Mental health issues associated with the management of tuberculosis in Homabay, Busia and Kakamega Counties, Kenya
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ABSTRACT:
SUBMITTER: Otieno J
PROVIDER: S-EPMC11020984 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:Artisanal and small-scale gold mining (ASGM) represents 20% of gold supply and 90% of gold mining workforce globally, which operates in highly informal setups. Pollutants from mined ores and chemicals introduced during gold processing pose occupational and inadvertent health risks to the extent that has not been well elucidated in Africa. Trace and major elements were analysed using inductively coupled plasma mass spectrometry in soil, sediment and water samples from 19 ASGM villages in Kakamega and Vihiga counties. Associated health risks for residents and ASGM workers were assessed. This paper focuses on As, Cd, Cr, Hg, Ni and Pb for which 96% of soil samples from mining and ore processing sites had As concentrations up to 7937 times higher than the US EPA 12 mg kg-1 standard for residential soils. Soil Cr, Hg and Ni concentrations in 98%, 49% and 68% of the samples exceeded respective USEPA and CCME standards, with 1-72% bioaccessibility. Twenty-five percentage of community drinking water sources were higher than the WHO 10 µg L-1 drinking water guideline. Pollution indices indicated significant enrichment and pollution of soils, sediment and water in decreasing order of As > Cr > Hg > Ni > Pb > Cd. The study revealed increased risks of non-cancer health effects (98.6) and cancer in adults (4.93 × 10-2) and children (1.75 × 10-1). The findings will help environment managers and public health authorities better understand the potential health risks in ASGM and support evidence-based interventions in ASGM processes, industrial hygiene and formulation of public health policy to protect residents and ASGM workers' health in Kenya.
| S-EPMC10403399 | biostudies-literature
Project description:Health behaviour refers to actions undertaken by a person who perceives self to be ill for the purpose of finding an appropriate remedy. Nurses as gate keepers of health are expected to seek formal treatment when they are taken ill because this is what they teach their patients. Nurses' working conditions all over the world are described as squalid with long working hours and workload. This scenario predisposes them to occupational health hazards and at the same time denies them time for self-care. Although nurses are knowledgeable about disease and its treatment and have access to health care, they engage in self-treatment in contrast to what they teach patients. Health behaviour among nurses in Kakamega County was investigated using a cross-sectional design. Data was collected using self-administered questionnaires and subjected to bivariate and logistic regression analyses. The study found that health behaviour of nurses in Kakamega County is below expectation, as 33% (n = 61) engaged in voluntary screening services. Further, 34.8% (n = 65) said that their health would improve if they engaged in health promotion activities. The study recommends empowering nurses to engage in positive health behaviour through education. The county should also provide affordable screening services to its nurses.
| S-EPMC5804103 | biostudies-other
Project description:BackgroundMalaria remains a major health problem worldwide especially in sub-Saharan Africa. In Kenya, 80% of the population is at risk of contracting the disease. Pregnant mothers and children under five years are the most affected by this disease. Antimalarial drug resistance poses a major threat in the fight against malaria necessitating continuous search for new antimalarial drugs. Due to inadequate and inaccessible health facilities, majority of people living in rural communities heavily depend on traditional medicine which involves the use of medicinal plants for the management of malaria. Most of these indigenous knowledge is undocumented and risks being lost yet such information could be useful in the search of new antimalarial agents.Aim of studyAn ethnobotanical survey was carried out among the Luhya community of Kakamega East sub-County, a malaria epidemic region, with the aim of documenting the plants used in the management of malaria.Materials and methodsSemi-structured questionnaires were used to collect information from 21 informants who included traditional medicine practitioners and other caregivers who had experience in use of plants in management of malaria. These were drawn from 4 villages located in Kakamega East sub-county, within Kakamega County based on their differences in topography. Information recorded included plant names, parts used, mode of preparation and administration and the sources of plant materials. A literature search was conducted using PubMed and google scholar to identify the reported traditional uses of these plants and studied antiplasmodial activities.ResultsIn this study, 57% of the informants were aged above 50 years and a total of 61% had either no formal education or had only attained primary school education. A total of 42 plant species belonging to 24 families were identified. Most plants used in the management of malaria in this community belonged to Lamiaceae (18%), Leguminosae (9%) and Compositae (9%) plant families. Plants mostly used included Melia azedarach L, Aloe spp, Ajuga integrifolia Buch. Ham, Vernonia amygdalina Del., Rotheca myricoides (Hochst.) Steane and Mabb, Fuerstia africana T.C.E.Fr., Zanthoxylum gilletii (De Wild.) P.G.Waterman and Leucas calostachys Oliv. Rumex steudelii Hochst.ex A. Rich and Phyllanthus sepialis Müll. Arg are reported for the first time in the management of malaria. Although Clerodendrum johnstonii Oliv. (Jeruto et al., 2011) and Physalis peruviana L.(Ramadan et al., 2015) are reported in other studies for management of malaria, no studies have been carried out to demonstrate their antiplasmodial activity. The plant parts mostly used were the leaves (36%) and stem barks (26%). Majority of these plants were prepared as decoctions by boiling and allowed to cool before administration (66%) while infusions accounted for 28% of the preparations. The literature mined supports the use of these plants for the management of malaria since most of them have demonstrated in-vitro and in-vivo antiplasmodial activities.ConclusionMost of the reported plant species in this study have been investigated for antiplasmodial activity and are in agreement with the ethnomedical use. Two (2) plants are reported for the first time in the management of malaria. There is need for documentation and preservation of the rich ethnomedical knowledge within this community given that most of the practitioners are advanced in age and less educated. There is also the danger of over-exploitation of plant species as most of them are obtained from the wild, mainly Kakamega forest. Therefore, there is need for determining the economically and medicinally important plants in this community and planning for their preservation.
| S-EPMC5176009 | biostudies-literature
Project description:ObjectivesKenya has long and porous borders with its neighbouring countries. These regions, predominantly inhabited by highly mobile rural communities with strong cross-border cultural ties, present major challenges in managing movement of people and COVID-19 preventive measures. Our study sought to assess knowledge of COVID-19 prevention behaviours, how these varied by socioeconomic (SEC) factors and the challenges of engagement and implementation, in two border counties of Kenya.MethodsWe conducted a mixed methods study using a household e-survey (Busia, N=294; Mandera, N=288; 57% females, 43% males), and qualitative telephone interviews (N=73: Busia 55; Mandera 18) with policy actors, healthcare workers, truckers and traders, and community members. Interviews were transcribed, English translated and analysed using the framework method. Associations between SEC (wealth quintiles, educational level) and knowledge of COVID-19 preventive behaviours were explored using Poisson regression.ResultsParticipants were mostly educated to primary school level (54.4% Busia, 61.6% Mandera). Knowledge of COVID-19 prevention varied by behaviour: hand washing-86.5%, use of hand sanitiser-74.8%, wearing a face mask-63.1%, covering the mouth when sneezing or coughing-56.3% and social distancing-40.1%. Differences in knowledge by area, educational level and the wealth index were marked, greatest for Mandera, the less educated and the poor. Interviews with stakeholders revealed challenges in health messaging, psychosocial and socioeconomic factors, lack of preparedness for truck border crossings, language barrier, denial and livelihood insecurity as key challenges to engagement with and implementation of COVID-19 prevention behaviours in the border regions.ConclusionThe influence of SEC disparities and border dynamics on knowledge and engagement with COVID-19 prevention behaviours calls for contextually appropriate risk communication strategies that are cognisant of community needs and local patterns of information flow. Coordinating response measures across border points is crucial in winning communities' trust and maintaining essential economic and social activities.
| S-EPMC10192579 | biostudies-literature
Project description:Live bird markets (LBMs) provide integral hubs for 95% of poultry produced for food. Surveillance systems in LBMs serving smallholder farmers in sub-saharan Africa are often non-functional, and data about public health risks and emerging pathogens are lacking. Studies in Kenya have reported 29-44% Campylobacter prevalence in poultry. We analysed such LBMs in Kenya for likely transmission of Campylobacter from poultry to humans. We conducted a cross-sectional survey among 186 live poultry traders (LPTs) in 14 LBMs in a region with widespread backyard poultry systems. A pretested structured questionnaire was administered to all LPTs having regular contacts with poultry to gather market data and risk information on campylobacteriosis. Campylobacter was detected in individual cloacal cultures and identified through PCR. The median score obtained from the outcome of risk assessment dichotomized respondents into high and low risk categories. We performed logistic regression at 95% confidence interval (CI) to compare market characteristics and Campylobacter positivity to risk categories to identify LBM-associated public health risks. Markets had a median of 13 traders, and mean age of 46.3 ± 13.7 years. Majority 162/186 (87.1%) were males. Market behavioural processes by LPTs varied: Only 58.6% LPTs held bird species separate; onsite slaughter (38.7%); encountered sick-bird (93%) and dead-bird (83%) amidst limited health inspection (31.2%). Campylobacter positivity in live birds was 43/112 (38.4%, 95% CI: 29.4-48.1). Risk information on campylobacteriosis was low 41/114 (36%, 95% CI: 27.2-45.5). Sanitary risks were related to accumulation of litter (adjusted prevalence odds ratio [aPOR]: 19.67, 95% CI: 3.01-128.52). Accessing hand-wash facilities (aPOR: .32, 95% CI: .13-.78) and access to information (aPOR: .24, 95% CI: .09-.61) were protective. Sanitary risks were related to poor hygiene. LBMs could be central surveillance sites for Campylobacter. Public health authorities/actors should consider appropriate targeting to improve sanitary measures and Campylobacter control strategies.
| S-EPMC9790384 | biostudies-literature
Project description:Previous studies about unaccompanied refugee minors (URMs) showed that they are a highly vulnerable group who have greater psychiatric morbidity than the general population. This review focuses on mental health issues among URMs. Articles in databases PsycINFO, Medline and PubMed from 1998 to 2008 addressing this topic were reviewed. The literature had a considerable emphasis on the assessment of PTSD symptoms. Results revealed higher levels of PTSD symptoms in comparison to the norm populations and accompanied refugee minors. In several studies, age and female gender predicted or influenced PTSD symptoms. The existing literature only permits limited conclusions on this very hard to reach population. Future research should include the analysis of long-term outcomes, stress management and a more thorough analysis of the whole range of psychopathology. Additionally, the development of culturally sensitive norms and standardized measures for diverse ethnic groups is of great importance.
| S-EPMC2682790 | biostudies-literature
Project description:Over 50% of young people have dated by age 15. While romantic relationship concerns are a major reason for adolescent help-seeking from counselling services, we have a limited understanding of what types of relationship issues are most strongly related to mental health issues and suicide risk. This paper used records of 4019 counselling sessions with adolescents (10-18 years) seeking help from a national youth counselling service for a romantic relationship concern to: (i) explore what types and stage (pre, during, post) of romantic concerns adolescents seek help for; (ii) how they are associated with mental health problems, self-harm and suicide risk; and (iii) whether these associations differ by age and gender. In line with developmental-contextual theory, results suggest that concerns about the initiation of relationships are common in early adolescence, while concerns about maintaining and repairing relationships increase with age. Relationship breakups were the most common concern for both male and female adolescents and for all age groups (early, mid, late adolescence). Data relating to a range of mental health issues were available for approximately half of the sample. Post-relationship concerns (including breakups) were also more likely than pre- or during-relationship concerns to be associated with concurrent mental health issues (36.8%), self-harm (22.6%) and suicide (9.9%). Results draw on a staged developmental theory of adolescent romantic relationships to provide a comprehensive assessment of relationship stressors, highlighting post-relationship as a particularly vulnerable time for all stages of adolescence. These findings contribute to the development of targeted intervention and support programs.
| S-EPMC4931381 | biostudies-literature
Project description:BackgroundFor women living with the human immunodeficiency virus (WLHIV), preventing untimed pregnancies during the postpartum period reduces vertical transmission and improves other maternal and child health outcomes. In Kenya, Busia County's HIV prevalence and mother-to-child transmission rate are higher than the national average yet uptake of postpartum family planning (PPFP) is generally low. This study examined health system factors influencing the consistent use of PP modern FP methods among WLHIV in Busia County.MethodsA retrospective study involving 314 WLHIV with children aged 12-24 months who were chosen using systematic random sampling was conducted from February to March 2024 from outpatient clinics in Busia County. Additionally, 14 health providers were purposively sampled as key informants. Quantitative data was collected using a pretested questionnaire, while qualitative data was gathered through key informant interview guides. Quantitative data was analyzed using STATA 15 with descriptive statistics, logistic regression, and Chi-square tests, while a deductive thematic analysis was used for qualitative data.ResultsThe mean age of the participants was 32.06 (± 6.00) with the majority (51.27) aged between 25 and 34 years, married (74.84%) and unemployed (77.39%). Overall, 73.25% had used postpartum (PP) modern family planning (FP) methods, but only 52.55% reported consistent use throughout the first year postpartum. The only factors found to increase the odds of PPFP use were being married (aOR 3.34, 95% CI 1.58-7.07, p = 0.002), being escorted by a preferred person during seeking maternal and child health services (aOR 2.29, 95% CI 1.36-3.83, p = 0.002), and perceiving that they were provided information on all types of FP (aOR 2.33, 95% CI 1.19-4.16, p = 0.012). Persistent stock-outs and inadequate counseling hindered consistent PPFP use.ConclusionThe study identified gaps in the consistent use of PP modern FP methods among WLHIV in Busia County, influenced by the availability of FP information and health system factors. Addressing stock-outs and improving counseling during clinic visits and pregnancy are crucial for improving FP service delivery and reducing maternal and child health risks in high HIV-incidence areas like Busia County.
| S-EPMC11556080 | biostudies-literature
Project description:Maternal and newborn health (MNH) service delivery redesign aims to improve maternal and newborn survival by shifting deliveries from poorly equipped primary care facilities to adequately prepared designated delivery hospitals. We assess the feasibility of such a model in Kakamega County, Kenya, by determining the capacity of hospitals to provide services under the redesigned model and the acceptability of the concept to providers and users. We find many existing system assets to implement redesign, including political will to improve MNH outcomes, a strong base of support among providers and users, and a good geographic spread of facilities to support implementation. There are nonetheless health workforce gaps, infrastructure deficits, and transportation challenges that would need to be addressed ahead of policy rollout. Implementing MNH redesign would require careful planning to limit unintended consequences and rigorous evaluation to assess impact and inform scale-up.
| S-EPMC8691889 | biostudies-literature
Project description:Naivasha thorn tree, Acacia xanthophloea, is grown for foliage, timber, shade and rehabilitation of soils in areas with high water tables in Kenya. Its production is threatened by insect pests, which cause major losses. Very little is documented on wood-boring beetles which cause considerable economic damage to lumber used in a variety of applications, and little is known about their natural enemies in Kenya. We conducted the study to evaluate the occurrence of wood-boring beetles on A. xanthophloea in two different regions of Kenya. Infested wood samples of A. xanthophloea with fresh exit holes were collected from three sites in Kenyatta University (KU), Nairobi and Mitaboni in Machakos, Kenya. The samples were placed in clear plastic buckets and kept at ambient temperatures 23±2°C, 65±10% relative humidity and 12L: 12D in a laboratory where they were observed daily for adult emergence. Adult beetles were collected every three days for identification and data recording. The experiment was replicated four times and data collected twice a week for 6 months. Data on abundance was subjected to analysis of variance using SAS software. A total of 5,850 and 4,691 beetles were collected where 2,187 and 3,097 were Bostrichidae, accounting for 37% and 66% in KU and Mitaboni, respectively. A total of 12 bostrichid species was identified, including Sinoxylon ruficorne, S. doliolum, Xylion adustus, Xyloperthodes nitidipennis, Xyloperthella picea, Xylopsocus castanoptera, Lyctus brunneus, Heterbostrychus brunneus, Xylopsocus sp., and Dinoderus gabonicus. The most abundant species in KU was Xylion adustus with 1,915 beetles accounting for 88.4%, and Sinoxylon ruficorne in Mitaboni with 1,050 beetles accounting for 33.9% of the total. Sinoxylon ruficorne was only recorded in Mitaboni while only 2 specimens of D. gabonicus were found in KU. The mean number of exit holes on A. xanthophloea differed significantly between sites, which corresponded approximately to the amount of economic damage caused by the beetles to the structural integrity of the lumber. In addition, a number of predators in the family Cerambycidae, Cleridae, Histeridae and parasitoids from Braconidae, Ichneumonidae, and Chalcididae were recovered, suggesting a need to conduct further studies to document these species' diversity, parasitism rates and efficacy for possible biological control.
| S-EPMC5870935 | biostudies-literature