Fathers and grandmothers experiences participating in nutrition peer dialogue groups in Vihiga County, Kenya.
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ABSTRACT:
SUBMITTER: Thuita F
PROVIDER: S-EPMC8269141 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundDespite robust Tuberculosis (TB) program with effective chemotherapy and high coverage, treatment interruption remains a serious problem. Interrupting TB treatment means that patients remain infectious for longer time and are at risk of developing drug resistance and death. This study was conducted to identify and describe predictors of TB treatment interruption.MethodsA cohort of 291 notified TB patients from 20 selected health facilities in Vihiga County were enrolled in to the study and followed up until the end of treatment. Patient characteristics that potentially predict treatment interruption were recorded during treatment initiation using structured questionnaires. Patients who interrupted treatment were traced and reasons for stoppage of treatment recorded. Kaplan Meier method was used to estimate probabilities of treatment interruption by patient characteristics and determine time intervals. The Log rank test for the equality of survival distributions analyzed significance of survival differences among categorical variables. For multivariable analysis, Cox proportional hazard model, was fitted to identify predictors of TB treatment interruption through calculation of hazard ratios with 95% Confidence Intervals (CIs). For variable analysis, statistical significance was set at P ≤ 0.05. Reasons for treatment interruption were categorized according to most recurrent behavioral or experiential characteristics.ResultsParticipants' median age was 40 years (IQR = 32-53) and 72% were male. Of the 291 patients, 11% (n = 32) interrupted treatment. Incidences of treatment interruption significantly occurred during intensive phase of treatment. Independent predictors of treatment interruption included alcohol consumption (HR = 9.2, 95% CI; 2.6-32.5, p < 0.001), being female (HR = 5.01, 95% CI; 1.68-15.0, p = 0.004), having primary or lower education level (HR = 3.09, 95% CI; 1.13-8.49, p < 0.029) and having a treatment supporter (HR = 0.33, 95% CI; 0.14-0.76, p = 0.009). Reasons for interrupting treatment were categorized as: alcoholism, feeling better after treatment initiation, associated TB stigma, long distance to health facility, lack of food, perception of not having TB and pill burden.ConclusionTB treatment interruption was high and largely associated with patients' socio-demographic and behavioral characteristics. These multidimensional factors suggest the need for interventions that not only target individual patients but also environment in which they live and receive healthcare services.
| S-EPMC8638988 | biostudies-literature
Project description:BackgroundTungiasis is a parasitic disease caused by the sand flea Tunga penetrans also known as jigger flea. Communities living in precarious conditions in tropical and sub tropical countries bear the brunt of the infection. The main objective of this study was to determine the burden of Tungiasis in Vihiga County in Kenya.MethodsThis was a cross-sectional study conducted in 21 villages in 3 Sub-locations in Vihiga County, western Kenya. A total of 437 participants, 5 years old and above were clinically examined for the presence of tungiasis after consenting to take part in the study. Diagnosis was made following standard methods. A semi- structured questionnaire was administered to assess socio-demographic factors, housing, presence and ownership of animals, knowledge and practice related to tungiasis. Data were analyzed using bivariate and multivariate regression analysis. GIS was used to map the geographic distribution of tungiasis in the area.ResultsThe overall prevalence was found to be (21.5%; 95% CI: 17.7-25.3%). The cases were analysed and visualized in a map form. Multivariate analysis suggested that the occurrence of tungiasis was associated with variables that indicated low economic status (like a monthly income of Ksh ≤ 1000 (adjusted odds ratio 27.85; 95% CI: 4.13-187.59), earthen floor (0.36; 0.13-1.024) and lack of toilet facilities (4.27; 0.82-22.34), age of participant ≤14 (27.414; 10.02-74.99), no regular use of closed footwear (1.98; 0.987-3.97) and common resting place inside the house (1.93; 0.96-3.89).ConclusionsTungiasis is an important health problem in Vihiga County occasioned by the low economic status of the people affected. Factors that point to poverty contribute to the occurrence of tungiasis. These findings suggest a need to design control strategies for tungiasis that are cost effective and easily accessible.
| S-EPMC6413899 | biostudies-literature
Project description:Rift Valley fever (RVF) is an emerging mosquito-borne viral hemorrhagic fever in Africa and the Arabian Peninsula, affecting humans and livestock. For spread of infectious diseases, including RVF, knowledge, attitude and practices play an important role, and the understanding of the influence of behavior is crucial to improve prevention and control efforts. The objective of the study was to assess RVF exposure, in a multiethnic region in Kenya known to experience RVF outbreaks, from the behavior perspective. We investigated how communities in Isiolo County, Kenya were affected, in relation to their knowledge, attitude and practices, by the RVF outbreak of 2006/2007. A cross-sectional study was conducted involving 698 households selected randomly from three different ethnic communities. Data were collected using a structured questionnaire regarding knowledge, attitudes and practices that could affect the spread of RVF. In addition, information was collected from the communities regarding the number of humans and livestock affected during the RVF outbreak. This study found that better knowledge about a specific disease does not always translate to better practices to avoid exposure to the disease. However, the high knowledge, attitude and practice score measured as a single index of the Maasai community may explain why they were less affected, compared to other investigated communities (Borana and Turkana), by RVF during the 2006/2007 outbreak. We conclude that RVF exposure in Isiolo County, Kenya during the outbreak was likely determined by the behavioral differences of different resident community groups. We then recommend that strategies to combat RVF should take into consideration behavioral differences among communities.
| S-EPMC5358895 | biostudies-literature
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:The need to transform mental health care toward person-centered, recovery-based, and network-oriented care is recognized worldwide. Open Dialogue (OD) is seen as a hopeful approach in the context of this transformation and is introduced in countries around the globe. Five Dutch mental health care organizations spread over the Netherlands introduced the Peer-supported Open Dialogue (POD) approach, which adds an explicit role of peer-support workers to the OD approach. It appeared that (P)OD-trained professionals face issues in introducing the (P)OD approach in existing MHC settings. One of the reasons, which is the focus of this study, may be that they encounter difficulties in explaining to non-(P)OD-trained professionals what (P)OD entails. The main objective of this study is to provide guidance to and contribute to making (P)OD better understandable for non-(P)OD-trained professionals. In this study, we used a qualitative design and conducted 23 semi-structured interviews with POD-trained professionals with various backgrounds, to cultivate a rich understanding of which aspects could contribute to a better understanding of POD for non-POD-trained professionals. We used a hybrid approach to analyze the data, meaning that the technique of both inductive and deductive thematic analyses has been applied. From these analyses, six aspects emerged that could give guidance to and contribute to making (P)OD more understandable for non-(P)OD-trained professionals: (1) Experiencing (P)OD by attending treatment network sessions, (2) a coherent and profound narrative about (P)OD, (3) adjusting terminology to better fit the context, such as the two terms "principles" and "responsibility" in this study, (4) the order in which (P)OD elements are introduced in the narrative, (5) bringing the elements "presence," "reflecting," and "expertise by experience" more to the foreground, and (6) conceptualizing the main elements in a "talking paper." A better understanding of (P)OD might be one of the building blocks for improving (P)OD adoption in existing MHC practices, which are on their way toward person-centered, recovery-based, and network-oriented care.
| S-EPMC9891459 | biostudies-literature
Project description:BackgroundIt has been established that use and utilization of nutrition services among adolescents are highly linked to availability, access, cost and quality of care. The main objective of this study was to assess the socio-demographic and facility-based factors as proxies to access to perceived quality of nutrition-specific and nutrition-sensitive services among adolescents in Trans-Mara East Sub-County, Narok County.MethodsThe study adopted a cross-sectional approach that employed mixed methods on 291 households. Probability proportionate to size sampling techniques using cluster and simple random methods were used to practically access adolescents who are pregnant or lactating. Data were collected using questionnaires, in-depth interview and Focus Group Discussion. Quantitative data was analyzed descriptively using frequencies and inferentially using odds ratio and Z-test. Framework analysis was employed to analyze qualitative data.ResultsA nutritionist was more likely to increase overall utilization (considered as a proxy index to access quality nutrition-sensitive and -specific services) by 3.18 times (OR = 3.18, 95% CI = 1.50-6.60, P = 0.002) and nurses 2.7 times (OR = 2.70, 95% CI = 1.40-5.30, P = 0.005). Generally, 80.7 and 69.4% attached positive value to environmental and basic personal hygiene, respectively, as being areas of nutrition-sensitive service delivery with a significant number higher than expected frequency of 50% (P < 0.05). An assessment of facility networks isolated only public health center as the key determinant of overall utilization. Public health centers among other health facilities were more likely to increase utilization (OR = 4.52, 95% CI = 1.50-13.50, P = 0.007). Assessment of distance to facility identified both distances as key determinants of overall utilization as those resident < 1 km from the facilities were 2.4 times more likely to utilize the facilities (OR = 2.42, 95% CI = 1.20-4.80, P = 0.012) while those resident 1-5 km were 5.3 times more likely to utilize the services (OR = 5.34, 95% CI = 1.90-15.10, P = 0.002) relative to longer distances. Finally, on methods of conveying messages, those who received messages through Information Education and Communication (IEC) materials were 7.8 times (OR = 7.85, 95% CI = 1.50-40.50, P = 0.014) and through face-to-face were 3.9 times more likely to utilize the services (OR = 3.91, 95% CI = 1.30-11.90, P = 0.016).ConclusionCritical facility-based determinants of utilization of nutrition services include personnel (mainly nutritionist and nurse), distance and IEC materials.
| S-EPMC7050766 | biostudies-literature
Project description:BACKGROUND:During pregnancy or lactating, adequate nutrition for adolescents becomes critical to reduce risks for both child and maternal-related morbidity and mortality. Power dynamics play a massive role in health outcomes. The main objective of this study was to examine the power dynamics in the families and communities and their impact on the pregnant and lactating adolescent girls' access and utilization of nutrition services in Trans-Mara East Sub-County, Narok County. METHODS:A cross-sectional approach that employed mixed methods with both quantitative and qualitative research was adopted. Probability proportionate to size sampling techniques using cluster and simple random methods were used to practically access pregnant or lactating adolescents. Data was collected using questionnaires, in-depth interview and Focus Group Discussion. Quantitative data was analyzed descriptively using frequencies and inferentially using odds ratio and Z-test. Framework analysis was employed to analyze qualitative data. P ≤ 0.05 was considered statistically significant. RESULTS:In the power dynamics analyses, the intrinsic capability (Intrinsic capabilities are those adolescent driven initiatives that facilitate their access to nutrition services) was more likely to decrease awareness by half (OR = 0.52, 95% CI = 0.4-0.7, P < 0.01) whereas extrinsic dependency was likely to increase utilization by 1.2 times (OR = 1.2, 95% CI = 1.0-1.5, P = 0.055). From the stakeholder power matrix, the health personnel had observable visible power to influence access and utilization of nutrition services. Additional results revealed that adolescents who draw their support from significant others were more likely to utilize nutrition services as compared to those who attempted to make their own efforts to seek these services. Furthermore, health personnel have the most influential powers in ensuring adolescents access services and thus the most important actors in the stakeholder matrix. Other actors requiring focus included parents, political figures and governments while stakeholder engagement have higher potential of increasing access and utilization of services through dialogue. CONCLUSIONS:Community access to nutritional services can be increased through use of multiple avenues to reach adolescents, including school-based, health system-based, community-based approaches and even marriage registries. A heightened engagement in the identified stakeholder network is necessary when planning community conversations, to ensure a multi-stakeholder approaches in meeting the nutrition needs of adolescents.
| S-EPMC7168838 | biostudies-literature
Project description:ObjectivesBreast-feeding is sensitive to somatic, hormonal, behavioral and psychological components of maternal capital. However, through grandmothering, older women may also influence breast-feeding by transferring informational resources to their daughters. We hypothesized that mothers with prolonged instrumental support from their own mother are more likely to have received advice and to have favorable attitudes/practices regarding breastfeeding, compared to those lacking such support, with implications for the grandchild's somatic capital.MethodsWe recruited 90 mother-infant dyads (52 with grandmaternal support, 38 without) in Merida, Yucatan, Mexico. All children were first-borns, aged ~2 years. Anthropometry and body composition were assessed. Data on grandmother's breastfeeding advice and maternal breastfeeding duration were obtained by questionnaire. Maternal attitudes to breast-feeding were assessed using the Iowa Infant Feeding Attitude Scale.ResultsWomen with instrumental support were more likely to have received grandmaternal advice during pregnancy/infancy on exclusive breast-feeding duration (60% vs. 37%, p = 0.033) and the type of first complementary food (81% vs. 47%, p = 0.001). However, women with support had a less favorable attitude to breastfeeding than those without and breastfed their children for less time (median 5 vs. 10.5 months, p = 0.01). No group differences were found in children's length, weight, skinfolds or lean mass z-score.DiscussionAlthough grandmothers providing instrumental support provided advice regarding breastfeeding, their attitudes may reflect issues beyond nutritional health. Advice of maternal grandmothers did not promote extended breastfeeding, however the differences in breastfeeding attitudes were not associated with the children's nutritional status. Grandmothers should be included in public health interventions promoting breastfeeding.
| S-EPMC9826188 | biostudies-literature
Project description:Mothers face trade-offs between infant care and subsistence/economic activities. In traditional populations, allomothers such as fathers and grandmothers support mothers with young infants, allowing them to reduce labour activities and focus on breastfeeding. Similarly, the positive impact of social support on breastfeeding has been highlighted in developed populations. However, these studies have generally focused on emotional support from fathers, peers and healthcare professionals. Given the availability of formula milk in developed populations, an evolutionary anthropological perspective highlights that practical support, unlike emotional support, may have negative associations with breastfeeding by enabling substitution of maternal care. Other kin, mainly grandmothers, may also be important allomothers influencing maternal breastfeeding levels. Here we explore the associations between different types of social support mothers receive from fathers/grandmothers and breastfeeding in the UK Millennium Cohort Study. We find frequent grandmother contact and father's parenting involvement are both associated with lower levels of breastfeeding, suggesting a negative relationship between practical support and breastfeeding. In contrast, father presence, potentially capturing emotional support, is associated with greater breastfeeding initiation. Our findings suggest that practical support and emotional support functions differently, and practical support may not encourage breastfeeding in developed populations.
| S-EPMC4507871 | biostudies-literature
Project description:Malaria is a major health problem in sub-Saharan Africa where over 90% of the world's malaria cases occur. Artemisinin-based combination therapy (ACT) is recommended by the World Health Organization as first-line and second-line treatments for uncomplicated falciparum malaria. However, there are a growing number of reports of sub-standard and falsified anti-malarial medicines in sub-Saharan Africa.A cross-sectional study was conducted in Embu County, Kenya on the quality of anti-malarial medicines available in public and private facilities. Sampling of anti-malarial medicines from public and private hospitals, health centers and pharmacies was conducted between May and June 2014. Quality control tests were performed at the Drug Analysis and Research Unit, University of Nairobi, using ultraviolet spectrophotometry and high-performance liquid chromatography. A test for microbial load was also conducted for suspension formulations.A total of 39 samples were collected from public and private facilities across the Embu County. A visual inspection of the medicines showed no signs of sub-standard or falsification. All ACT passed identification, assay and dissolution tests. Of 11 suspension samples collected, none failed the microbial load test although one sample had 50 colony forming units (cfu). No oral artemisinin monotherapy medicines were encountered during the survey. Amodiaquine and chloroquine monotherapy products accounted for 5% of the collected samples, despite their ban in Kenya. Two herbal anti-malarial formulations were collected during the survey. Sulfadoxine/pyrimethamine (SP) was also found to be available use for malaria treatment, not in accordance with malaria treatment guidelines.All the anti-malarial drugs analysed in this study passed the quality control tests. This is encouraging given the high malaria burden in Kenya. Regulatory actions are required to counter SP and herbal products for malaria treatment.
| S-EPMC6138895 | biostudies-other