Factors influencing Vitamin A supplementation among mothers of children under five years old at Mbagathi District Hospital, Kenya

Background: Vitamin A supplementation is one of the best-proven and most costeffective interventions to improve vitamin A status and save children’s lives.Objective: To assess factors affecting practices and utilisation of Vitamin Asupplementation services among mothers with children below five years attending Mbagathi District Hospital.Design: Cross-sectional descriptive study.Setting: Mbagathi District Hospital (MDH) Maternal and Child Health Clinic (MCH) and Paediatric Out Patient Department (POPD).Subjects: Mothers attending MDH MCH and POPD.Main Outcome Measures: Utilisation, Practices and Awareness of vitamin Asupplementation (VAS)Results: A total of one hundred and fifty eight respondents were interviewed. About a half (52%) of the respondents had their children up to date with VAS while less than a half (43%) of the mothers had received vitamin A after delivery. Three quarters of the respondents’ children had missed the vitamin A capsule because they were either not aware of schedule (41%) or had stopped coming to clinic (35%). This notwithstanding, 91% of the respondents neither encountered any problems when seeking VAS services nor had negative beliefs or superstitions about vitamin A.Conclusion: The main factors affecting utilisation of VAS services was lack of information and awareness among both health workers and mothers. These services are averagely well utilised at MDH though still below the National 80% coverage target

Analysis of the temporal evolution of total column nitrogen dioxide and ozone over Nairobi, Kenya using daily OMI measurements

Concurrent measurement and analysis of Nitrogen dioxide (NO2)and Ozone (O3) are essential for improved understanding of ozone distribution. This study sought to analyse the temporal evolution of total column NO2 and O3 over Nairobi using satellite-derived daily data between 2009 and 2013. Seasonality is observed in O3 distribution with minimum and maximum occurring during the dry and wet seasons, respectively. Additionally, a lag of about a month or two occurs between the onset of a season and corresponding minimum or maximum NO2 and O3 concentration. The established association between monthly NO2 and O3 is such that, above average concentration of NO2 is likely to lead to above average levels of O3 during the same month (r=0.79) and below average levels about 5 months later (r=0.39).  The Quasi Biennial Oscillation (QBO) is the main phenomenon behind the oscillating biennial feature exhibited by NO2 and O3 interannual trend. The study shows that NO2 and O3 are increasing at annual average rates of about 0.27% and 0.46% per year compared to mean values, respectively. Daily variation of both NO2 and O3 depicts stagnating trends over the entire period of study. This difference is attributed to the fact that, whereas daily NO2 and O3 are influenced by mechanisms that control the slow shift between the dry and wet periods within the course of a year, interannual variability is driven by the differences in each year’s general weather conditions. Key Words: Evolution, Nitrogen dioxide, Ozone, Total Column, Quasi Biennial Oscillatio

One year symptom severity and health-related quality of life changes among Black African patients undergoing uterine fibroid embolisation.

BACKGROUND: The main aim in the treatment of symptomatic fibroids by various modalities including uterine fibroid embolisation (UFE) is to alleviate symptoms and ultimately improve the quality of life. The efficacy of this modality of treatment in Black African women with significant fibroid burden and large uterine volumes is not clear. The main objective of the study was to examine potential changes in symptom severity among Black African patients 1 year following UFE for symptomatic uterine fibroids in a resource-constrained setting, rated using a validated questionnaire (UFS-QOL). Secondary outcomes examined were changes in quality of life and potential associations with age, parity, uterine volume and fibroid number prior to UFE. Additional interventions after UFE were also recorded. METHODS: A prospective before and after study of Black African patients undergoing UFE was undertaken. Participants underwent pelvic MR imaging prior to UFE and completed the UFS-QOL, a validated condition-specific questionnaire at baseline and at 1 year. Ninety five participants were recruited and data from 80 completing 1 year of follow up were available for analysis of changes in the symptom severity scores. RESULTS: The mean reduction in symptom severity score was 29.6 [95% CI 23.6 to 35.6, P < 0.001] and the mean improvement in HRQOL score was 35.7 [95% CI 28.4 to 42.9, P < 0.001]. A greater number of fibroids identified prior to UFE was associated with a more substantial improvement in symptom severity score (rs = 0.28, n = 80, P = 0.013) and participants of higher parity reported a greater improvement in HRQOL score (r = 0.336, P = 0.002). Major and minor surgical interventions were needed in 5 (6.3%) and 10 (12.5%) participants respectively. CONCLUSIONS: UFE is associated with clinically useful and statistically significant symptom relief in Black African patients. Symptom improvement following UFE is not compromised by a large fibroid burden and the rate of subsequent intervention is within an acceptable range. UFE is a safe alternative and efforts are needed to widen access to this non-surgical treatment modality

Vitamin A supplementation awareness among mothers of children under five years old at Mbagathi District Hospital, Nairobi, Kenya.

Background: Vitamin A deficiency is one of the leading micro-nutrient deficiencies of public health importance in Kenya. Provision of vitamin A supplements every six months is an inexpensive, safe, quick and effective way to improve vitamin A status and save children's lives.Objectives: To determine vitamin A supplementation awareness, attitudes and beliefs among mothers of children under five years old attending Mbagathi District Hospital.Methods:Design: Cross sectional study.Setting: Mbagathi District Hospital (MDH) Maternal and Child Health Clinic (MCH) and Paediatric Out Patient Department (POPD).Participants: Mothers attending MDH MCH and POPD.Data collection: Both quantitative and qualitative data using questionnaires, in-depth interviews and focus group discussions.Sampling: A systematic random sampling where every alternate client was recruited and questionnaires administered to make 158 respondents. Key informants were purposively chosen for in-depth interviews and focus group discussions.Results: Ninety four percent of the respondents reported having heard about vitamin A, major source of information being the health worker (82%). While 58% of the respondents were aware that the recommended schedule for VAS for children is every 6 months, almost half (49%) of respondents were aware vitamin A was given to mothers. Most of the respondents were positive and supportive of VAS. There were no negative beliefs or attitudes mentioned. However, majority (66%) had never discussed about Vitamin A with other mothers / people. Only 18% of the respondents believed VAD was associated with eye problems/blindness. Most mothers did not believe there was a specific consequence of VAD. Majority (64%) of the respondents did not believe there were any possible hindrances to taking their children for VAS.Conclusion: Mothers were positive and supportive of VAS, major source of information being the health worker but there was lack of information and awareness among both health workers and mothers