DNA Genotype of Human Papilloma Virus Infection among Adolescent Girls at Kenyatta National Hospital Youth Clinic

Background: Adolescents have risky sexual behaviour exposing them to the Human Papilloma Virus (HPV ) infection. With clear causal relationship between high risk the HPV (16 and 18) infection and invasive cancer, this study focuses on the distribution of HPV genotypes among the female adolescent and youth at the Kenyatta National Hospital (KNH) youth clinic.Objective: To determine DNA genotype of HPV infection among adolescent girls at KNH - Youth Clinic and use it as an advocacy tool for the introduction of the HPV vaccine provision in the clinic.Design: Cross-sectional study.Setting: Kenyatta National Hospital Youth clinic.Subjects: Adolescent (and youths) girls aged between 12-24 years.Results: Two hundred and sixty four participants were recruited into the study for a period of three months. The recruitment was done in the clinic till the required sample size was obtained. The prevalence of cervical HPV infection was 9.8% (95% CI : 6.13 to 13.41). There were multiple serotypes with 27% infected with HPV strain type 18 and 66. Type 16 was 5%, type 18 was 9%, and there were mixed genotype infections in the rest. There were no low risk strains isolated and 18% of the respondents who tested positive for HPV DNA had uncharacterised strains.Conclusion: The prevalence of HPV among the adolescent girls at KNH youth clinic was 9.8%. Twenty seven percent had co-infection with type 18 and 66

Ogilvie’s syndrome: case report of spontaneous rupture of the ceacum following caesarean section

In acute colonic pseudo-obstruction (ACPO) there is colonic distension without an organic obstacle (intrinsic or extrinsic to intestinal wall). This becomes a potential site of ceacal rapture which can lead to the demise of the patient. Presented is a case of a mother who had spontaneous caecal rapture five days after Caesarean delivery. At Laparotomy the ceacal rapture was confirmed and a colostomy was done. The patient succumbed in Intensive care unit two days post-operatively

Retrospective cohort study: Clinical presentation and outcomes of pre-eclampsia and eclampsia at Kenyatta National Hospital, Nairobi, Kenya

Pre-eclampsia has two distinct subtypes: early onset pre-eclampsia, which occurs before 34 weeks of gestation, and late onset pre-eclampsia, which occurs after 34 weeks. Few studies examine and compare early and late onset pre-eclampsia in a low- and middle-income country setting. This study’s goal was to establish a profile of patients with hypertensive disorders in pregnancy, especially pre-eclampsia and eclampsia, over a two-year period. At Kenya’s national referral hospital, clinical presentation at admission was examined, as was management of complications, along with maternal and newborn health outcomes in the hospital’s maternity unit, to ascertain any differences in health outcomes for early and late onset pre-eclampsia. This report details the study’s findings, showing that out of the 620 records reviewed, 44 percent of pre-eclamptic and eclamptic women exhibited early onset of pre-eclampsia, while 56 percent had late onset. Early onset of pre-eclampsia was associated with greater disease severity as well as adverse maternal and perinatal outcomes. Early detection, continuous monitoring, identification of risk factors, and prompt referral are critical in mitigating the serious consequences of pre-eclampsia and eclampsia

Intermittent preventive treatment and bed nets uptake among pregnant women in Kenya

Background: Malaria in pregnancy is a preventable disease which results in poor pregnancy outcomes. The use of intermittent preventive treatment in pregnancy (IPTp) and long-lasting insecticide treated nets (LLINs) have been shown to reduce maternal malaria episodes.Objectives: To describe i) The proportion receiving first and second dose (IPTp1 and 2) in malaria endemic zones, ii) proportion receiving IPTp 1 and 2 stratified by coast and lake endemic zones iii) proportion receiving LLINs, stratified by coastal and lake endemic zones.Design: A retrospective descriptive study.Setting: Lake and Coast region malaria endemic zones.Subjects: Pregnant women.Results: IPTp2 dose during an ANC revisit fell by 29% between 2012 and 2015, with 76% receiving an IPTp2 in 2012 and only 47% receiving it in 2015. More pregnant women in Coastal endemic areas received IPTp2 compared to Lake, with 88% versus 73% in 2012, and 53% versus 44% in 2015, respectively.There was steady increase in bed net usage from 69% and 54% in 2012 to 96% and 95% in 2015 for lake and coast endemic zones respectively. The uptake of LLINs was 15% higher in the lake region compared to the coastal endemic region in 2012 and significantly declined over the five years to 6%, 7% and 1% in 2013, 2014 and 2015, respectively.Conclusion: Our study found that there has been a significant decline from 2012 through 2015, in the number of pregnant women in Kenya receiving recommended malaria prophylaxis in the regions of highest malaria burden. However, the coverage of LLIN has consistently improved over the same period

Trends of reported outpatient malaria cases to assess the Test, Treat and Track (T3) policy in Kenya

Background: Kenya reports over six million malaria cases annually. In 2012 the country adopted the Test, Treat and Track (T3) policy to ensure that all suspected malaria cases are tested, confirmed cases are treated with quality-assured drugs and timely accurate malaria surveillance are in place to guide policy and practice.Objective: To describe the trends of confirmed outpatient malaria cases and the consumption of artemisinin-based combination therapy (ACT) in the government health facilities in Kenya following the roll out of the T3 initiative.Design: A retrospective review study.Setting: All government health facilities in the 47 counties.Subjects: Secondary data on all outpatient malaria cases and ACT consumed as reported in the District Helth Information Software (DHIS).Results: Total malaria cases decreased from 8.5 to 6.8million cases in 2012 and 2015, respectively. Confirmed malaria cases increased from 1.97 (23%) to 4.9 (72%) million cases. The greatest decrease in total malaria cases and the greatest rise in confirmation of suspected cases occurred in the lower level health facilities. More confirmation of suspected cases occurred in the malaria endemic regions compared to other epidemiological zones. Excess ACT consumption reduced by 46% to reach 27% in 2015.Conclusion: Though there was increased confirmation of suspected malaria, still onethird of the outpatients were treated clinically in 2015. About one-third of ACTs were also used in excess in 2015. There is need for enhanced efforts to adhere to the T3 policy and malaria elimination guidelines

Dairy Development Forum—Quo Vadis?

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Uptake of isoniazid preventive therapy and its associated factors among HIV positive patients in an urban health centre, Kenya

Background: Isoniazid Preventive Therapy (IPT) is an effective intervention for prevention of tuberculosis (TB) among HIV positive patients, and its use is recommended by the World Health Organization (WHO). Unfortunately the uptake of IPT in Kenya remains low (33%-40%) with limited knowledge on the factors that affect its uptake.Objective: To determine the uptake of IPT and its associated factors among HIV-positive patients enrolled in a urban health centre.Design: Hospital based cross-sectional studySetting: Riruta Health Centre, Nairobi, KenyaSubjects: HIV-positive patients ≥18 years who have been on care and treatment services in the health centre for at least six months preceding the study.Results: Four hundred and thirty six participants were enrolled with a mean age of 41 years (standard deviation± 9years). Females were 276 (63%), anti-retroviral therapy uptake of 427 (98%) and overall IPT uptake rate of 336 (77%). On multivariate analysis, fear of acquiring TB (adjusted odds ratio (AOR) 4.6, 95% confidence interval, CI 2.6-8.1), having received IPT-associated health education (AOR 5.0, 95% CI 3.0-8.4) and having a good relationship with the healthcare worker (HCW) (AOR 2.0, 95% CI 1.2-3.4) were independently associated with initiation of IPT.Conclusion: The uptake rate was above the current national coverage but fell below the national set target of 90%. Fear of acquiring TB, receipt of IPT-associated health education and favourable relationship with the HCWs promoted the initiation of IP

Question Typology in Kenyan TV Argumentative Talk Shows

The argumentative talk on radio and TV has become a popular feature of media discourse in Kenya. Question-answer sequences as the talk unfolds through the joint participation of co-participants in the talk have emerged as a means to put argumentative talk into effect. Yet, the nature of questions and their categorization remain little understood. Given the recursive nature of question-answer sequences, this paper investigates question typology that sets apart argumentative talk shows from other types of talk. The data consists of transcripts from two Kenyan TV argumentative talk shows: Checkpoint on KTN and Opinion Court on Citizen TV. A question classification scheme by Schirm [2008] was used to discuss the incidence and usage of questions in argumentative talk shows. Findings revealed that clashing, rhetorical, classic clarifying, and opinion-eliciting questions were the most frequently used types in the data sets. It was also noted that different question types served unique rhetorical purposes leading to the conclusion that argumentative talk shows on TV exhibit recursive interactional resources qualifying it as a genre

The Structured Operational Research and Training Initiative (SORT IT), second workshop using the national tuberculosis routinely collected program data

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