Factors associated with non adherence to regulations on sale of alcohol by alcohol outlets operators in Thika Municipality, Kiambu County

Objective: To determine factors associated with non-adherence of existing alcohol regulations and policies on alcohol sale in Thika municipality Kiambu County.Design: A descriptive cross-sectional study.Setting: Thika Municipality, Kiambu County, KenyaSubjects: Eighty nine (89) participants were enrolled in the study. Ten (10) Key Informant Interviews were conducted among the security personnel, health officers, managers and supervisors.Results: Out of the 89 outlet operators enrolled in the study, (70.8%) among therespondents were not aware of the alcohol control act. Association between marital status and non adherence of the act was significant (p=0.003). There was low knowledge of 5.6%, who were aware of when the alcohol act was implemented, majority who totaled to 70.8% were not aware on when the alcohol control policy came into existence. Majority of the respondent 62.9% reported not to adhere to the alcohol control act of 2010; also the study showed that 57.3% of the responded were not aware of measures to control illicit brew. From the In-depth interviews most of the respondents interviewed confirmed that many of the operators were not aware of the act and it was difficult to implement thus subjecting the consumers into alcohol abuse. They also confirmed that with lack of employment, many women engaged into the alcohol operations which also contributed to the breakdown of their families given the mode of operations.Conclusion: This study concludes that there is failure in enforcement and adherence of the 2010 alcohol regulations. The study recommends the review of the alcohol control act of 2010 to ensure tough measures and penalties are adapted to anyone who fails to adhere to the act. Also there is need for awareness to be initiated to ensure members are informed and adhere to the policy. Setting up of an independent unit that will be mandated to enforcement and adherence of the 2010 alcoholic act

Personality traits as markers of psychosis risk in Kenya: Assessment of temperament and character

Specific personality traits have been proposed as a schizophrenia-related endophenotype and confirmed in siblings at risk for psychosis. The relationship of temperament and character with psychosis has not been previously investigated in Africa. The study was conducted in Kenya, and involved participants at clinical high-risk (CHR) for psychosis

Assessment of Patient Satisfaction with Nursing Care at a Large Public Referral Hospital in Kenya

Patient satisfaction with nursing care is known to predict patient outcomes. Nursing care offered by the largest single technical group in any hospital, is known to often determine the overall quality of care offered. This study hence examined the extent to which patients at a Referral hospital in Western Kenya are satisfied with the nursing care they receive. A cross sectional exit survey of discharged patients using a self-administered patient questionnaire was used. 274 patients participated, of which 65.6% were female. 94.1% had formal education with 59.1% reporting that this was their maiden visit to the hospital. Overall, 87% of patients felt satisfied with nursing care received. Most (81.8%) of the patients interviewed felt they had been promptly attended to, with a further 71.6% rating the nurses as competent and knowledgeable in their clinical care. The ward in which the patient had been admitted and the number of days a patient had spent in hospital were found to be significantly associated with reporting of overall satisfaction with nursing care (p=0.037 & 0.03 respectively). Since nursing care is determinant of patient outcomes during hospitalization, clinical care administrators should often emphasize on the Nurses’ technical competence and interpersonal relationships throughout patient care. Prompt quality nursing care should be prioritized to match with patient expectations in each hospital units and ensure patient satisfaction through reduction of length of stay in hospital. Key words: Assessment, patient satisfaction, nursing car

Can I speak to the manager? The gender dynamics of decision-making in Kenyan maize plots

Gender and social inclusion efforts in agricultural development are focused on making uptake of agricultural technologies more equitable. Yet research looking at how gender relations influence technology uptake often assumes that men and women within a household make farm management decisions as individuals. Relatively little is understood about the dynamics of agricultural decision-making within dual-adult households where individuals’ management choices are likely influenced by others in the household. This study used vignettes to examine decision-making related to maize plot management in 698 dual-adult households in rural Kenya. The results indicated a high degree of joint management of maize plots (55%), although some management decisions—notably those related to purchased inputs—were slightly more likely to be controlled by men, while other decisions—including those related to hiring of labor and maize end uses—were more likely to be made by women. The prevalence of joint decision-making underscores the importance of ensuring that both men’s and women’s priorities and needs are reflected in design and marketing of interventions to support maize production, including those related to seed systems, farmer capacity building, and input delivery

Complete genome sequences of dengue virus type 2 strains from Kilifi, Kenya

Dengue infection remains poorly characterized in Africa and little is known regarding its associated viral genetic diversity. Here, we report dengue virus type 2 (DENV-2) sequence data from 10 clinical samples, including 5 complete genome sequences of the cosmopolitan genotype, obtained from febrile adults seeking outpatient care in coastal Kenya

Health worker performance in the management of paediatric fevers following in-service training and exposure to job aids in Kenya

BACKGROUND: Improving the way artemether-lumefantrine (AL) is provided to patients attending clinics is critical to maximize the benefit of this new medicine. In 2007, a new initiative was launched in one part of Kenya to improve malaria case-management through enhanced in-service training and provision of job aids. METHODS: An evaluation of the intervention using pre- and post-intervention cross sectional health facility surveys was conducted in Bondo district. The surveys included: audit of government health facilities, health worker structured interviews and exit interviews with caretakers of sick children below five years of age. The outcome indicators were the proportions of febrile children who had AL prescribed, AL dispensed, and four different dispensing and counseling tasks performed. RESULTS: At baseline 33 government health facilities, 48 health workers and 386 febrile child consultations were evaluated. At follow-up the same health facilities were surveyed and 36 health workers and 390 febrile child consultations evaluated. The findings show: 1) no health facility or health worker was exposed to all components of the intervention; 2) the proportion of health workers who received the enhanced in-service training was 67%; 3) the proportion of febrile children with uncomplicated malaria treated with the first-line anti-malarial drug, artemether-lumefantrine (AL), at health facilities where AL was in stock increased from 76.9% (95%CI: 69.4, 83.1) to 87.6% (95% CI: 82.5, 91.5); 4) there were modest but non-significant improvements in dispensing and counseling practices; and 5) when the analyses were restricted to health workers who received the enhanced in-service training and/or had received new guidelines and job aids, no significant improvements in reported case-management tasks were observed compared to baseline. CONCLUSION: In-service training and provision of job aids alone may not be adequate to improve the prescribing, dispensing and counseling tasks necessary to change malaria case-management practices and the inclusion of supervision and post-training follow-up should be considered in future clinical practice change initiatives

Quantifying previous SARS-CoV-2 infection through mixture modelling of antibody levels.

As countries decide on vaccination strategies and how to ease movement restrictions, estimating the proportion of the population previously infected with SARS-CoV-2 is important for predicting the future burden of COVID-19. This proportion is usually estimated from serosurvey data in two steps: first the proportion above a threshold antibody level is calculated, then the crude estimate is adjusted using external estimates of sensitivity and specificity. A drawback of this approach is that the PCR-confirmed cases used to estimate the sensitivity of the threshold may not be representative of cases in the wider population-e.g., they may be more recently infected and more severely symptomatic. Mixture modelling offers an alternative approach that does not require external data from PCR-confirmed cases. Here we illustrate the bias in the standard threshold-based approach by comparing both approaches using data from several Kenyan serosurveys. We show that the mixture model analysis produces estimates of previous infection that are often substantially higher than the standard threshold analysis

The Impact of Retail-Sector Delivery of Artemether–Lumefantrine on Malaria Treatment of Children under Five in Kenya: A Cluster Randomized Controlled Trial

In a cluster randomized trial, Beth Kangwana and colleagues find that provision of subsidized packs of the malaria therapy artemether-lumefantrine to shops more than doubled the proportion of children with fever who received drugs promptly

Malaria Rapid Testing by Community Health Workers Is Effective and Safe for Targeting Malaria Treatment: Randomised Cross-Over Trial in Tanzania

Early diagnosis and prompt, effective treatment of uncomplicated malaria is critical to prevent severe disease, death and malaria transmission. We assessed the impact of rapid malaria diagnostic tests (RDTs) by community health workers (CHWs) on provision of artemisinin-based combination therapy (ACT) and health outcome in fever patients. Twenty-two CHWs from five villages in Kibaha District, a high-malaria transmission area in Coast Region, Tanzania, were trained to manage uncomplicated malaria using RDT aided diagnosis or clinical diagnosis (CD) only. Each CHW was randomly assigned to use either RDT or CD the first week and thereafter alternating weekly. Primary outcome was provision of ACT and main secondary outcomes were referral rates and health status by days 3 and 7. The CHWs enrolled 2930 fever patients during five months of whom 1988 (67.8%) presented within 24 hours of fever onset. ACT was provided to 775 of 1457 (53.2%) patients during RDT weeks and to 1422 of 1473 (96.5%) patients during CD weeks (Odds Ratio (OR) 0.039, 95% CI 0.029-0.053). The CHWs adhered to the RDT results in 1411 of 1457 (96.8%, 95% CI 95.8-97.6) patients. More patients were referred on inclusion day during RDT weeks (10.0%) compared to CD weeks (1.6%). Referral during days 1-7 and perceived non-recovery on days 3 and 7 were also more common after RDT aided diagnosis. However, no fatal or severe malaria occurred among 682 patients in the RDT group who were not treated with ACT, supporting the safety of withholding ACT to RDT negative patients. RDTs in the hands of CHWs may safely improve early and well-targeted ACT treatment in malaria patients at community level in Africa.\ud \ud \ud \u