User Perception on Electronic Medical Records Support for Treatment in Mama Lucy and Mbagathi Hospital

Electronic health records offer a valuable resource to improve health surveillance an evaluation as well as informing clinical decision making.  This has been introduced in many different settings including low and middle income countries. The focus on healthcare as one of Kenya’s big four agenda will greatly be achieve in an EMR environment. The objective of this study was to establish users’ perception on EMR support for treatment in Mama Lucy and Mbagathi hospital. The study employed technology acceptance model and was guided by descriptive research design. A sample size of 238 out of a population of 630 employees working at Mama Lucy Kibaki hospital and Mbagathi hospital was used. Primary data was collected using questionnaires. Additional data was collected from secondary sources using documentary analysis. Analysis was done by SPSS Version 23.0, and presented in form of tables and charts. The findings confirmed that Mama Lucy and Mbagathi hospital service providers perceived that an EMR system is the best and easy use during service delivery compare to use paper. They also believe that there is improvement in the quality of care and services for the patients; use of EMRs speeds up registration of patient information; and it reduces medication and prescription errors in the hospitals. This study recommends that; the two facilities should make sure that there is adoption of a fully electronic medical records system in so as to improve the quality of delivery of services to the patients to receive better perception.  Both Mama Lucy and Mbagathi hospitals should train the service providers and emphasize on the benefits of EMR so as to improve perceptions of EMR of the users as they interact with the system. Keywords: User Perception, Electronic Medical Records, Support for Treatment, Mama Lucy Hospital, Mbagathi Hospital DOI: 10.7176/IKM/11-1-03 Publication date: January 31st 202

User Perception on Electronic Medical Records Support for Treatment in Mama Lucy and Mbagathi Hospital

Electronic health records offer a valuable resource to improve health surveillance an evaluation as well as informing clinical decision making.  This has been introduced in many different settings including low and middle income countries. The focus on healthcare as one of Kenya’s big four agenda will greatly be achieve in an EMR environment. The objective of this study was to establish users’ perception on EMR support for treatment in Mama Lucy and Mbagathi hospital. The study employed technology acceptance model and was guided by descriptive research design. A sample size of 238 out of a population of 630 employees working at Mama Lucy Kibaki hospital and Mbagathi hospital was used. Primary data was collected using questionnaires. Additional data was collected from secondary sources using documentary analysis. Analysis was done by SPSS Version 23.0, and presented in form of tables and charts. The findings confirmed that Mama Lucy and Mbagathi hospital service providers perceived that an EMR system is the best and easy use during service delivery compare to use paper. They also believe that there is improvement in the quality of care and services for the patients; use of EMRs speeds up registration of patient information; and it reduces medication and prescription errors in the hospitals. This study recommends that; the two facilities should make sure that there is adoption of a fully electronic medical records system in so as to improve the quality of delivery of services to the patients to receive better perception.  Both Mama Lucy and Mbagathi hospitals should train the service providers and emphasize on the benefits of EMR so as to improve perceptions of EMR of the users as they interact with the system. Keywords: User Perception, Electronic Medical Records, Support for Treatment, Mama Lucy Hospital, Mbagathi Hospital DOI: 10.7176/IKM/10-7-08 Publication date: December 31st 202

Below the Radar: What does Innovation in Emerging Economies have to offer other Low Income Economies?

Between 1970 and 2000 the proportion of global R&D occurring in low income economies rose from two percent to more than 20 percent. However, this rising commitment to R&D does not easily translate into the emergence of a family of innovations meeting the needs of low income consumers "at the bottom of the pyramid", since much of these technological resources are invested in outdated structures of innovation. A number of transnational corporations are targeting these markets but it is our contention that much of the previously dominant innovation value chains are either ignorant of the needs of consumers at the bottom of the pyramid, or lack the technologies and organisational structures to meet these needs effectively. Instead, the firms and value chains that are likely to be most successful in these dynamic new markets are those that are emerging in China and India and other developing countries, disrupting global corporate and locational hierarchies of innovation.Science and Technology, Asian drivers, Innovation Systems, Millennium Development Goals

Below the radar: What does innovation in the asian driver economies have to offer other low income economies

Between 1970 and 2000, the proportion of global R&D occurring in low income economies rose from two percent to more than 20 percent. However, this rising commitment to R&D does not easily translate into the emergence of a family of innovations meeting the needs of low income consumers “at the bottom of the pyramid”, since much of these technological resources are invested in outdated structures of innovation. A growing number of transnational corporations are targeting these markets reflecting dynamic new currents in best-practice innovation. Yet it is our contention that much of the previously dominant innovation value chains are either ignorant of the needs of consumers at the bottom of the pyramid, or lack the technologies and organisational structures to meet these needs effectively. Instead, the firms and value chains which are likely to be most successful in these dynamic new markets are those which are emerging in China and India, disrupting global corporate and locational hierarchies of innovation

Shading by Napier Grass Reduces Malaria Vector Larvae in Natural Habitats in Western Kenya Highlands

Increased human population in the Western Kenya highlands has led to reclamation of natural swamps resulting in the creation of habitats suitable for the breeding of Anopheles gambiae, the major malaria vector in the region. Here we report on a study to restore the reclaimed swamp and reverse its suitability as a habitat for malaria vectors. Napier grass-shaded and non-shaded water channels in reclaimed sites in Western Kenya highlands were studied for the presence and density of mosquito larvae, mosquito species composition, and daily variation in water temperature. Shading was associated with 75.5% and 88.4% (P < 0.0001) reduction in anopheline larvae densities and 78.1% and 88% (P < 0.0001) reduction in Anopheles gambiae sensu lato (s.l.) densities in two sites, respectively. Shading was associated with a 5.7°C, 5.0°C, and 4.7°C, and 1.6°C, 3.9°C, and 2.8°C (for maximum, minimum, and average temperatures, respectively) reduction (P < 0.0001) in water temperatures in the two locations, respectively. An. gambiae s.l. was the dominant species, constituting 83.2% and 73.1%, and 44.5% and 42.3%, of anophelines in non-shaded and shaded channels, respectively, in the two sites, respectively. An. gambiae sensu stricto (s.s.) constituted the majority (97.4%) of An. gambiae s.l., while the rest (2.6%) comprised of Anopheles arabiensis. Minimum water temperature decreased with increasing grass height (P = 0.0039 and P = 0.0415 for Lunyerere and Emutete sites, respectively). The results demonstrate how simple environmental strategies can have a strong impact on vector densities

Changing Patterns of Malaria Epidemiology between 2002 and 2010 in Western Kenya: The Fall and Rise of Malaria

The impact of insecticide treated nets (ITNs) on reducing malaria incidence is shown mainly through data collection from health facilities. Routine evaluation of long-term epidemiological and entomological dynamics is currently unavailable. In Kenya, new policies supporting the provision of free ITNs were implemented nationwide in June 2006. To evaluate the impacts of ITNs on malaria transmission, we conducted monthly surveys in three sentinel sites with different transmission intensities in western Kenya from 2002 to 2010.Longitudinal samplings of malaria parasite prevalence in asymptomatic school children and vector abundance in randomly selected houses were undertaken monthly from February 2002. ITN ownership and usage surveys were conducted annually from 2004 to 2010. Asymptomatic malaria parasite prevalence and vector abundances gradually decreased in all three sites from 2002 to 2006, and parasite prevalence reached its lowest level from late 2006 to early 2007. The abundance of the major malaria vectors, Anopheles funestus and An. gambiae, increased about 5-10 folds in all study sites after 2007. However, the resurgence of vectors was highly variable between sites and species. By 2010, asymptomatic parasite prevalence in Kombewa had resurged to levels recorded in 2004/2005, but the resurgence was smaller in magnitude in the other sites. Household ITN ownership was at 50-70% in 2009, but the functional and effective bed net coverage in the population was estimated at 40.3%, 49.4% and 28.2% in 2010 in Iguhu, Kombewa, and Marani, respectively.The resurgence in parasite prevalence and malaria vectors has been observed in two out of three sentinel sites in western Kenya despite a high ownership of ITNs. The likely factors contributing to malaria resurgence include reduced efficacy of ITNs, insecticide resistance in mosquitoes and lack of proper use of ITNs. These factors should be targeted to avoid further resurgence of malaria transmission

Comprehensive transcriptome of the maize stalk borer, Busseola fusca, from multiple tissue types, developmental stages, and parasitoid wasp exposures

International audienc

Characterization of Methicillin-Resistant Staphylococcus Aureus from Skin and Soft Tissue Infections in Patients in Nairobi, Kenya

Article JournalSkin and soft tissue infections (SSTIs) are among the most common infectious diseases and a frequent cause of hospital visits. In this study we sought to assess the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and antibiotic susceptibility patterns in SSTIs in patients attending hospitals in Kenya. Methods: Eighty-two S. aureus isolates recovered from SSTIs from both inpatients and outpatients were screened for antibiotic susceptibility, possession of staphylococcal cassette chromosome mec (SCCmec)gene type, and the Panton–Valentine leukocidin (PVL) toxin gene. The prevalence of MRSA was investigated in relation to the type of patient and infection type, as well as the type of health care facility. Results: Of 60 boil cultures, 39 (65%) grew S. aureus, of out of which 34 (87.2%) were MRSA. Of the 60 abscess cultures, 14 (23.3%) grew S. aureus, of which 10 (71.4%) were MRSA. Of 34 cellulitis cultures, 18 (52.9%) grew S. aureus, of which 16 (88.8%) were MRSA. Of 25 ulcer cultures, 11 (44%) grew S. aureus, of which nine (81.8%) were MRSA. Sixty-nine of 82 S. aureus (84.1%) were MRSA, with 52 (75.4%) possessing SCCmec II type and 14 (20.3%) being positive for the PVL gene. Based on hospitals, it was noted that most MRSA were isolated at publicly funded health care facilities serving an economically disadvantaged segment of Nairobi’s population, such as those living in urban informal settlements. All 82 S. aureus were susceptible to vancomycin and resistant in high numbers to macrolides, aminoglycosides, and quinolones. Bacterial isolates were mostly susceptible to vancomycin, ciprofloxacin and co-trimoxazole, and none was resistant to vancomycin. However, most organisms showed decreased susceptibility to erythromycin and clindamycin. Conclusions: These findings suggest that SCCmec II MRSA and a PVL strain of MRSA are significant pathogens in patients with SSTIs presenting to hospitals in Kenya, and that MRSA cases are prevalent at publicly funded health care facilities

SCHISTOACT: a protocol for an open-label, five-arm, non-inferiority, individually randomized controlled trial of the efficacy and safety of praziquantel plus artemisinin-based combinations in the treatment of Schistosoma mansoni infection

Abstract Background Schistosomiasis control relies on praziquantel for preventive chemotherapy. Alternative drugs are needed for the treatment and control of schistosomiasis. Praziquantel is effective against adult schistosome worms but ineffective against larval stages of the parasite and cannot prevent re-infection or interrupt the transmission of infection. Continued reliance on praziquantel for wide-scale schistosomiasis control will likely accelerate the emergence of drug resistance. Artemisinin derivatives are effective against the juvenile stages but ineffective against adult worms. The SCHISTOACT study aimed to evaluate the efficacy and safety of praziquantel plus one of four artemisinin-based combinations in treating Schistosoma mansoni infection in Kenya. Methods The SCHISTOACT study is an open-label, head-to-head, five-arm, proof-of-concept, non-inferiority, individually randomized controlled trial with a follow-up of 12 weeks. A total of 540 primary school-aged children from the Mwea area, Kirinyaga County in central Kenya, diagnosed with S. mansoni infection (by Kato-Katz method) are randomly allocated (1:1:1:1:1) to a single dose of praziquantel plus a 3-day course of artesunate-sulfalene/pyrimethamine, or artesunate-amodiaquine, or artesunate plus mefloquine, or dihydroartemisinin-piperaquine, or praziquantel control arm. The primary endpoints are efficacy (cure rate, assessed by microscopy) and safety (adverse events) of each study arm 6 weeks after treatment. Secondary endpoints include cumulative cure rate, egg reduction rate, and re-infection 12 weeks after treatment. The non-inferiority margin is set at − 10 for the risk difference in cure rates between praziquantel and the combined treatment. Discussion This study assesses a strategy for repurposing artemisinin-based combination therapies (ACTs) for treating schistosomiasis. It adopts a head-to-head comparison of four different ACTs to test a non-inferiority hypothesis and to strengthen local capacity to conduct clinical trials for interventions against neglected tropical diseases. Trial registration Pan-African Clinical Trials Registry PACTR202001919442161 . Retrospectively registered on 6 January 202