The Prevalence and Knowledge of Emergency Contraceptive Pills (ECP’s) among women in Kibera, Nairobi

Background: Emergency contraception (EC) refers to the use of certain contraceptive methods by women and girls to prevent pregnancy after unprotected sexual intercourse. Many women who have a need for emergency contraception do not use it. Usually, women simply do not know that it exists or, if they know, they do not know where to get it or how or when to use it.Young and unmarried women constitute a high risk group for unsafe abortions. It has been estimated that widespread use of emergency contraception may significantly reduce the number of abortion-related morbidity and mortality. The Consortium for Emergency has set a goal of making emergency contraceptive pills a standard part of reproductive health care worldwide. Objectives: The main objective of this study was to evaluate the prevalence, knowledge, attitudes and practises towards the uptake of emergency contraceptive pills by women in Kibera slum,Nairobi, Kenya Design: A Cross-sectional survey was conducted in Kibera, Nairobi Method: Multi stage sampling was used to determine the study population and 384 women were interviewed using a structured questionnaire. SPSS version 16 and STATA version 11 were used for statistical analyses. Results: The results were that the mean age of the women was 26 years with a standard deviation of 7.4. Majority of the women were married (52%). More than half (58%) reported to use a method of contraception. The prevalence of emergency contraceptive pill was found to be (23%).The findings of this study show that knowledge of emergency contraceptive pills was high (74%) meaning many women have heard about it. The main source of information of Emergency Contraceptive Pills (ECPs) was from friends and family (34%). However when it came to its usage, (37%) of the women thought that it would cause health problems if they used it, while (25%) were not familiar with the emergency contraceptive pill itself, hence were afraid of using it. The main reason for the women not using emergency contraceptives was because of misinformation (62%) followed by a lack of awareness (38%). Conclusion: This study found the prevalence of ECP to be 23% and that knowledge on ECP was adequate with more than half the women reporting to have heard of ECP. However awareness does not lead to use of ECP’s and the method is underused. The major constraint to ECP use was misinformation, with many women fearing that ECP might cause health problems or interfere with their fertility. Religion was also a constraint to ECP with only Protestants reporting its use.&nbsp

Evaluating Institutional Repositories’ (IR) capabilities for long-term preservation with a focus on content, file format and metadata practices in selected public university libraries in Kenya

The type of content and file format influences the success of digital preservation strategies. Institutional repositories are custodians of digital resources that are to be held in perpetuity necessitating the need to consider long term preservation of these resources. The purpose of this study was to evaluate the suitability of digital content and its metadata for long term digital preservation. The study was qualitative in nature utilizing interviews as well as document analysis. websites and IR database investigations were utilized to check on content, format and metadata adequacy. The findings revealed great inadequacies in the IRs’ capabilities to support long term preservation as evidenced by haphazard content and format selection, ingest procedures that did not consider long-term preservation as well as metadata that focused on access only. Recommendations included the need to involve archivist in develop selection and appraisal policies as well as development comprehensive metadata policies that ensured that preservation metadata was also captured as required. Creation of awareness among repository administrators to expose them to the importance of adopting open file formats and standard as well as benchmarking were also proposed. The paper provides insights into universities on the relationship between selection and processing of digital resources and their long-term preservation within the IRs in Kenya

Intimate partner violence and forced migration during pregnancy: Structural constraints to women's agency

Little is known about migration during pregnancy related to intimate partner violence (IPV). In this paper, we examine issues of agency in relation to pregnant women\u2019s migrations in a high HIV prevalence area of Kenya. We qualitatively explored forced migration among pregnant women, using data from in-depth interviews, focus groups and IPV screening forms. To quantitatively examine migration during pregnancy, we analysed data from a prospective study of 614 pregnant women. The qualitative data revealed that women had varied responses to violence in pregnancy, with some being able to leave the marital home voluntarily as a strategy to escape violence. Others were \u2018sent packing\u2019 from their marital homes when they dared to exercise autonomy, in some cases related to HIV status. Quantitative analyses revealed that pregnant women who migrated were more educated, less likely to be living with a partner and had fewer children than other women. Migration among pregnant women in Kenya illustrates the complexity of understanding women\u2019s agency in the context of IPV. The findings indicate that there is not a dichotomy between \u2018victim\u2019 and \u2018agent\u2019, but rather a complex dynamic between and within pregnant women, who may sequentially or simultaneously experience aspects of victimhood and/or agentic response

Systematic review and meta-analysis: prevalence of alcohol use among young people in eastern Africa.

OBJECTIVE: Systematic review and meta-analysis of published studies of alcohol use among young people (age 15-24 years) in eastern Africa to estimate prevalence of alcohol use and determine the extent of use of standardised screening questionnaires in alcohol studies. METHODS: Five databases (MEDLINE, EMBASE, Global Health, Africa-wide, and PsycINFO) were searched for publications until 30th June 2013. Results were summarised using the guidelines on preferred reporting items for systematic reviews and meta-analyses (PRISMA) and on quality assessment using the modified quality assessment tool for systematic reviews of observational studies (QATSO). Heterogeneity was assessed using the I(2) statistic (DerSimonian-Laird). RESULTS: We identified 2785 potentially relevant studies, of which 56 were eligible for inclusion. Only two studies (4%) used the standardised Alcohol Use Disorder Identification Test (AUDIT) questionnaire, and six studies (13%) used the Cut down, Annoyed, Guilt, Eye opener (CAGE) questionnaire. The reported median prevalence of alcohol use was ever-use 52% [interquartile range (IQR): 20-58%], use in the last month 28% (IQR: 17-37%), use in the last year 26% (IQR: 22-32%), and problem drinking as defined by CAGE or AUDIT 15% (IQR: 3-36%). We observed high heterogeneity between studies, with the highest prevalence of ever use of alcohol among university students (82%; 95%CI: 79-85%) and female sex workers (66%; 95%CI: 58-74%). Current use was most prevalent among male sex workers (69%; 95%CI: 63-75%). CONCLUSIONS: Reported alcohol use and problem drinking were common among diverse groups of young people in eastern Africa, indicating the urgent need for alcohol-focused interventions in this population. Few studies have used standardised alcohol screening questionnaires. Epidemiological research to investigate alcohol-focused interventions in young people should aim to apply such questionnaires that should be validated for use in this population

Evidence for position effects as a variant ETV6-mediated leukemogenic mechanism in myeloid leukemias with a t(4;12)(q11-q12;p13) or t(5;12)(q31;p13)

The ETV6 gene (first identified as TEL) is a frequent target of chromosomal translocations in both myeloid and lymphoid leukemias. At present, more than 40 distinct translocations have been cytogenetically described, of which 13 have now also been characterized at the molecular level. These studies revealed the generation of in-frame fusion genes between different domains of ETV6 and partner genes encoding either kinases or transcription factors. However, in a number of cases-including a t(6;12)(q23;p13), the recurrent t(5;12)(q31;p13), and some cases of the t(4;12)(q11-q12;p13) described in this work-functionally significant fusions could not be identified, raising the question as to what leukemogenic mechanism is implicated in these cases. To investigate this, we have evaluated the genomic regions at 4q11-q12 and 5q31, telomeric to the breakpoints of the t(4;12)(q11-q12;p13) and t(5;12)(q31;p13). The homeobox gene GSH2 at 4q11-q12 and the IL-3/CSF2 locus at 5q31 were found to be located close to the respective breakpoints. In addition, GSH2 and IL-3 were found to be ectopically expressed in the leukemic cells, suggesting that expression of GSH2 and IL-3 was deregulated by the translocation. Our results indicate that, besides the generation of fusion transcripts, deregulation of the expression of oncogenes could be a variant leukemogenic mechanism for translocations involving the 5' end of ETV6, especially for those translocations lacking functionally significant fusion transcripts

Health worker views on pre-treatment loss to follow-up in adults with pulmonary TB in Western Kenya

SETTING: County referral hospital in Western Kenya. OBJECTIVES: To explore factors contributing to pre-treatment loss to follow-up (PTLFU) in adults with pulmonary TB and propose solutions to address PTLFU from healthcare worker (HCW) perspectives. DESIGN: This was an exploratory qualitative study using thematic analysis. RESULTS: We conducted 19 key informant interviews with HCWs representing laboratory, clinical care, management and the community. Participant age ranged from 26 to 62 years; 14 (74%) were females; and most (74%) had worked in TB care for 5 years. They reported that patients experienced stigma and had misconceptions about TB that contributed to PTLFU. HCWs were hesitant to work in the TB clinic, which contributed to suboptimal patient care, leading to PTLFU. Unclear linkage between laboratory and clinician, and limited financial resources to track patients were among the healthcare system factors that led to PTLFU. HCWs suggested having proper patient preparation, assigning resources to track patients and holding regular interdisciplinary meetings as practical solutions to address PTLFU. CONCLUSION: HCWs reported multiple factors that may influence PTLFU and recommended various solutions to address these. Knowledge of TB management, patient preparation, resources to track patients and multidisciplinary meetings will be central to addressing PTLFU