African Journal of Health Sciences https://www.ajol.info/index.php/ajhs <p>The Journal of African Health Sciences has been in production and circulation since 1994.The Journal has been produced through the efforts of Kenya Medical Research Institute (KEMRI) and the African Forum for Health Sciences (AFHES).</p> <p>A lot of interest had been created in the Journal locally and internationally. The Journal was regularly patronized by scientist as one of the leading scientific publication in Africa.</p> <p>The Publications Committee, a committee comprised of the senior scientists that peruses all publications emanating from KEMRI, felt that it was essential to continue with the publication and circulation of the Journal as soon as possible. Therefore the Publications Committee formed a new team to revive the publication and circulation of the Journal and to ensure future sustainability of the Journal. The new team felt there is need for mechanism to fund the above activities towards revival of the Journal on behalf of the scientist.</p> <p>Other websites related to this journal: <a href="https://www.ajhsjournal.com/" target="_blank" rel="noopener" data-saferedirecturl="https://www.google.com/url?q=https://www.ajhsjournal.com/&amp;source=gmail&amp;ust=1586252458578000&amp;usg=AFQjCNHKfMMjh0ioi4HrILMs43LW9UIERQ">https://www.ajhsjournal.com/</a>&nbsp;</p> en-US africanjournal@kemri.org (Dr. Peter Wanzala) africanjournal@kemri.org (Website Administrator) Mon, 15 Mar 2021 11:23:57 +0000 OJS 3.1.2.4 http://blogs.law.harvard.edu/tech/rss 60 Editorial: Hypertension in developing societies https://www.ajol.info/index.php/ajhs/article/view/203958 <p>No Abstract.</p> Hudson A. Lodenyo Copyright (c) https://www.ajol.info/index.php/ajhs/article/view/203958 Mon, 15 Feb 2021 00:00:00 +0000 Predictors of Hypertension among Rural Women <I>The Case of Amagoro in Western Kenya</I> https://www.ajol.info/index.php/ajhs/article/view/203960 <p><strong>Background</strong>: Hypertension's association with other chronic illnesses such as cardiovascular diseases, Diabetes, cause common health burden to individuals and societies resulting to a significant loss of quality life-years. It is becoming a major health hazard with a national prevalence of 24.5% and a rural prevalence of 21.4%. In 2017, WHO ranked hypertension as the 12th leading cause of death in Kenya [3-7]</p> <p><strong>Objective</strong>: Investigations to establish the predictors of hypertension amongst rural women, informed the researhers to interview residents of Amagoro Division, Busia County, in Western Kenya.</p> <p><strong>Methodology</strong>: A descriptive survey involving 260 women aged 15- 90 years drawn from various households in Amagoro Division predominantly Tesos. Cluster and proportional sampling was employed. Data was collected using a pre-tested structured questionnaire through face-to-face interviews. Weight, height, Waist Circumference (WC) and Hip Circumference (HC) measurements were taken. Body<br>mass index was then computed as weight (kg)/height2 and waist-to-hip ratio was computed as WC/HC. Blood pressure measurements were taken twice and average recorded. Hypertension was defined by blood pressure ≥140/90mmHg or taking anti-hypertensive drugs.</p> <p><strong>Results</strong>: The prevalence of hypertension was 22.3%. Age and household income emerged as the strongest independent risk factors&nbsp; (p&lt;0.05). increased prevalence of hypertension with increasing BMI despite the fact that majority of participants had BMI below normal [28], marital status, gender, ethnicity, scarcity of formal employment, work frustrations, such as meger renumerations were all strongly associated. Suggestion that being disadvantaged in early and adult life may be associated with hypertension [40] was a reality. The concentrations of homocysteine including its metabolites were significantly higher in the hypertensive patients (p&lt;0.01).</p> <p><strong>Conclusion</strong>: All other factors being constant, aging and household income can predict the risk of hypertension in a population. The increasing prevalence with age could be due to elevated homocysteine levels which have been found to increase gradually with age. The concentrations of High homocystein level and stiffening of the arteries during ageing [10] could be used to explain the increasing&nbsp; prevalence of hypertension with age in this study. Those who spent 6 hours or more resting are more likely to suffer from hypertension as opposed to those spending 1 to 3 hours (OR=3.74, p=0.354). Beside enthinicity being a factor, there was no association due to the fact that<br>91% came from the same ethnic grouping.</p> <p><strong>Recommandation:</strong> With rising life expectancy, hypertension intervention strategies should not target only the elderly but also young people to encourage them modify their lifestyle.</p> <p><strong>Key words:</strong> blood pressure, hypertension, elderly, women, Kenya </p> Rebecca. A. Ebere, Violet. N. Kimani, Jasper K. Imungi Copyright (c) https://www.ajol.info/index.php/ajhs/article/view/203960 Mon, 15 Feb 2021 00:00:00 +0000 Addressing Poverty, Malnutrition and Poor Health for Adolescent Mothers in Rural Eastern Uganda: <I>Recommendations of Local Level Stakeholders</I> https://www.ajol.info/index.php/ajhs/article/view/203961 <p><strong>Background:</strong> Adolescent mothers in Uganda were a large and highly vulnerable population with inadequate food, economic and social resources thus nutrition and health care unlike their adult counterparts. This could place young mothers at risk of poor wellbeing.</p> <p><strong>Objective</strong>: To identify perceived individual and community-level recommendations and capacity building support young mothers for improved adolescent maternal/child nutrition and health.</p> <p><strong>Methodology</strong>: This qualitative study was conducted in rural Budondo sub-county (Jinja district), Eastern Uganda which is one of the poorest regions. Interviews were conducted with 101 adolescent mothers aged 14-16 years, family members and service providers in the fields of health, education and community administration. The unique application of the social cognitive theory (SCT) took cause, while interview guides were translated into the Lusoga language, guidelines laid down in the Declaration of Helsinki and all procedures were approved by the Office of Research Ethics of the University of Waterloo (ORE # 20708). Pretesting was done in rural Butagaya sub-county<br>with a few members representatives of the target groups. community members whose perceptions were framed around constructs of the social cognitive theory and thematic analysis was conducted using Atlas-ti (version 7.5.4).</p> <p><strong>Results</strong>: The study identified diverse needs and barriers facing young mothers such as Sensitizing community members to treat them kindly; monitoring health-related services; job creation; paying service providers for additional roles; provision of medical staff houses, operating theatres, medical equipment/materials; using tailored nutrition and health education videos; creating facilities to support food skills training; designating spaces within health facilities for young mothers; and supplying adequate and needs-based drugs.</p> <p><strong>Conclusion</strong>: Capacity building, training of: health personnel to serve young mothers, community workers to counsel parents. instructors in handcraft and food nutrition skills. The social cognitive theory, point to changes in behaviors or practices on the part of individuals, families, community, society and government to better support these very vulnerable group and their babies.</p> <p><strong>Recommendation</strong>:&nbsp; Specialized community-based adolescent maternal / child friendly services built on available strength at individual and environmental level are required. Partnering organizations might help furnish the income generating projects, training support or capital/supplies as recommended by many participants as a capacity-building avenue.</p> <p><strong>Keywords</strong>: Adolescent mother, nutrition, health, , capacity building, social cognitive theory</p> Josephine Nabugoomu, Gloria K. Seruwagi, Rhona Hanning Copyright (c) https://www.ajol.info/index.php/ajhs/article/view/203961 Mon, 15 Feb 2021 00:00:00 +0000 Institutional Related Factors Influencing Emergency Preparedness among Nurses at Machakos Level 5 Hospital Machakos County, Kenya https://www.ajol.info/index.php/ajhs/article/view/203962 <p><strong>Background</strong>: An emergency plan is a dynamic document that frequently set and adapt to the changing trends of emergencies. Prioritizing and anticipating for situations that are not easily predicted requiring immediate action can be challenging. Health care institutions should&nbsp; continually remain prepared in order to handle emergencies and disasters effectively. Machakos Level 5 Hospital serves as a link to health facilities in the Eastern part of Kenya and the main referral centre for it's neighbouring counties. With the overwhelming influx of patients, quality nursing care delivery is a hospital responsibility to support its professionals.<br><strong>Objectives</strong>: To recognize an emergency management plan as an essential framework for providing quality nursing care to the affected victims in case of an emergency This study chose to determine the institutional related factors at Machakos Level 5 Hospital (ML5H).<br><strong>Methodology</strong>: Utilizing a descriptive cross-sectional design between October and December 2018, 132 nurses’ working at ML5H were enrolled using stratified and systemic random sampling after consenting to participate in the study. Data was collected using a self-administered questionnaire and an observation checklist. Cochrane’s formula was used to calculating the sample size, after which duty rosters were used to pick every third nurse on the roster. The questionnaire was divided into 2 parts; the first part consisted Institutional related factors influencing emergency preparedness and the second contained an observation checklist used to measure the level of<br>emergency preparedness in the health facility. A pre-test was carried out at the Accident and Emergency Unit of Makueni Level 5 Hospital to measure the validity and reliability of the research instruments using the Cronbach alpha coefficient. The Data was coded and entered into Statistical Package for Social Science (SPSS) version 25.<br><strong>Results</strong>: The study highlight how the hospital management supported over 70% of emergency preparedness unlike 76.5% of the&nbsp; respondents reporting that the hospital did not provide regular emergency drills while 23.5% reported there were regular drills.<br><strong>Conclusion</strong>: The results showed that, 83.3% of emergency preparedness measures were available while 16.7% of emergency preparedness measures were not available. The study recommends that the hospital liaise with the County Government of Machakos to provide regular drills to all health workers working in the hospital.<br><strong>Recommendation</strong>: The hospital management need to monitor and regularly review the contents of the emergency management plan; and regularly perform emergency drills and exercises to its healthcare professionals;</p> <p><strong>Key word:</strong> Institutional related factors, Hospital Emergency preparedness, nurses </p> Alice Ngina Muthiani, Nilufa Jivraj Shariff, Albanus Kyalo Mutisya Copyright (c) https://www.ajol.info/index.php/ajhs/article/view/203962 Mon, 15 Feb 2021 00:00:00 +0000 Determinants of Patients’ Satisfaction with Musculoskeletal Dysfunction and Stroke Physiotherapy Health Care: <I>Community-Based Evidence</I> https://www.ajol.info/index.php/ajhs/article/view/203963 <p><strong>Background:</strong> Patients’ satisfaction is an individualistic construct that has overbearing role in physiotherapy service delivery. Evenlthough physiotherapy is under public health services in Ghana, there was no information about patients’ satisfaction at the community level.<br><strong>Objective:</strong> This study aimed to assess the factors that determine patients’ satisfaction with physiotherapy health care delivery in a community setting in Ghana.<br><strong>Materials and Methodology:</strong> 299 patients with severe musculoskeletal dysfunction (190, 63.5%), stroke (109, 36.5%), and observed under physiotherapy health care for at least three months were recruited for the study. The samples had mean age of 53.9±10.2years, mostly females (57.2%) and married (59.5%). Modified SERVQUAL questionnaire was used as tool for data collection.<br><strong>Results:</strong> Majority of the patients (96.0%) were ‘at least satisfied’ with physiotherapy care. The hierarchy of determinants was neatness and cleanliness of treatment area (98.3%); kindness, caring and courteousness (96.0%); consideration for privacy, dignity and comfort during care (91.4%); provision of adequate instructions regarding treatment (79.3%); involvement in decisions on care (71.4%) and involvement in treatment plans (68.45). Age (P=0.010) and personal factors (P =0.001) significantly determined patients’ satisfaction with physiotherapy health care.<br><strong>Conclusion</strong>:&nbsp; The study provides insight and evidence into community-based physiotherapy service delivery as veritable avenue to meet regenerative health care. Determinants with pecuniary advantages should be used prominently while those with challenges should be given educational orientation for sustainable satisfaction.</p> <p><strong>Key words</strong>: Community–Based, Patients’ satisfaction, Physiotherapy care, Ghana </p> Owusu Godfred Osei, Dassah Edward Tieru, Moses Monday Omoniyi Copyright (c) https://www.ajol.info/index.php/ajhs/article/view/203963 Mon, 15 Feb 2021 00:00:00 +0000 HIV-1 Drug-Resistant Mutations in Relation to Virological Failure among Adults in Busia County, Kenya https://www.ajol.info/index.php/ajhs/article/view/203964 <p><strong>Introduction</strong>: Busia County of Kenya with a Human Immune-deficiency Virus prevalence rate of 7.7% is two-fold higher than the Kenyan national prevalence at 4.9%. Antiretroviral (ARV) therapy is standard care for all HIV infected patients to mitigate viral loads. The current ARV therapy coverage in the county is 95% among adults. Recently there has been an observation of virologic failure due to viral drug resistance. Limited information on HIV-1 drug-resistance exists with the ARV therapy scale-up in the county. Therefore, this study was designed to investigate the existing&nbsp; -1 drug-resistant mutations among adults in Busia County attributable to virological failure.<br><strong>Materials and Methodology</strong>: The samples were analyzed for viral load and HIV-1 drug-resistance targeting the pol gene. Viral load was detected and quantified by real time PCR. Alignment of sequences was done using Recall software and HIV-1 drug-resistance was determined by Stanford University HIV database.<br><strong>Results:</strong> Of 50 samples, 37(74.0%) had mutations and 34(68.0%) had viral loads of 1000cp/ml and above. Generally, a total of 142 (82 in males and 60 in females) mutations were detected. M184V, K65R, K70R, D67N and T215F were the predominant mutations encoding resistance to nucleoside reverse transcriptase inhibitors. K103N, Y181C, G190A and K101E were predominant to nonnucleotide reverse transcriptase inhibitor mutations. L231, V82A, 150L, E138G, G48V, I501T, I54V and M461were the protease inhibitor mutations identified. About 30(60%) samples had mutations encoding for NRTIs, 34(68%) for NNRTIs, and 6(12%) for PIs ARVs. We observed an association between samples with mutations and viral load of 1000 cp/ml and above (Fisher’s exact test of &lt;0.05) and virological failure especially in males (Fisher’s exact test of 0.013).<br><strong>Conclusion</strong>: There is need for the change in the recombination of treatment regimens especially the NNRTIs and NRTIs as first line therapy. There is also need for more investigations as to why males are resisting drugs than females, this will inform intervention. Routine HIV drug-resistance testing is needed before the initiation of any ARVs. This will minimize resistance.</p> <p><strong>Keywords</strong>: ARVs, HIV-1, drug resistance, mutations, viral load, NNRTIs, NRTIs, PIs </p> Olipher Makwaga, Maureen Adhiambo, David Mulama, John Muoma, Matilu Mwau Copyright (c) https://www.ajol.info/index.php/ajhs/article/view/203964 Mon, 15 Feb 2021 00:00:00 +0000 Hygiene and Sanitation Related Factors Influencing Diarrhea among Children Below 5 Years in Bondhere District Somalia https://www.ajol.info/index.php/ajhs/article/view/203965 <p><strong>Background</strong>: Diarrhea is ranked the second cause of childhood mortality in developing countries. Studies have documented Somalia as among the country with significant high rates of diarrhea among children below 5 years.<br><strong>Objective</strong>: The aim of this study was to assess hygiene and sanitation related factors influencing diarrhea among children below 5 years.<br><strong>Methodology:</strong> The study employed a descriptive cross-sectional study design where data was collected using semi structured&nbsp; questionnaires. Simple random sampling was employed to identify respondents of the study. The data analysis was done using SPSS version 20 at 95% confidence interval. The data was subjected to descriptive and regression analysis.<br><strong>Results:</strong> Were presented using tables and graphs. Ethical clearance was sought from University of Eastern Africa Baraton ethical review committee. the administrative leadership of Bondhere district and caregivers respectively. The prevalence of diarrhea among children under 5 years was 22.4%. Hygiene and sanitation related factors reported to significantly influence childhood diarrhea were; hand<br>washing before preparing baby’s food and source of water for household use.<br><strong>Conclusion</strong>: The findings of this study may have policy implications on health interventions and suggests that focusing on hand-washing and improving sources of water may have profound benefits on childhood diarrhea in Somalia. Additionally the Somalia infrastructure is characterized by poor sanitary facilities and lack of piped water.</p> <p><strong>Keywords</strong>: Diarrhea, children under 5 years, hygiene and sanitation, prevalence</p> Mahad Dahir Turyare, Japheth Nzioki Mativo, Mary Kerich, Alex Karuiru Ndiritu Copyright (c) https://www.ajol.info/index.php/ajhs/article/view/203965 Mon, 15 Feb 2021 00:00:00 +0000 Factors Associated with Tungiasis Infestation among School age Children in Ugenya Sub-County, Siaya County, Kenya https://www.ajol.info/index.php/ajhs/article/view/203966 <p><strong>Background</strong>: Tungiasis recognized as a neglected parasitic tropical disease by the WHO is caused by female Tunga penetrans (jigger, Flea) which has remained a significant public health problem. It affects resource-poor communities causing various health disabilities. By 2016, about 2.6 million Kenyans were infested out of whom 1.5 million were school going children who developed physical and mental disabilities.<br><strong>Objective</strong>: The study aimed at assessing factors that influence practices towards prevention and control of tungiasis infestation among school children in Ugenya Sub-County, Kenya.<br><strong>Methodology</strong>: A descriptive cross-sectional study design and quantitative data collection method was used between January and March 2018. A total of 385 participants clinically examined for the presence of tungiasis after consenting were enrolled. Male 200 (51%) and female 185(49%) . Using standard methods, macroscopic examination was performed by carefully inspecting the legs, feet, hands and arms of school pupils aged 6 to 14 years. Initially, information meetings were held with County officials in the line ministries, School committees and Community representatives to sensitize on disease prevention, control, and ownership of the process. Community Health Workers (CHWs) getting involved on how to identify classification of tungiasis as performed for them and by field officers. Simple random sampling technique was applied for selection. A pretested semistructured questionnaire had been administered in English/ Vernacular on approximately 10% of the participants. Data was keyed-into Microsoft Excel and analyzed using IBM SPSS version 23.<br><strong>Results</strong>: The overall prevalence was found to be 31.1% which was slightly higher than a previous community-based study that had a prevalence of 25% [24] indicating higher infestation in schools than in the community. Remarkably, the majority of pupils infested in classes 5 – 6 were 191(49%). Gender of pupils (p&lt;0.005) showed a statistical significance with tungiasis infestation. Infestation of family member at (p&lt;0.005) and action taken when family member was infested (p=0.042) with posted level of significance. A positive relationship between sleeping area in the house (p=0.048) as well as waste disposal (p=0.017) with tungiasis infestation.</p> <p><strong>Conclusions</strong>: Factors including gender, invasion of a family member, action taken upon infestation, sleeping area in the house and waste disposal, significantly predicted tungiasis infestation. Diagnosis of tungiasis having been done by experienced community members and confirmed using ‘Fortaleza classification’. following surgical extraction of the flea, thorough cleansing and covering of the remaining crater with a topical antibiotic cream to prevent secondary infection was guaranteed. [2] School age children in developing countries bore the greatest health burden from neglected tropical infections including tungiasis.<br><strong>Recommendations</strong>: The key word here is hygiene. Imperative control programs to adopt a more comprehensive approach including School and Community health education to reduce the spread and morbidity from tungiasis is essential. However, sustainable control measures against tungiasis could only be developed if the epidemiological situation is well understood [4] Oral antibiotics and un-expired<br>Tetanus prophylaxis should be readily availed within such endemic areas.</p> <p><strong>Key words</strong>: Practice, Tungiasis, Prevention, Control, Ugenya, Infestation </p> Judy Mwai, Mohamed H. Abdi, E. Githinji Copyright (c) https://www.ajol.info/index.php/ajhs/article/view/203966 Mon, 15 Feb 2021 00:00:00 +0000 A Model of Community Health Insurance for Nigeria https://www.ajol.info/index.php/ajhs/article/view/203967 <p><strong>Background</strong>: The increasing population pressure in African countries coupled with dwindling financial resources calls for new measures to improve health care financing. Health insurance is one of the strategies advocated by World Health Organization in health care financing and organizational reforms in developing countries [1]<br><strong>Objective</strong>: To have health insurance policy reach district and village levels of a community.<br><strong>Methodology</strong>: Organization of community health insurance committee members should include; district head, councilor for accounts/finance, councilor for health, religious leaders, lawyer, accountant, medical officer and representatives of associations<br><strong>Conclusion / Recommendation</strong>: Community health insurance based on partnership between governments and communities might address health care financing shortfalls. It will benefit individuals and families by improving their access, utilization and sustainability of quality health services, ultimately translating into good health, wellbeing and social security. Hence, it requires good organizational and managerial leadership for success.&nbsp; </p> Sani R. Aminu Copyright (c) https://www.ajol.info/index.php/ajhs/article/view/203967 Mon, 15 Feb 2021 00:00:00 +0000