The role of maternal, psychosocial and social-cultural factors in HIV-exposed infants’ service uptake; Nakuru County Referral Hospital, Kenya

Objective: To assess relationship between maternal determinants, psychosocial, social-cultural factors and uptake of routine HEI services among HIV- Exposed Infants in Nakuru County Referral Hospital, Kenya.Design: A cross-sectional descriptive studySetting: Nakuru County Referral Hospital, Kenya.Subjects: Three hundred and twenty-nine (329) mother/baby pairs were enrolled in to the study.Result: The study showed significant statistical association between maternal factors and immunization services uptake timeliness (X2 =7.67, df=1, P=0.001). Psycho-social factors had significant association with timeliness in immunization (X2 =8.87, df= 1, P=0.03) while timeliness in uptake of Early Infant Diagnosis (EID) was (X2 =28.9, df=1, P=˂0.001). Further findings on the respondents who had disclosed their HIV status to their male partners showed significant statistical association (X2 =6.88, P=0.009).Conclusion: Maternal characteristics, psychosocial and social-cultural factors influenced service uptake and recommended for promotion of PMTCT psychosocial support groups among all HIV positive women and inclusion of mentor mothers as champions in demand creation, campaigns and interpersonal communication to improve the timely uptake of early infant diagnosis (EID) and immunization services

Association between the use of biomass fuels on respiratory health of workers in food catering enterprises in Nairobi Kenya

Introduction: Indoor air pollution from biomass fuel use has been found to be responsible for more than 1.6 million annual deaths and 2.7% ofthe global burden of disease. This makes it the second biggest environmental contributor to ill health, behind unsafe water and sanitation.Methods: The main objective of this study was to investigate if there was any association between use of bio-fuels in food catering enterprisesand respiratory health of the workers. A cross-sectional design was employed, and data collected using Qualitative and quantitative techniques.Results: The study found significantly higher prevalence of respiratory health outcomes among respondents in enterprises using biomass fuelscompared to those using processed fuels. Biomass fuels are thus a major public health threat to workers in this sub-sector, and urgent interventionis required. Conclusion: The study recommends a switch from biomass fuels to processed fuels to protect the health of the workers.Key words: Indoor air pollution, biomass fuels, health, respiratory, worker

Factors associated with default from treatment among tuberculosis patients in nairobi province, Kenya: A case control study

<p>Abstract</p> <p>Background</p> <p>Successful treatment of tuberculosis (TB) involves taking anti-tuberculosis drugs for at least six months. Poor adherence to treatment means patients remain infectious for longer, are more likely to relapse or succumb to tuberculosis and could result in treatment failure as well as foster emergence of drug resistant tuberculosis. Kenya is among countries with high tuberculosis burden globally. The purpose of this study was to determine the duration tuberculosis patients stay in treatment before defaulting and factors associated with default in Nairobi.</p> <p>Methods</p> <p>A Case-Control study; Cases were those who defaulted from treatment and Controls those who completed treatment course between January 2006 and March 2008. All (945) defaulters and 1033 randomly selected controls from among 5659 patients who completed treatment course in 30 high volume sites were enrolled. Secondary data was collected using a facility questionnaire. From among the enrolled, 120 cases and 154 controls were randomly selected and interviewed to obtain primary data not routinely collected. Data was analyzed using SPSS and Epi Info statistical software. Univariate and multivariate logistic regression analysis to determine association and Kaplan-Meier method to determine probability of staying in treatment over time were applied.</p> <p>Results</p> <p>Of 945 defaulters, 22.7% (215) and 20.4% (193) abandoned treatment within first and second months (intensive phase) of treatment respectively. Among 120 defaulters interviewed, 16.7% (20) attributed their default to ignorance, 12.5% (15) to traveling away from treatment site, 11.7% (14) to feeling better and 10.8% (13) to side-effects. On multivariate analysis, inadequate knowledge on tuberculosis (OR 8.67; 95% CI 1.47-51.3), herbal medication use (OR 5.7; 95% CI 1.37-23.7), low income (OR 5.57, CI 1.07-30.0), alcohol abuse (OR 4.97; 95% CI 1.56-15.9), previous default (OR 2.33; 95% CI 1.16-4.68), co-infection with Human immune-deficient Virus (HIV) (OR 1.56; 95% CI 1.25-1.94) and male gender (OR 1.43; 95% CI 1.15-1.78) were independently associated with default.</p> <p>Conclusion</p> <p>The rate of defaulting was highest during initial two months, the intensive phase of treatment. Multiple factors were attributed by defaulting patients as cause for abandoning treatment whereas several were independently associated with default. Enhanced patient pre-treatment counseling and education about TB is recommended.</p

Factors Influencing Fertility Choices Among HIV Infected Mothers in Uasin Gishu District, Kenya

Kenya has borne the major brunt of HIV/AIDS for close to two decades. The problem being exacerbated amongchildbearing mothers as the probability of giving birth to HIV infected baby is heightened. Availability of safe andeffective contraceptive and high quality reproductive health counseling can help a woman practice safer sex anddetermine her future childbearing on a more responsible and informed basis. Therefore, a study to determine howknowledge on contraceptives influenced fertility choices was conducted in Uasin Gishu district Rift valley provincein Kenya from September 2005 to December 2005. Data was collected by systematic random sampling from 400HIV infected mothers in their reproductive age. Interview schedules were administered to the respondents at threesites. Data was analyzed by descriptive statistics. Knowledge on contraceptive was almost universal among therespondents with 99.0% of the respondents being aware of at least one method that women could use to avoidpregnancy. Majority (41.6%) knew at least three methods of family planning followed by 30.4% who knew at leastfour methods while few respondents (3.5%) knew more than six methods of family planning. Desire for additionalchildren was found to increase markedly with the number of methods that respondents were knowledgeable about;none of the respondents who were knowledgeable about one method desired to get any more additional childrenwhereas 30.5% of those who knew at least three methods desired to get additional children. However, desire foradditional births reduced drastically among those who knew more than four family planning methods with noneof those who knew six methods desiring to get additional children. It is seen from the study that it is only withadequate knowledge regarding family planning that one is able to adopt better family planning practices. It is thusrecommended that reproductive health counseling be improved among the HIV infected mother

Effectiveness of Food Safety Training on Food Safety Knowledge and Practices of Hospital Food Handlers in Selected Hospitals in Kenya

Epidemiological research has indicated that foodborne nosocomial diseases continue to be critical in the hospital environments. Additionally, research on foodborne disease risk factors has indicated that most outbreaks are associated with food service establishments can be attributed to food handlers’ improper food handling practices and observation studies have revealed that food handlers frequently engage in unsafe food hygiene practices. Food safety training has been identified as a way to assure public health, yet evidence supporting the effectiveness of training has been remains inconclusive. The objective of this study was to assess food safety knowledge and practices of food handlers working in selected hospitals in Kenya before and after food safety training. This study employed a quasi experimental study design. A systematic random sample of 42 hospitals in kenya was selected to assess the effect of training on food safety knowledge and practices. A total of 140 food handlers employees (68 control and 73 interventional) participated in this study. Pre and post- training assessments were conducted on knowledge and practices on food safety practices. Overall knowledge (P <0.05) improved significantly between pre- and post-training (56.5 ±16.5 - 87.8 ±15.5) while practices did not improve significantly (101.3±11.6 - 105.3±12.2), however some improvements were observed in some individual practices that were examined independently. Results indicated that training can improve knowledge but might not always improve practices. The results of this study support the assumption that the development and delivery of a food safety education training for food handlers would increase food safety knowledge and practices. Yet, increasing knowledge is not a guarantee that practices will change as demonstrated by high scores in knowledge and low scores in practices. Future studies investigating on ways in which acquired food safety knowledge can be translated into practice are warranted