Factors influencing behaviour patterns in 3-5-year-old children attending three public paediatric dental clinics in Nairobi, Kenya

Objective: To determine factors that influence behaviour patterns in 3-5year olds attending paediatric dental clinics.Design: A descriptive cross-sectional study.Setting: The School of Dental Sciences, University of Nairobi Dental Hospital,Kenyatta National Hospital, Dental Clinic, and the Lady Northey Children’s ClinicSubjects: Three hundred and thirty children aged 3-5 years who had been accompanied by their parents/guardians.Results: Among the 330 children (174males and 156 females) examined those with ‘Definitely negative’ behaviour observed were 33 (10%) of the children, while 94 (28.5%) had ‘negative’ behaviour, 108 (32.7%) had ‘positive’ behaviour and 95 (28.8%) had ‘definitely positive’ behaviour. There was no relationship between child behaviour and previous clinical experience of the parent/guardian (p=0.21). The older children were significantly better behaved than the younger children (p=0.04). There was a significant relationship between child behaviour exhibited and previous clinical experience of the child (p=0.004). Parents/guardians were accurately able to predict the behaviour of their children in the clinic (p=0.00).Conclusion: Positive behaviour was significantly related to the age of the child and parents were able to accurately predict the behaviour of their children. Behaviour was also significantly related to previous clinical experiences of the child. Hence the dentists management of the child may result in negative or positive behaviour

Impact of internalized stigma on HIV prevention behaviors among HIV-infected individuals seeking HIV care in Kenya

In general, an initial diagnosis of HIV is likely to be correlated with the onset of HIV stigma. HIV-positive individuals are likely to internalize stigma, may suffer from psychosocial issues, or engage in maladaptive behaviors to cope with the diagnosis. Internalized stigma stems from fear of stigmatization also known as felt stigma. The current study examined the impact of HIV felt stigma on overall health and success of HIV prevention behaviors among 370 participants living with HIV and receiving care at an urban HIV clinic in Kenya. An 18-item instrument was cross culturally adapted to measure felt stigma. Descriptive and logistic regression analyses examined the data. Findings indicate that 25.9% (n=96) of participants who reported experiencing high levels of felt stigma related to other people's attitudes toward their condition, ostracizing, and a disruption of their personal life, were likely to not adhere to prescribed HIV medication and not disclose their HIV serostatus to one other person. Those who also experienced felt stigma related to a disruption of their personal lives while mediated by depression were likely to report poor overall health. Findings support having HIV clinics and interventions develop relevant HIV prevention strategies that focus on the emerging dimensions of felt stigma which can significantly impact disclosure of serostatus, medication adherence, and overall health

High impact = high statistical standards? Not necessarily so.

What are the statistical practices of articles published in journals with a high impact factor? Are there differences compared with articles published in journals with a somewhat lower impact factor that have adopted editorial policies to reduce the impact of limitations of Null Hypothesis Significance Testing? To investigate these questions, the current study analyzed all articles related to psychological, neuropsychological and medical issues, published in 2011 in four journals with high impact factors: Science, Nature, The New England Journal of Medicine and The Lancet, and three journals with relatively lower impact factors: Neuropsychology, Journal of Experimental Psychology-Applied and the American Journal of Public Health. Results show that Null Hypothesis Significance Testing without any use of confidence intervals, effect size, prospective power and model estimation, is the prevalent statistical practice used in articles published in Nature, 89%, followed by articles published in Science, 42%. By contrast, in all other journals, both with high and lower impact factors, most articles report confidence intervals and/or effect size measures. We interpreted these differences as consequences of the editorial policies adopted by the journal editors, which are probably the most effective means to improve the statistical practices in journals with high or low impact factors

Evaluation of dietary habits and caries experience among children with and without hearing disability

Objective: To determine the caries experience of children with hearing disability (HD) in comparison to children without hearing disability. The study also aimed to determine the effect of nutritional status and confectionary diet on caries experience of children with hearing disability (HD) in comparison to children without hearing disability.Design: A descriptive cross-sectional study.Setting: Four Nairobi city council primary schools and centres which had an established unit for deaf children learning along with children who had normal hearing.Subjects: One hundred and sixty two children were recruited in the study. 81 had hearing disability (HD) as an isolated handicapping condition attending four city council deaf units in Nairobi. Matching was done for age and gender with 81 children without HD from the same schools.Results: Of the 81 children with HD, 58 (71.61%) had profound hearing impairment, 21 (25.93%) had severe hearing impairment, and 2 (2.46%) had moderate hearing impairment. Among the 81 children without HD, 7 children had slight hearing impairment while 74 had no hearing impairment. In both groups, the mean age of children was 10.3 years; 36 (44.4%) were males and 45 (55.6%) were female. The Mean dftwas lower among children with HD (1.06 ±2.34) compared to those without HD (1.11 ±2.72). This was not statistically significant (p = 0.67). The mean DMFT was higher among the children with HD (0.56 ±1.42) compared to those without HD (0.19 ±0.55). This was statistically significant (p = 0.05). Generally, there was a negative correlation between caries experience and nutritional status in both groups, though this was not statistically significant. It was found that 37.68% of children with HD consumed confectionaries more than twice a week and 36.96% of children without HD consumed confectionaries more than twice a week. This was not statistically significant (p=O.OS). Frequency of taking "kool" was found to have an association with the dft among the children with HD (p = 0.001), while milk/ tea with sugar was found to have an association with dft of the children without HD (p = 0.02). "Kool" is a snack made from sugar, artificial colouring and water, which is then cooled to ice.Conclusion: Children with HD had statistically significant higher mean DMFT compared to the children without HD. There was no relationship between nutritional status and dental caries of children with HD and those without HD. However there was a relationship between the dietary habits and dental caries. "Kool" was related to caries experience of children with HD while milk/tea with sugar was related to caries experience of children without HD

Examining the unit costs of COVID-19 vaccine delivery in Kenya

Background Vaccines are considered the path out of the COVID-19 pandemic. The government of Kenya is implementing a phased strategy to vaccinate the Kenyan population, initially targeting populations at high risk of severe disease and infection. We estimated the financial and economic unit costs of procuring and delivering the COVID-19 vaccine in Kenya across various vaccination strategies. Methods We used an activity-based costing approach to estimate the incremental costs of COVID-19 vaccine delivery, from a health systems perspective. Document reviews and key informant interviews(n = 12) were done to inform the activities, assumptions and the resources required. Unit prices were derived from document reviews or from market prices. Both financial and economic vaccine procurement costs per person vaccinated with 2-doses, and the vaccine delivery costs per person vaccinated with 2-doses were estimated and reported in 2021USD. Results The financial costs of vaccine procurement per person vaccinated with 2-doses ranged from 2.89-13.09 US dollars in the 30% and 100% coverage levels respectively, however, the economic cost was 17.34 US dollars across all strategies. Financial vaccine delivery costs per person vaccinated with 2-doses, ranged from 4.28-3.29 US dollars in the 30% and 100% coverage strategies: While the economic delivery costs were two to three times higher than the financial costs. The total procurement and delivery costs per person vaccinated with 2-doses ranged from 7.34-16.47 US dollars for the financial costs and 29.7-24.68 US dollars for the economic costs for the 30% and 100% coverage respectively. With the exception of procurement costs, the main cost driver of financial and economic delivery costs was supply chain costs (47–59%) and advocacy, communication and social mobilization (29–35%) respectively. Conclusion This analysis presents cost estimates that can be used to inform local policy and may further inform parameters used in cost-effectiveness models. The results could potentially be adapted and adjusted to country-specific assumptions to enhance applicability in similar low-and middle-income settings

A qualitative exploration of participants’ preferred elements of the 4-week, youth-led, youth-focused, group-based Shamiri intervention: A brief overview

Introduction: Adolescent mental health challenges have been identified as a public health concern globally, especially in low- and middle-income countries (LMICs), due to the scarcity of services, where help-seeking is often hampered by social stigma. A strategy to increase the availability of services is to implement, brief, stigma-free, and scalable interventions. The Shamiri Intervention (the Kiswahili word for “thrive”) is an example of a 4-week, group-based intervention which is implemented via 1-hour sessions within high school settings

Dietary patterns and dental caries in nursery school children in Nairobi, Kenya

(East African Medical Journal, 2001: 78 (12): 673-677

Preliminary Findings on the Carrier Status of Pasteurella multocida in Farmed and Traded Healthy-appearing Scavenging Indigenous Chickens and Ducks in Kenya

One hundred and twenty three indigenous chickens and 24 ducks reared under free range scavenging system were examined for the carrier status of Pasteurella multocida. Both the oropharynyngeal and cloacal swab samples were examined for the presence of the organisms by means of mouse passage and inoculation into blood agar. Of these, 53 chickens and 24 ducks were from different smallholder farms in Nairobi, and Machakos districts, 41 chickens were from various slaughterhouses in Nairobi, while 29 were market chickens obtained from various market centers in Nairobi. The traded (market and slaughter) chickens all originated from rural districts in various parts of the country. From the 123 chickens examined, Pasteurella multocida subspecies were isolated only from four birds. The isolates were recovered from the traded chickens only. Pasteurella organisms were not from any of the 24 ducks. On the basis of biochemical characterization, the organisms were differentiated as P. multocida multocida (1/4), P. multocida septica (1/4) and P. multocida gallicida (2/4). This study suggests that healthy traded poultry could be carriers of Pasteurella multocida. It describes the first report of Pasteurella multocida isolation from indigenous birds in Kenya. Kenya Veterinarian Vol. 31 (1) 2007: pp. 1-

Volunteer based approach to dog vaccination campaigns to eliminate human rabies: Lessons from Laikipia County, Kenya

Background An estimated 59,000 people die from rabies annually, with 99% of those deaths attributable to bites from domestic dogs (Canis lupus familiaris). This preventable Neglected Tropical Disease has a large impact across continental Africa, especially for rural populations living in close contact with livestock and wildlife. Mass vaccinations of domestic dogs are effective at eliminating rabies but require large amounts of resources, planning, and political will to implement. Grassroots campaigns provide an alternative method to successful implementation of rabies control but remain understudied in their effectiveness to eliminate the disease from larger regions. Methodology/Principal Findings We report on the development, implementation, and effectiveness of a grassroots mass dog rabies vaccination campaign in Kenya, the Laikipia Rabies Vaccination Campaign. During 2015–2017, a total of 13,155 domestic dogs were vaccinated against rabies in 17 communities covering approximately 1500 km2. Based on an estimated population size of 34,275 domestic dogs, percent coverages increased across years, from 2% in 2015 to 24% in 2017, with only 3 of 38 community-years of vaccination exceeding the 70% target. The average cost of vaccinating an animal was $3.44 USD with in-kind contributions and$7.44 USD without in-kind contributions. Conclusions/Significance The evolution of the Laikipia Rabies Vaccination Campaign from a localized volunteer-effort to a large-scale program attempting to eliminate rabies at the landscape scale provides a unique opportunity to examine successes, failures, and challenges facing grassroots campaigns. Success, in the form of vaccinating more dogs across the study area, was relatively straightforward to achieve. However, lack of effective post-vaccination monitoring and education programs, limited funding, and working in diverse community types appeared to hinder achievement of 70% coverage levels. These results indicate that grassroots campaigns will inevitably be faced with a philosophical question regarding the value of local impacts versus their contributions to a larger effort to eliminate rabies at the regional, country, or global scale