African Journal of Health Sciences

Decubitus ulcers: A common problem in bedridden patients

2024-01-26T05:53:32+00:00

No Abstract

Pressure Ulcer Preventive Measures Utilized and Its Perceived Effectiveness Among Nurses in Selected Hospitals in Benin City, Edo State, Nigeria

2024-01-26T06:18:04+00:00

Background: Pressure ulcers represent a largely preventable patient safety issue, serving as an indicator of nursing care quality and patient safety within healthcare settings. This study aimed to assess the utilization and effectiveness of pressure ulcer preventive measures among nurses in selected hospitals.

Materials and Methods: This descriptive cross-sectional survey involved 304 nurses purposefully selected from surgical wards/units in the chosen hospitals. A well-structured, pretested questionnaire with a reliability index of 0.842 was employed for data collection. Descriptive statistics, including mean, frequency, and percentage, were used for data analysis.

Results: Findings indicated that risk assessment (mean 3.67±0.56) was the most frequently used preventive measure, followed by skin repositioning every 2 hours (3.46±0.71), use of barrier creams (3.35±0.71), and the utilization of pressure-relieving devices such as air beds (3.33±0.75). Prophylactic sacral dressing (3.14±0.76) and massaging of bony prominences (3.17±0.86) were also commonly employed. The most effective measures were risk assessment (mean 2.66±0.5), repositioning every 2 hours (2.56±0.54), and skin assessment (2.54±0.54). Barriers to preventive measures included limited equipment (3.31±0.96), nursing shortages (3.12±0.77), lack of skill/training (3.09±0.85), and heavy workloads (3.14±0.82).

Conclusion And Recommendation: This study highlights that risk assessment was the most used and effective preventive measure among nurses. Challenges, such as the lack of training and heavy workloads, hindered utilization. Recommendations include regular updates on best practices for staff, especially new nurses, to bridge the theory-practice gap and promptly implement research findings.

Choice of Healthcare Facilities for Antenatal Care, Delivery Services and Satisfaction Received by Mothers of Infants in Lagos, Nigeria

2024-01-26T06:30:01+00:00

Introduction: Increased utilisation of Antenatal Care (ANC) and delivery with a skilled birth attendant helps to prevent or effectively manage the majority of complications of pregnancy and delivery. This will improve the maternal mortality ratio nationally and globally. This study assessed the choice of healthcare facilities for ANC, child delivery services and satisfaction with the care received by mothers of infants attending child immunization clinics at selected Primary Healthcare Centres (PHCs) in Lagos, Nigeria.

Materials/Methods: A descriptive cross-sectional study was conducted among mothers who attended antenatal care (ANC) in a health facility during pregnancy, delivered at the same facility, and brought their infants for immunization at the selected PHCs in Lagos, Nigeria. A total of 355 respondents were recruited from the five selected PHCs. Data were collected with an interviewer-administered questionnaire. Descriptive and inferential statistics were conducted and the level of significance (p) was set at less than or equal to 5% (p≤0.05).

Results: Less than half of the respondents 170 (47.9%) registered for ANC in the first trimester, 206 (58.0%) of the respondents utilised private hospitals only while very few 55 (15.5%) utilised PHCs for ANC and delivery. Most of the respondents (59.1%) had between 9 to 15 ANC visits during pregnancy, with a mean attendance of 11.3 ± 4.7. Some of the reasons given for the choice of ANC and delivery centre by the respondents were quality service 325 (91.6%), availability of skilled healthcare staff 276 (77.7%), clean environment 236 (66.5%), and good staff attitude 234 (65.9%) among others. The majority of the respondents 349 (98.3%) were satisfied with the overall care received in the health facilities utilised for ANC and delivery services during pregnancy. Statistically significant associations were found between respondents’ monthly income, spousal’s level of education, enrolment in health insurance scheme and the choice of health facility used for ANC and delivery (p<0.05).

Conclusion: Continuous health educational programs are recommended for women of reproductive age and their spouses on the benefits and importance of antenatal care in pregnancy at healthcare facilities and skilled birth attendants at delivery. Improved funding for government hospitals may enhance public trust in healthcare facilities and increase utilization.

Prevalence, Levels and Correlates of Intellectual Disability among Adolescents Incarcerated in a Correctional Facility in Kaduna, NorthWestern Nigeria

2024-01-26T06:41:18+00:00

Background: Adolescents with intellectual disability are disproportionately represented within correctional facilities. Studies have shown that such adolescents are vulnerable to manipulation and influence including coercion into homosexual relationships, as well as to being victims of homicide compared to others. However, there are few studies on intellectual disability among adolescents in correctional facilities in Northern Nigeria. This study thus aimed to assess the prevalence, levels and correlates of intellectual disability among adolescents in a correctional facility in Kaduna, Northwestern Nigeria

Materials And Methods: This cross-sectional study was conducted among all the adolescents incarcerated at the Borstal Training Institution in Kaduna, North-western Nigeria between March and June 2018 who gave informed consent/assent. Data collection was done using a sociodemographic questionnaire; Raven’s Progressive Matrices (RPM); Adverse Childhood Experiences (ACE) Questionnaire and Perceived parental support questionnaire.

Results: The 93 participants aged 13 years to 19 years were all males with a mean age of 17.71 years (SD ±1.19). The majority (88.2%) were below average intellectually while 58.1% were intellectually defective. Participants with below-average IQ had experienced parental death (χ2 = 4.099, p=0.043), had mothers with less than 12 years of education (χ2 = 5.653, p=0.015) and scored lower on perceived combined parental support (t=-4.704, p=0.032), maternal (t=- 4.334, p=0.000) and paternal support (t=-3.506, p=0.001).

Conclusions: Intellectual disabilities are prevalent among adolescents in incarceration. There is a need to put in place programs for the identification of such adolescents in our correctional facilities so that programs which minimize the disability while emphasizing the adolescents' strengths can be instituted thus probably reducing their representation in the prison population as well as enhancing the success of rehabilitation back into the society. In addition, identified correlates should be incorporated into targeted prevention strategies for vulnerable adolescents effectively and sustainably to reduce their occurrence.

Impact of Referral Guideline Enforcement on Orthopedic and Trauma Admissions at Kenyatta National Teaching and Referral Hospital, Kenya: A Pre-Post Test Design

2024-01-26T07:05:53+00:00

Background: The suboptimal utilization of tertiary health facilities and inadequate management of referral systems in low- and middle-income countries pose challenges to health system administration, characterized by frequent self-referrals and bypassing of lower-tier health facilities. On July 1, 2021, Kenyatta National Hospital (KNH) implemented referral guidelines, mandating that all admitted patients be referred from lower-tier health facilities, aligning with the KNH legal statute of 1987. This study aimed to evaluate the impact of enforcing referral guidelines on the spatial distribution of orthopedic and trauma admissions at KNH.

Methodology: A pre-posttest study design was employed, reviewing a total of 459 and 446 charts in 2021 before and after the enforcement of referral guidelines. Measures of central tendencies and Chi-squared tests were applied, and density plots were generated using Geographic Information System (QGIS 2.18.19) to illustrate the spatial distribution of admissions.

Results: of KNH admissions, 85.3% and 79.3% originated from Nairobi County and its environs. Admissions were geographically diverse, with a notable concentration from Nairobi County and its environs. Enforcement of referral guidelines led to a significant decrease in admissions from Nairobi County, dropping from 64.3% to 56.9% (p=0.019). Declines were particularly observed in Kamukunji, Embakasi, and Ruaraka sub-counties, serving as the catchment population for Mama Lucy Kibaki Referral Hospital. Conversely, admissions from Kibra and most of Kajiado County were notable. There was a concurrent increase in admissions from other parts of the country (p = 0.003).

Conclusion: Over four-fifths of KNH admissions are from Nairobi County and its environs. The enforcement of referral guidelines resulted in decreased local admissions and an uptick in admissions from other regions in the country.

Effects of Moderate Acute Malnutrition Treatment and HIV-Exposure on Body Composition among Children Under Five Years in SubSaharan Africa: A systematic review

2024-01-26T07:31:39+00:00

Background: Malnutrition poses a global threat to Childhood growth and survival. Coupled with HIV exposure and infection, under-nutrition risk is greatly increased. Infection with HIV results in Acquired Immune Deficiency Syndrome which increases the body’s nutrient requirements and may significantly affect the body composition parameters. This study aimed to review data from published articles to identify the changes in body composition among children under five in sub-Saharan Africa as a result of Moderate Acute Malnutrition (MAM) and HIV exposure

Materials And Methods: We conducted a systematic review of published articles on body composition, moderate acute malnutrition treatment and HIV exposure among children under five years. Data was searched from PubMed, Ovid-MedLine, Google Scholar, Cochrane Central Register of Controlled Trials and EMBASE. The review was done as per Cochrane reviews and Preferred Reporting Items for Systematic Reviews and MetaAnalyses guidelines (PRISMA). The articles were then screened for suitability of inclusion and analysis.

Results: A total of 1,505 records were identified; 520 articles from PubMed, 535 from Medline and 430 from EMBASE. On the first screening step, 755 duplicate records were removed. Screening the articles by abstract and title led to the elimination of 717 records. Further, 88 records were excluded due to a lack of full-text articles, not related to the topic, no prospective studies and the wrong age group (above five years). We finally ended up with 9 articles that were included for review.

Conclusions: There is an interrelationship between MAM treatment, HIV Exposure and body composition. Treatment of MAM using standard ready-to-use supplemental foods and locally produced specialized nutritious formulas improves the body composition parameters of children under five years. HIV-exposed infected children exhibit poorer body composition parameters than HIV-exposed uninfected and HIV-unexposed uninfected children.

Competence of Healthcare Providers in Managing Lymphedema Post Breast Cancer Treatment: A study in western Kenya hospitals

2024-01-26T07:51:21+00:00

Background: Globally, breast cancer, the most diagnosed cancer, affects around 2.3 million individuals. Approximately 28% to 38% of breast cancer patients develop lymphedema post-treatment, impacting one in five patients. Without intervention, the condition leads to serious complications, affecting daily tasks. Sub-Saharan Africa reports increasing comorbidities related to lymphedema, yet no data exists on its prevalence in Kenya. This study assessed clinical management strategies for breast cancer treatment-induced lymphedema in selected Western Kenya hospitals.

Material And Methods: This was a cross-sectional analytic study. Simple random sampling was used to select healthcare facilities offering cancer screening and treatment. Healthcare providers were randomly selected from five health facilities depending on the number required at each health facility. 192 healthcare providers were selected to participate in the study. Data collection was by structured questionnaires, observation checklist and focus group discussion, analysed by SPSS version 23.1 and Qualitative data thematically analysed guided by questions on knowledge, skills and management strategies.

Results: The results showed healthcare providers' knowledge ranging from low to average with a deficit in important areas of practice such as skincare (OR=0.56, p=0.01). stocking pressure (OR=1.841, P=0.004, positive stemmer's sign test (OR=2.217, p=0.001) with over 50% getting incorrect answers. Good history and assessment Skills were demonstrated (0R=1.6; CI;1.0-24; P=0.037) but patient education was poorly done. Focus group discussion showed a deficit in knowledge by failure to clearly define lymphedema.

Conclusion: Structured education of lymphedema is needed to increase the knowledge of healthcare providers and improving knowledge may fill the gaps in knowledge and demonstrate good practical skills in patient management

Health Workers' Perspectives on Antenatal Care and the Efficacy of a Community-Based Strategy in Augmenting ANC Follow-Up Contacts in Nyamira County, Kenya

2024-01-26T07:59:18+00:00

No Abstract

Determinants of Induced Abortion Intention among Adolescents Seeking Youth-Friendly Services in Homa Bay County, Kenya

2024-01-26T08:09:41+00:00

Background: Approximately 6.4 million women die because of unsafe abortion in Africa. Abortion contributes to 35% of maternal deaths nationally, out of these adolescents account for 17%. Homa Bay County is among the 15 high-burden counties in the country, which accounts for 97% of maternal deaths. Interestingly, 23% of the deaths are as a result of teenage pregnancy. The study aimed to determine the induced abortion intention among adolescents seeking youth-friendly services in Homa Bay County.

Methods And Material: A cross-sectional was implemented for the study from April to June 2020. Systematic random sampling was used to select 332 participants among 1652 adolescents in the study areas. Data was collected through self-administered questionnaires. Univariate analysis, stepwise selection and multivariate logistic regression were employed to find determinants of induced abortion intention. The study was approved by the Ethical Review Committee of Masinde Muliro University of Science and Technology (MMU/COR: 509099) and NACOSTI offered a research permit NACOSTI/P/20/4496.

Results: The study revealed a significant association between induced abortion intention and being multiparous (OR: 0.064; 95% CI: 0.005-0.918: p= 0.028). The current study found a strong association between adolescents' belief that their physical health reduces the likelihood of pregnancy from unprotected sex. Respondents who had a low perception of physical health were susceptible and had higher odds of having induced abortion intention. Similarly, the respondents who agreed that they do not talk to their partners about pregnancy were thrice as likely to have had induced abortion intention (OR: 3.2; 95% CI: 1.7- 6.1: p= 0.0002). In addition, those who believed that if they continued with the pregnancy their academic career would be endangered were 4.3 times as likely to have had induced abortion intention (OR: 4.3: 95% CI: 2.2 – 8.1; p < 0.0001).

Conclusion: In this study, induced abortion intention was significant among adolescents who had a misinformed perception of their physical health and chances of getting pregnant even if they practised unprotected sex, lacked disclosure to partners and were urged not to discontinue their career and profession. Governments should embrace and operationalize multisectoral and pre-counselling approaches coupled with comprehensive sexual reproductive health education in and out of school in Adolescents programs. Similarly, Adolescent' programs should scale up male involvement.

Client’s Experiences on Skilled Delivery Services among Women of Reproductive Age in Rural Communities in Kenya

2024-01-26T08:41:36+00:00

Background: Globally Skilled delivery services are critical aspects to combat Maternal and neonatal mortality. In Kenya, skilled deliveries account for 62% of all deliveries; unskilled deliveries pose a higher risk of maternal and neonatal mortality and morbidity. The maternal mortality ratio in Kenya is currently 462 per thousand live births, with 40% of these deaths occurring at home. The main objective of the study was to explore the experiences of women of reproductive age on skilled delivery services.

Materials And Methods: The baseline study was conducted between November 2022 and January 2023. It employed a cross-sectional research design involving 347 women of reproductive age. The study aimed to examine their current practices, challenges, and experiences with skilled delivery services. Focus Group Discussions (FGDs) were conducted with 48 recently delivered women (within one year), as well as with 48 Community Health Volunteers (CHVs) and 10 Community Extension Workers (CHEWs). In-depth interviews were also held with local health facility administrators. Quantitative data analysis was performed using SPSS version 25.0. Measures of central tendency were employed for continuous data tabulation. The analyzed data was then presented through charts, tables, and frequencies. The qualitative data underwent thematic arrangement and analysis using NVIVO version 13 and then triangulated with descriptive data.

Results: The results revealed that (90.6%) of women's previous childbirth experiences influenced their utilization of skilled birth attendance services in subsequent pregnancies. Women who had never given birth in health facilities or had chosen home births were less likely to utilize skilled birth attendance services.

Conclusion and Recommendations: This study identified factors influencing skilled birth attendance use in Kandara SubCounty, highlighting the role of previous childbirth experiences, health facility-related factors, and danger signs during pregnancy. To improve utilization, interventions should focus on health facility conditions, health worker attitudes, and community awareness programs.

Newborn and Infant Hearing Screening for Early Detection of Hearing Loss in Nairobi, Kenya

2024-01-26T08:55:26+00:00

Background: Early detection of hearing loss and subsequent intervention leads to better speech, language and educational outcomes giving way to improved socioeconomic prospects in adult life. This can be achieved through establishing universal newborn hearing screening (UNHS) programs. The objectives of this study were to assess the feasibility of implementing a UNHS program and to also determine the prevalence of hearing loss in newborns in Nairobi, Kenya.

Materials And Methods: A cross-sectional pilot study was conducted at the National Hospital and a sub-county hospital immunization clinic. A total of 9,963 babies aged 0-3 years, were enrolled in the hearing screening program through convenient sampling over nine months. A case history was administered followed by Distortion Product Oto-acoustic emissions (DPOAEs) and automated auditory brainstem response (AABR) hearing screening.

Results: The screening coverage rate was 98.6% (9963/10,104). The referral rate for the initial screen was 3.6% (356/ 9,963), and the return rate for follow-up rescreening was 72% (258 babies out of 356) with a loss to follow-up rate of 28% (98/356). The referral rate of the second screen was 10% (26/258). All 26 babies referred from the second screen returned for diagnostic hearing evaluation and were confirmed to have hearing loss, yielding a prevalence of 3/1000.

Conclusions: Establishing universal newborn and infant hearing screening programs in Kenya is feasible and essential for early detection and intervention for hearing loss. Data management and efficient follow-up systems are an integral part of achieving diagnostic confirmation of hearing loss and early intervention.

Delay of Acceptance of Covid-19 Vaccine Among Health Care Workers in Western Kenya

2024-01-26T09:24:57+00:00

Background: Healthcare workers play a key role in the prevention and control of communicable diseases but some studies have reported concerns with their vaccine hesitancy. To address the concerns, there is a need to investigate the time to acceptance to inform programmatic interventions. This study determined the time to acceptance and further investigated the possible reasons for the time to acceptance of the COVID-19 vaccine among the 256 healthcare workers in Homa Bay town sub-county, Homa Bay county in western Kenya.

Method: A cross-sectional web-based study was done between August 2022 to October 2022. An online survey was used to collect quantitative data, which was analyzed using SPSS version 23 and Pearson’s Chi-square test. However, the qualitative data was analyzed using thematic.

Results: The uptake level was at 98.8% and 60.9% of HCWs accepted the vaccine within the first six months of rollout, 83.6% accepted it within the first year of vaccine rollout and 1.2% did not accept it after more than one year of rollout. The qualitative results suggest the reason for the slow time to acceptance of the vaccine is side effects and concerns with the safety and effectiveness.

Conclusion: The study shows that the time to acceptance of the vaccine by the HCW remains a public health concern. Consequently, there is a need to explore strategies to improve the time to acceptance of the vaccines given the increasing pandemics. We recommend further studies on time to acceptance with a cost-effective programmatic intervention.

Fingerprint Dermatoglyphic Patterns among Adults with Type II Diabetes Mellitus in Western Kenya

2024-01-26T09:34:45+00:00

Background: Dermatoglyphics is the study of epidermal ridges and their configurations on the skin of the palms and soles of the foot. The patterns can be grouped into loops, whorls, and arches each of them having a unique characteristic that appears to be influenced by genetic factors. Diabetes Mellitus is a common metabolic disorder caused by reduced insulin secretion. Type 2 diabetes results from genetic disorders involving multiple genes that control insulin secretion and action. This study aimed to assess the variations in fingerprint patterns among adults with Type II diabetes mellitus which could be used as an early, easy, cheap and painless method of screening diabetes.

Materials and Methods: A comparative cross-sectional study design was used where 150 diabetic patients were compared with 150 non-diabetics as controls all selected from Kakamega County Teaching Referral Hospital, Western Kenya. Socio- demographic data and family history were recorded, thereafter fingerprints were taken using the Indian ink method. The chi-square test was used to check for a significant association between the pattern variations in diabetics and the control group.

Results: The study involved 300 respondents where 33.33% were aged above 60 years with females being the majority at 60.67 % while among diabetics 68 % had a family history of diabetes. Whorl (p=0.0003) and ulna loops (p=0.002) patterns were decreased among male diabetics when compared to male non-diabetics while in female diabetics, whorl patterns were increased (p=0.02929) when compared to female non- diabetics. There was an association between whorl patterns and family history among diabetics (p=0.049). Ulna loops were significantly low (p=0.004) while whorls were significantly high (p=0.016) among diabetics when compared to non-diabetics.

Conclusion: This study showed that dermatoglyphic patterns could be used as a feature for early screening of type II diabetes.

The Effectiveness of an Education Intervention based on Self-Care Model on Depressive Symptoms among adolescents with Type 1 Diabetes Mellitus

2024-01-26T09:51:24+00:00

Introduction: Over the past years, evidence has shown a high prevalence of depression among Type 1 Diabetes Mellitus (T1DM) patients. This interventional study was performed to decrease depressive symptoms using education based on the self-care model in Kiambu County, Kenya.

Methodology: The study was conducted from January to August 2021 at diabetic clinics of Thika Level 5 Hospital (TL5H) and Kiambu Level 5 Hospital (KL5H). The study employed a pre-test post-test non-equivalent quasi-experimental study design. There were 96 adolescents with T1DM obtained by stratified random sampling, and assigned into experimental (48 respondents) and control group (48 respondents). Depressive symptoms were evaluated in the first and seventh months using the Center for Epidemiology Studies Short Depression (CES-D) scale. Paired sample T-test and Independent sample T-test were used to analyze data.

Results: The results of the Independent sample T-test showed that there was a statistically significant difference in the mean score difference of depressive symptoms at postintervention (t = -2.968, df = 94, p = 0.004), but no statistically significant difference in the mean score difference of depressive symptoms at baseline (t = -1.100, df = 86, p =0.274). The result of the paired sample T-test revealed that there was a statistically significant difference in the mean score difference of depressive symptoms in the intervention group (t = -4.374, df = 47, p = <0.001), but no statistically significant difference in the mean score difference of depressive symptoms in the control group (t= -1.304, df = 47, p =0.199).

Conclusions: Education intervention based on the self-care model is an effective program that can improve depressive symptoms. In addition, the education intervention based on the self-care model needs to be implemented continuously to prevent diabetes-related complications and improve depressive symptoms among diabetic patients.

Antiplasmodial Properties of Ethanol Stem-Bark Extract of Newbouldia Laevis (P. Beauv) Seem in P. Berghei Infected Mice

2024-01-26T09:58:51+00:00

Background: Despite substantial improvement in the management of malaria infection over the last centuries, it remains a significant public threat especially to those in the tropical and subtropical African regions due to the emergence of drug-resistant P. falciparum strains, delayed diagnosis, high cost as well as contraindications of some available antimalarial medications. Hence, the need for necessary measures in terms of alternative therapeutic approaches to counter this threat is of utmost importance. The present study was aimed at determining the antimalarial potential of ethanol stem-bark extract of Newbouldia laevis in P. berghei (NK65) infected mice.

Methodology: The antimalarial activity of Newbouldia laevis stem-bark at 250, 500 and 1,000 mg/kg was investigated in mice infected with 1 x 10⁷ parasitized erythrocytes using three experimental animal models: Peter's 4-day suppressive, curative and prophylactic models. Phytochemical screening of the stem bark was also conducted.

Results: The extract at all tested doses of 250, 500 and 1000 mg/ kg showed significant (p<0.01) and dose-dependent reductions in the parasitemia levels of the treated rats with percentage chemosuppresion of 90.7, 91.8 and 94% respectively in the Peters 4-day suppressive test. There were also significant (p<0.01) dose- dependent reductions in parasitemia density of the treated rats at all doses of 250, 500 and 1000 mg/kg in the curative and prophylactic studies compared to the distilled water group. Phytochemical screening revealed the presence of carbohydrates, tannins, alkaloids, flavonoids, saponins, terpenoids, cardiac glycosides, steroids and anthraquinones in the crude extract.

Conclusion: The results suggest that ethanol stem-bark extract of Newbouldia laevis possesses antimalarial activity and this justifies the traditional use of the stem-bark of the plant in antimalarial herbal remedy.

Fungal Infections: A silent health crisis in Africa

2024-01-26T10:12:56+00:00

No Abstract

Effect of Nurse-Led PMTCT Health Education on HIV Disclosure among HIV-Positive Women in Mombasa County: A quasi-experimental study

2024-01-26T10:18:11+00:00

Background: This study investigated the impact of nurse-led PMTCT (Prevention of Mother-toChild Transmission) health education on enhancing HIV status disclosure among HIVpositive women in Mombasa County, Kenya. HIV status disclosure is crucial for the prevention of mother-to-child transmission and the overall well-being of affected individuals and their families.

Methods: A quasi-experimental design was employed, with participants divided into an intervention group of 107 receiving nurse-led PMTCT health education and a control group of 107 receiving standard care. Demographic information, knowledge, attitudes, and practices related to HIV status disclosure were collected at baseline and post-intervention phases. Descriptive statistics were computed and a chi-square test was used to compare the level of self-disclosure of HIV status to sexual partners across the groups. Difference in differences (DID) analysis was used to evaluate the effectiveness of the intervention. Results: The study initially found that at baseline, 60.4% of HIV-positive women in the control group did not disclose their status to sexual partners, compared to 55.4% in the intervention group. However, there was no significant difference between the two groups at this stage. In the end-line survey, the control group had 64% non-disclosure, while the intervention group showed a significant improvement, with only 20% not disclosing. Chi-square analysis revealed a substantial difference (p < 0.001) in disclosure rates between the intervention and control groups. Additionally, a Difference-in-Differences (DID) analysis indicated a significant improvement in self-disclosure (23.1% net intervention effect, p < 0.0001). Overall, the nurse-led health education intervention notably increased HIV status disclosure among HIV-positive women in selected Mombasa County health facilities.

Conclusion: Nurse-led PMTCT education enhances HIV disclosure in Mombasa County, improving PMTCT outcomes and curbing mother-to-child transmission. Tailored interventions are vital in addressing HIV challenges in diverse contexts.