East African Medical Journal

BACKGROUND: HIV diagnosis is the gateway to antiretroviral therapy. However, 20-50% of HIV-infected individuals are unaware of their HIV status, derailing epidemic control. OBJECTIVE: To increase awareness of HIV status and enrollment into HIV care & treatment (C&T) services through a national HIV testing services (HTS) rapid results initiative (RRI) campaign in Kenya. DESIGN: This cross-sectional analysis presents yield of undiagnosed people living with HIV (PLHIV) and their enrollment into HIV C&T resulting from HTS RRI implemented in July-August 2013 as an example of utilizing RRIs to catalyze achievement of UNAIDS targets...

OBJECTIVE: This study aimed to translate, determine the comprehensibility and examine the linguistic equivalence of a Luganda Oral Mucositis Daily Questionnaire (OMDQ MTS) among patients undergoing chemotherapy. DESIGN: This was a validation study design in which bilingual patients who were receiving chemotherapy at Uganda cancer institute and had experienced some sort of oral discomfort after the start of their treatment were asked to complete OMDQ MTS Luganda followed by the English version on the same visit...

Objectives: To describe the incidence of antiretroviral treatment failure and associated factors in a pediatric clinical cohort within the East African International epidemiology Databases to Evaluate AIDS (EA-IeDEA) consortium. Design: A retrospective cohort study. Clinical treatment failure was defined as advancement in clinical WHO stage, or CDC class at least 24 weeks after initiation of treatment. Immunological failure was defined as developing or returning to the following age-related immunological thresholds after at least 24 weeks on treatment; CD4 count of <200 or CD4%<10% for children aged 2-5 years and CD4 count of < 100 for a child aged > 5years...

INTRODUCTION: Africa bears the greatest burden of stillbirth and yet, there is a paucity of data from this setting. The aim of this study was to determine the association between quality of intrapartum care and fresh stillbirth in Nairobi, Kenya. METHODS AND MATERIALS: This was a case control study in 4 tertiary public hospitals in Nairobi county from August 2018 to April 2019. Two hundred and fourteen women with stillbirths and 428 women with livebirths between 28-42 weeks were enrolled...

Background: Despite national policy guidelines advocating exclusive breastfeeding for the first six months of life to promote and accelerate child survival, the proportion of women exclusively breastfeeding for the first six months has remained small. Objective: To describe the knowledge and practices of mothers regarding exclusive breastfeeding in a semi-urban Ugandan population. Design: A descriptive cross-sectional study. Setting: Semi-urban Ugandan population in four parishes in Adjumani District, the West Nile region of Uganda...

Non-communicable diseases (NCD) are emerging as the leading cause of morbidity & mortality globally, with the greatest rise in incidence of cardiovascular disease cases observed in Sub-Saharan Africa. This is in addition to the heavy burden of infectious diseases already present in this setting. Describing the cross-cutting epidemiology of NCDs and infectious diseases with focus on the interaction between tuberculosis and diabetes mellitus, HIV and cardiovascular disease, HIV and cervical cancer as well as assessing the disparities in funding and service delivery systems between NCDs and infectious diseases; we review this rising double burden of infectious and non-infectious diseases and propose four lessons that can be learnt from the HIV response and adapted to inform the scale up of NCD control in Kenya which are also applicable in other African countries...

BACKGROUND: Changes in susceptibility patterns of bacterial pathogens isolated from urinary tract infections emphasize the need for regional surveillance to generate information that can be used in management of patients. Knowledge on the current status of antimicrobial resistance in uropathogens, and the prevalence of expanding spectrum beta-lactamases (ESBLs) in the isolates will guide policy formulations and encourage prudent use of antimicrobials. OBJECTIVE: Identify bacterial pathogens causing UTI and determine the association between the pathogens isolated from patients attending KNH...

BACKGROUND: Uganda's rapid population growth (3.2%) since 1948 has placed more demands on health sector and lowered living standard of Ugandans resulting into 49% of people living in acute poverty especially in post conflict Northern Uganda. The population rise was due to low use of contraceptive methods (21% in rural areas and 43% in urban areas) and coupled with high unmet need for family planning (41%). This indicated poor access to reproductive health services. Effective use of family planning could reduce the rapid population growth...

BACKGROUND: Intentional childbearing may place heterosexual couples at risk of HIV infection in resource-limited settings with high HIV prevalence areas where society places great value on having children. OBJECTIVE: To explore cognitive, cultural, and spatial mapping of sexual and reproductive health domains and services in western Kenya among men and women. DESIGN: Community-based formative qualitative study design. SETTING: Five administrative/geographical divisions of Nyando District, western Kenya...

Delayed complications of an established surgical procedure like transvescical prostatectomy can occur in rural settings, where different factors can influence the outcome, beyond appropriate indication for surgery and technical skills of surgeons. Here we present a case that was per se surgically unremarkable, however a number of delayed omplications appeared in the post operative period, including infectious, neurologic, metabolic, hematologic ones, beyond purely post-surgery complications.

The insurance fraud is a known phenomenon and old in rich countries. The problem is relatively new in black Africa. Thanks to the installation of private companies and the emergence of social security fund, this phenomenon tends to grow without having precise figures. These frauds often involve the simulation of imaginary symptoms that primarily affect the five senses. The eye has a special place, its anatomical position easily exposed to work accident. Using simple clinical tests, the ophthalmologist must demonstrate that the patient with suspicion of visual loss is capable of normal vision and has no organic underlying deficit...

BACKGROUND: The environments can be contaminated by infectious agents that constitute a major health hazards as sources of community and hospital-acquired infections due to various activities. OBJECTIVE: A comparative study on the level of bacteriological contamination of automatic teller machines (ATMs), public toilets and commercial motorcycle crash helmets were conducted in Kigali city during the period of January to March, 2013. DESIGN: Samples were collected from selected ATMs, public toilets and commercial motorcycle crash helmets surfaces...

OBJECTIVE: To determine the uptake ana factors associated with the uptake of modern contraceptives among women of reproductive age (15-49 years) attending Maternal Child Health and Family Planning Clinics/Units in Rift Valley Provincial Hospital in Kenya. DESIGN: A descriptive cross-sectional study. SETTING: Rift Valley Provincial hospital which is a level five health facility situated in Nakuru County, Kenya. SUBJECTS: Women of reproductive age (15-49 years) who were attending Maternal Child Health and Family Planning Clinics at the Rift Valley Provincial Hospital...

OBJECTIVE: To determine the effect of two levels of counselling on the provision of Intrauterine Contraceptive Device (IUCD) at six weeks post-partum of the post-placental intrauterine device. SETTING: Embu Provincial General Hospital, Kenya. SUBJECTS: One hundred and thirty seven pregnant women at the gestation of 36 weeks to term, who attended Antenatal clinic and were followed until delivery and at six weeks post-partum. DESIGN: A randomised "open-label" clinical trial...

BACKGROUND: Meat is amajor source of food and raw materials for a number of industries, yet a lot of meat is wasted each year due to deterioration as a result of spoilage by microorganisms such as Pseudomonas, Acinetobacter, Moraxella, Bacillus, Campylobacter, Escherichia, Listeria, Clostridium, Salmonella and Staphylococcus species. OBJECTIVE: To determine efficacy of antimicrobial activity of garlic extracts on bacterial pathogens commonly found to contaminate meat...

OBJECTIVE: To evaluate the use of whole blood and blood products in our ICU to determine patterns and outcome after transfusion. DESIGN: A retrospective, case-control study. SETTING: The Intensive care unit (ICU) of the University of Benin Teaching Hospital, a seven-bed open unit for the management of surgical, medical and paediatric patients. SUBJECTS: Patients who received blood transfusion in the ICU. Every patient who received blood transfusion was matched for a similar case without blood transfusion...

UNLABELLED: Objectives: To describe the anatomical sub-types of Anorectal malformations, their management and the early outcome at Moi Teaching and Referral Hospital (MTRH) over a 16 month period. Design: A prospective study. SETTING: MTRH, in the neonatal Unit and paediatric surgical wards for theinitial capture of patients and initial follow up. The Paediatric Surgical out-patient clinic was used for the subsequent follow ups. SUBJECTS: All infants diagnosed with ARM (Anorectal malformations) at MTRH from November 2011 to April 2013...

Foreign bodies within the rectum are an infrequent occurrence with a wide variety of objects either inserted or swallowed. Many techniques of removal have been described to remove these objects in case series mainly in developed countries. We report a case of unusually large rectal foreign body we managed by sigmoidotomy with primary closure.

Tuberculosis (TB) is caused by mycobacterium tuberculosis. It remains a public health concern especially in developing country. Pulmonary infection is the main presentation. However, genitourinary TB is common especially with the increase in Human Immunodeficiency virus (HIV) infection. Genitourinary TB is one of the most common causes of extrapulmonary tuberculosis which affects 12% patients with pulmonary tuberculosis. It is common in women less than 40 years of age and rarely occurs in post-menopausal. Therefore it is more likely to affect women in reproductive years leading to infertility...

BACKGROUND: Genetic variability is a common feature of many organisms. The existence of genetic variation in man is caused by many factors along with selection, migration, gene flow and genetic drift. Human genetics are known as hereditary traits, these hereditary traits include the dominant and recessive traits in humans. Most of the genes are transmitted in the Mendelian pattern and a few are transmitted through the non-Mendelian pattern. OBJECTIVE: To show variation pattern in earlobe attachment, hair line distribution and presence or absence of cheek dimples and to determine prevalence of these traits among the Esan ethnic group of Southern Nigeria...