Improved diagnosis of Ziehl-Neelsen smear negative tuberculosis using sodium hypochlorite sedementation method

No Abstract. East African Medical Journal Vol. 84 (10) 2007: pp. 455-45

Combination of bleach and flourescent microscopy: a milestone in the diagnosis of smear negative tuberculosis

No Abstract. East African Medical Journal Vol. 84 (10) 2007: pp. 460-46

Sero-prevalence of human cytomegalovirus infection and predisposing factors among HIV infected patients attending comprehensive care clinic at Kenyatta National Hospital, Kenya

Background: Human Cytomegalovirus (hCMV) is one of the opportunistic infections in HIV patients. During an active infection it's a common cause of Pneumonia, retinitis, gastro-intestinal disease, and hepatitis. It is significantly associated as a HIV disease co-factor. It does quicken HIV acquisition, disease progression and high mortality and morbidity in HIV patients. Currently there is scanty data on this disease in Kenya leading to lack of recognition on the magnitude especially in HIV patients.Objective:To determine the sero-prevalence and predisposing factors associated with hCMV infection among HIV infected individuals attending comprehensive care clinic (CCC) at Kenyatta National Hospital, Nairobi County, Kenya.Design: A cross sectional study.Setting: Kenyatta National Hospital.Subjects: A total of 400 consenting patients were systematically sampled from HIV comprehensive clinic of Kenyatta National Hospital between July and August 2015Results: A total of 400 HIV-infected individuals who were 18 years and above with an average age of 42.73 (SD, 9.5) years were screened for CMV infections. Of these, 246(61.5%) were female and 154(38.5%) were male. Of 400,398 (99.0%) were hCMV IgG sero-positive, 32 (8.0%) were hCMV IgM sero-positive. Age group between 19 and 28 years [OR= 4.8 95% CI: (1.4-16.4); P=0.012], never been married [OR= 4.3 95% CI: (1.3-14.5); p=0.020], never had children [OR=3.2 95% CI: (1.2-8.5); p=0.022] and use of highly active anti-retroviral therapy (HAARn [OR=3.5 95% CI: (1.2-10.3); p=0.031]were found to be significantly associated with CMV sero-positivity in bivariate analysis. In multivariate analysis, bothCD4 (p <0.001) and viral loads (p <0.001) were found to be significantly associated with CMV sero-positivity.Conclusion: The 99.0% sero-prevalence of hCMV in the HIV patient's calls for routine screening for hCMV infections in order to prevent neurological clinical manifestations associated with CMV in HIV patients. Human cytomegalovirus preventive measures may be necessary to decrease mortality and morbidity associated with hCMV infections

Oral rehydration therapy and social marketing in rural Kenya

In just a few years, oral rehydration therapy (ORT) has become the standard treatment to reduce infant diarrhoeal disease mortality in the developing world. The paper describes an ORT intervention campaign in a rural area in Western Kenya (Kakamega District). After about a year of careful preparation, the campaign was launched in January 1986 and compared the use of a value-added product (flavoured sachets) sold through private outlets in addition to primary care distribution of an unflavoured sachet in an experimental cell (Bukura Division). In a control cell (Novakholo Division), only unflavoured sachets were distributed free of charge through primary health care facilities. Using local perceptions of diarrhoeal disease management, the campaign in the experimental cell was carefully designed and mass communication techniques employed and adapted according. Outcome assessments of the campaign, which lasted until March 1987, included the overall ORT utilization over time. Changes in perceptions towards diarrhoeal disease management, direct assessment of mixing a 'safe and effective' solution accurately and other relevant process parameters were evaluated. Comparing several recent ORT intervention projects, the paper concludes that a combination of a commercial approach and mass communication techniques can further ORS use. If a proper incentive system for shopkeepers is installed and message design and ORS product are fully tailored to the perception and preferences of the target population, the commercial availability of ORS will create an extra demand of the product. However, this will not replace distribution of ORS salts delivered free of charge through primary care sources.