% of all cancer cases. Mortality rates are greatest in low-income countries owing to a lack of awareness, screening and early-detection programs, and adequate treatment facilities. We aimed to estimate survival rates and determine survival predictors among women with cervical cancer and limited resources in western Kenya. Methods We retrospectively reviewed the charts of women diagnosed with cervical cancer in the 2 years from the date of histologic diagnosis. The outcome of interest was 2-year mortality or survival. Kaplan–Meier survival estimates, log-rank tests, and Cox proportional hazards regression were used in the survival analysis. Results We included 162 women in this study. The median time from diagnosis to death was 0.8 (interquartile range [IQR] 0.3–1.6) years. The mean age at diagnosis was 50.6 (standar...

Research paper thumbnail of A qualitative exploration of perceived causes of cervical cancer in Busia and Trans Nzoia, Western Kenya (416)

Research paper thumbnail of Ovarian Burkitt’s Lymphoma in a Four-Year-Old Girl: A Rare Case

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2020

Burkitt’s Lymphoma (BL) is one of the most common paediatric cancers in Sub-Saharan Africa. It is... more Burkitt’s Lymphoma (BL) is one of the most common paediatric cancers in Sub-Saharan Africa. It is a high-grade lymphoma associated with Epstein Barr Virus (EBV) and malaria infections as co-factors. It may occur as an abdominal tumour with ovarian involvement in a few cases. Previous incidences range between 0.5% to 1.5% of all ovarian neoplasm and are involved in 19% of all adnexal lymphomas. Its occurrence is often among those aged between 6-62 years but very rare among four-year-old girls. This study describes a case of ovarian BL in a four-year-old girl presenting with difficulty in breathing, abdominal pain and distension. The lymphoma had spread to several sites within a short duration. This case represents a great challenge in paediatric oncology management as to when medical or surgical treatment should be considered. Significant laboratory findings were elevated serum Cancer Antigen (CA) 125 and Lactate Dehydrogenase (LDH). Furthermore, flow cytometry, histopathology and im...

Research paper thumbnail of Strengthening Weak Healthcare Systems for Maternal and Neonatal Care in Low and Middle Income Countries: The Missing Link

Advances in Sexual Medicine, 2022

Introduction: Preventable maternal and newborn mortalities still occur in local communities in Ke... more Introduction: Preventable maternal and newborn mortalities still occur in local communities in Kenya since access to maternal and newborn healthcare services remains a big challenge. Barriers to access in resource-constrained settings have not been examined adequately in literature. The World Health Organization (WHO) has 6 building blocks for strengthening healthcare systems that informed this study. This paper examines how user-side and institutional factors influence access and use of Maternal and Newborn Healthcare (MNH) Services in Matayos sub-County-Busia County. Methods: A mixed method approach, with an ethnographic inquiry and a descriptive cross-sectional design, was adopted to assess access to MNH services in Matayos-Busia County, Western Kenya. Postpartum women who had delivered within the previous 12 months and health care providers in the study area were recruited as respondents. A total of 348 postpartum women were selected through stratified systematic random sampling for the survey. Purposive sampling was used to select postpartum women, conventional and traditional health care providers for 16 in-depth interviews and 7 focus group discussions. Data were analyzed using descriptive and inferential statistics. Qualitative data analysis was done thematically. Results: Institutional delivery was low at 68% and family planning at 75% although demand for services was high at 99%. User-side barriers to access included shared beliefs and practices in the community; high direct transport costs from home; and high costs for missing drugs and other supplies in hospitals. Middle (5 th-7 th) order deliveries occurred at home with traditional birth attendants. The choice of place of delivery in households was influenced by spouses to respondents and communities of residence where respondents lived or were married.

Research paper thumbnail of Radical surgery for early cervical cancer in a resource limited setting: survival and challenges

Journal of obstetrics & gynaecology of Eastern and Central Africa, 2020

Introduction: Cervical cancer is one of the most common cancers affecting women, with the highest... more Introduction: Cervical cancer is one of the most common cancers affecting women, with the highestincidence and mortality rates reported in East Africa. This study aimed to evaluate the outcomes of patientswith early-stage cervical cancer treated with radical surgery in Western Kenya.Methodology: This was a retrospective study of 131 consecutive patients with early cervical cancer (FIGOstage IA2 - IIA) treated over 5 years at Moi Teaching and Referral Hospital in Western Kenya. Nonparametricstatistics, the log-rank test and Cox regression were used to evaluate the effects of the covariatesanalysed on survival.Results: The mean age was 44.8 years, and the modal age group was 41-50 years (38.9%). HIVseroprevalence was 45.8%, while squamous cell carcinoma was the predominant histologic type seen in123 (93.9%) patients. The surgical margins were positive in 4 (3.1%) patients. Pelvic nodal metastases wereseen in 42 (35.9%) patients. The number of patients who required adjuvant chemo-radia...

Research paper thumbnail of Survival of cervical cancer patients at Moi teaching and Referral Hospital, Eldoret in western Kenya

BMC Cancer

Background Cervical cancer is a major health burden and the second most common cancer after breas... more Background Cervical cancer is a major health burden and the second most common cancer after breast cancer among women in Kenya. Worldwide cervical cancer constitutes 3.1% of all cancer cases. Mortality rates are greatest among the low-income countries because of lack of awareness, screening and early-detection programs and adequate treatment facilities. The main aim was to estimate survival and determine survival predictors of women with cervical cancer and limited resources in western Kenya. Methods Retrospective charts review of women diagnosed with cervical cancer and follow-up for two years from the date of the histologic diagnosis. The outcome of interest was death or survival at two years. Kaplan Meier estimates of survival, log-rank test and Cox proportional hazards regression were used in the survival analysis. Results One hundred and sixty-two (162) participants were included in the review. The median duration was 0.8 (interquartile range (IQR) 0.3, 1.6) years. The mean age...

Research paper thumbnail of Mortality factors in high and ultra-high-risk gestational trophoblastic neoplasia at moi teaching & referral hospital: A decade-long observation in kenya

Gynecologic oncology reports, Apr 1, 2024

Research paper thumbnail of Colposcopic and Histopathologic Comparative Interpretations Among Patients Undergoing Evaluation for Cervical Dysplasia in Western Kenya

European medical journal. Reproductive health, Apr 9, 2024

Research paper thumbnail of 411 Cervical cancer management in a low resource setting: a 10-year review in a tertiary care hospital in Kenya

Research paper thumbnail of Loop Electrosurgical Excision Procedure is More Effective than Cryotherapy as Treatment for Cervical Intraepithelial Neoplasia in Women with HIV in Western Kenya

Research paper thumbnail of LEEP more effective than cryotherapy as effective treatment for CIN lesions in women living with HIV and without HIV in western Kenya (2129)

Research paper thumbnail of #636 Palliative care attitude and knowledge of clinicians attending to cervical cancer patients in moi teaching and referral hospital, Kenya

Research paper thumbnail of Case Records and Commentaries

In part fulfillment for examination of Masters Of Medicine In Obstetrics and Gynaecology Of the U... more In part fulfillment for examination of Masters Of Medicine In Obstetrics and Gynaecology Of the University Of Nairobi

Research paper thumbnail of Human Immunodeficiency Virus Type 1 RNA Genital Tract Shedding After Cryotherapy for Cervical Intraepithelial Neoplasia in Western Kenya

Open Forum Infectious Diseases

This prospective study of 39 women living with human immunodeficiency virus (HIV) on antiretrovir... more This prospective study of 39 women living with human immunodeficiency virus (HIV) on antiretroviral therapy in Western Kenya aimed to quantify genital tract HIV-1 RNA (GT-HIV RNA) shedding before and after cryotherapy for cervical intraepithelial neoplasia. Most GT-HIV RNA shedding was detected precryotherapy, suggesting that cryotherapy was not the primary cause of shedding.

Research paper thumbnail of Bethune Round Table 2012: 12th Annual Conference: Filling the GapImpact of international collaboration on surgical services in a Nigerian tertiary centreSurgeons OverSeas Assessment of Surgical Needs (SOSAS) Rwanda: a useful rural health experience for medical studentsPreinternship Nigerian medic...

Canadian Journal of Surgery, 2012

Research paper thumbnail of Knowledge of Cervical Cancer and Acceptability of Prevention Strategies Among Human Papillomavirus-Vaccinated and Human Papillomavirus-Unvaccinated Adolescent Women in Eldoret, Kenya

Cervical cancer is a critical public health concern in sub-Saharan Africa. Adolescents are key ta... more Cervical cancer is a critical public health concern in sub-Saharan Africa. Adolescents are key targets in primary prevention strategies. Following a human papillomavirus (HPV) vaccination initiative (Gardasil) in Eldoret, Kenya, the knowledge and source of information of cervical cancer and acceptance of prevention strategies among vaccinated and unvaccinated adolescents were evaluated. A cross-sectional comparative study enrolled 60 vaccinated and 120 unvaccinated adolescent women. Institutional ethical approval was obtained and signed consent was obtained from the parents. Data collection was performed using interviewer-administered questionnaires derived from factual statements based on information from print material used for community sensitization on cervical cancer. The median age of the participants was 14.0 years (interquartile range [IQR] = 13.0-15.0). Of 60 vaccinated adolescents, 56 (93.3%) had heard of the HPV vaccine compared with 6 (5%) of unvaccinated participants (p < 0.001). Of 60 vaccinated participants, 58 (96.7%) had heard of cervical cancer compared with 61 (50.8%) unvaccinated participants (p < 0.001). Both cohorts identified the school as the main source of information for cervical cancer. The two groups also showed similarity in their selection of cervical cancer prevention strategies acceptable to them such as delaying sexual debut, limiting number of sexual partners, and use of condoms for protection against sexually transmitted infections. Of 120 unvaccinated participants, 63.7% expressed willingness to be vaccinated. Exposure to the HPV vaccine was associated with a higher knowledge of cervical cancer. The adolescents predominantly rely on the school for health information. Both cohorts of adolescents showed remarkable acceptability for cervical cancer prevention strategies.

Research paper thumbnail of EP338/#105 Epidemiological profile and clinico-pathological features of pediatric gynecological cancers at moi teaching & referral hospital, Kenya

Research paper thumbnail of The East Africa Consortium for human papillomavirus and cervical cancer in women living with HIV/AIDS

Research paper thumbnail of Epidemiological profile and clinico-pathological features of pediatric gynecological cancers at Moi Teaching & Referral Hospital, Kenya

Gynecologic Oncology Reports, 2022

Highlights • Fertility-sparing surgery for pediatric gynecological cancers should be the primary ... more Highlights • Fertility-sparing surgery for pediatric gynecological cancers should be the primary management.• Dysgerminomas are the commonest ovarian germ cell tumors.• Neo-adjuvant chemotherapy is feasible in advanced germ cell tumors.• Pediatric gynecological cancers can have excellent prognosis.• Early diagnosis and treatment can improve prognosis for germ cell tumors in LMICs.

Research paper thumbnail of EP033/#52 A qualitative exploration of perceived causes of breast cancer in Busia and Trans Nzoia, Western Kenya

Research paper thumbnail of Survival of Patients With Cervical Cancer at Moi Teaching and Referral Hospital in Eldoret, Western Kenya

Background Cervical cancer is a major health burden and the second most common cancer after breas... more Background Cervical cancer is a major health burden and the second most common cancer after breast cancer among women in Kenya. Worldwide, cervical cancer constitutes 3.1% of all cancer cases. Mortality rates are greatest in low-income countries owing to a lack of awareness, screening and early-detection programs, and adequate treatment facilities. We aimed to estimate survival rates and determine survival predictors among women with cervical cancer and limited resources in western Kenya. Methods We retrospectively reviewed the charts of women diagnosed with cervical cancer in the 2 years from the date of histologic diagnosis. The outcome of interest was 2-year mortality or survival. Kaplan–Meier survival estimates, log-rank tests, and Cox proportional hazards regression were used in the survival analysis. Results We included 162 women in this study. The median time from diagnosis to death was 0.8 (interquartile range [IQR] 0.3–1.6) years. The mean age at diagnosis was 50.6 (standar...

Research paper thumbnail of A qualitative exploration of perceived causes of cervical cancer in Busia and Trans Nzoia, Western Kenya (416)

Research paper thumbnail of Ovarian Burkitt’s Lymphoma in a Four-Year-Old Girl: A Rare Case

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2020

Burkitt’s Lymphoma (BL) is one of the most common paediatric cancers in Sub-Saharan Africa. It is... more Burkitt’s Lymphoma (BL) is one of the most common paediatric cancers in Sub-Saharan Africa. It is a high-grade lymphoma associated with Epstein Barr Virus (EBV) and malaria infections as co-factors. It may occur as an abdominal tumour with ovarian involvement in a few cases. Previous incidences range between 0.5% to 1.5% of all ovarian neoplasm and are involved in 19% of all adnexal lymphomas. Its occurrence is often among those aged between 6-62 years but very rare among four-year-old girls. This study describes a case of ovarian BL in a four-year-old girl presenting with difficulty in breathing, abdominal pain and distension. The lymphoma had spread to several sites within a short duration. This case represents a great challenge in paediatric oncology management as to when medical or surgical treatment should be considered. Significant laboratory findings were elevated serum Cancer Antigen (CA) 125 and Lactate Dehydrogenase (LDH). Furthermore, flow cytometry, histopathology and im...

Research paper thumbnail of Strengthening Weak Healthcare Systems for Maternal and Neonatal Care in Low and Middle Income Countries: The Missing Link

Advances in Sexual Medicine, 2022

Introduction: Preventable maternal and newborn mortalities still occur in local communities in Ke... more Introduction: Preventable maternal and newborn mortalities still occur in local communities in Kenya since access to maternal and newborn healthcare services remains a big challenge. Barriers to access in resource-constrained settings have not been examined adequately in literature. The World Health Organization (WHO) has 6 building blocks for strengthening healthcare systems that informed this study. This paper examines how user-side and institutional factors influence access and use of Maternal and Newborn Healthcare (MNH) Services in Matayos sub-County-Busia County. Methods: A mixed method approach, with an ethnographic inquiry and a descriptive cross-sectional design, was adopted to assess access to MNH services in Matayos-Busia County, Western Kenya. Postpartum women who had delivered within the previous 12 months and health care providers in the study area were recruited as respondents. A total of 348 postpartum women were selected through stratified systematic random sampling for the survey. Purposive sampling was used to select postpartum women, conventional and traditional health care providers for 16 in-depth interviews and 7 focus group discussions. Data were analyzed using descriptive and inferential statistics. Qualitative data analysis was done thematically. Results: Institutional delivery was low at 68% and family planning at 75% although demand for services was high at 99%. User-side barriers to access included shared beliefs and practices in the community; high direct transport costs from home; and high costs for missing drugs and other supplies in hospitals. Middle (5 th-7 th) order deliveries occurred at home with traditional birth attendants. The choice of place of delivery in households was influenced by spouses to respondents and communities of residence where respondents lived or were married.

Research paper thumbnail of Radical surgery for early cervical cancer in a resource limited setting: survival and challenges

Journal of obstetrics & gynaecology of Eastern and Central Africa, 2020

Introduction: Cervical cancer is one of the most common cancers affecting women, with the highest... more Introduction: Cervical cancer is one of the most common cancers affecting women, with the highestincidence and mortality rates reported in East Africa. This study aimed to evaluate the outcomes of patientswith early-stage cervical cancer treated with radical surgery in Western Kenya.Methodology: This was a retrospective study of 131 consecutive patients with early cervical cancer (FIGOstage IA2 - IIA) treated over 5 years at Moi Teaching and Referral Hospital in Western Kenya. Nonparametricstatistics, the log-rank test and Cox regression were used to evaluate the effects of the covariatesanalysed on survival.Results: The mean age was 44.8 years, and the modal age group was 41-50 years (38.9%). HIVseroprevalence was 45.8%, while squamous cell carcinoma was the predominant histologic type seen in123 (93.9%) patients. The surgical margins were positive in 4 (3.1%) patients. Pelvic nodal metastases wereseen in 42 (35.9%) patients. The number of patients who required adjuvant chemo-radia...