http://erepository.uonbi.ac.ke/handle/11295/13925 2026-04-28T13:04:10Z 2026-04-28T13:04:10Z Laisser, Rose M Chimwaza, Angela F Grace M, Omoni McGowan, Linda Maclean, Gaynor Wakasiaka, Sabina Lavender, Tina http://erepository.uonbi.ac.ke/handle/11295/166700 2025-01-21T06:34:24Z 2019-01-01T00:00:00Z

Crisis: an educational game to reduce mortality and morbidity Laisser, Rose M; Chimwaza, Angela F; Grace M, Omoni; McGowan, Linda; Maclean, Gaynor; Wakasiaka, Sabina; Lavender, Tina Background: Maternal mortality and morbidity rates remain high in sub-Saharan Africa, yet with appropriate management, these rates could be reduced significantly. Midwifery training to improve the management of women during intrapartum period is often lacking, calling for innovative training methods in midwifery clinical care. Aims: To develop and evaluate a game, aimed at the prevention and management of the main causes of maternal morbidity and mortality. Methods: In collaboration with the Lugina Africa Midwives Research Network (LAMRN), the authors developed an educational board game and field tested the final version in Kenya, Tanzania and Malawi with midwives (n=56) and student midwives (n=32). Findings: Qualitative and quantitative evaluation demonstrated that the game was well liked for its ease of use, acceptable appearance and relevance to practice. Conclusions: The board game, named ‘Crisis’, has potential to influence practice; however, further research is required to assess its ability to improve outcomes.

2019-01-01T00:00:00Z Mugo, Cyrus Njuguna, Irene N Beima-Sofie, Kristin Mburu, Caren W Onyango, Alvin Itindi, Janet Richardson, Barbra A Oyiengo, Laura John-Stewart, Grace Wamalwa, Dalton C http://erepository.uonbi.ac.ke/handle/11295/164218 2024-01-04T06:45:36Z 2023-01-01T00:00:00Z

Adolescent experiences, perceptions, and preferences for the process of HIV status disclosure in Kenya Mugo, Cyrus; Njuguna, Irene N; Beima-Sofie, Kristin; Mburu, Caren W; Onyango, Alvin; Itindi, Janet; Richardson, Barbra A; Oyiengo, Laura; John-Stewart, Grace; Wamalwa, Dalton C Introduction: Disclosure of HIV status to adolescents living with HIV has been associated with improved treatment outcomes. However, there are limited data regarding the experiences of, perceptions of, and preferences for the process of disclosure of HIV status among adolescents and young adults living with HIV (AYLH), especially in sub-Saharan Africa. Methods: Young adults living with HIV from 20 HIV clinics in Kenya who participated in a clinical trial evaluating the effectiveness of a disclosure and transition package completed an anonymous survey in 2019. We described their experiences and preferences using counts and proportions and assessed factors associated with satisfaction with the disclosure process using linear regression, reporting age-adjusted mean differences (aMD), and 95% confidence intervals (95%CIs). Results: Of the 375 enrolled AYLH, 265 (71%) had perinatally acquired HIV, of whom 162 (61%) were female. The median age of the enrolled AYLH was 16 years (IQR: 14-19 years), and all of them were on antiretroviral therapy (ART). For over half (55%) of the participants, caregivers disclosed their HIV status, and 57% preferred that their caregivers disclose the status to them. Most (78%) of the participants preferred full disclosure by 12 years of age. The majority (69%) believed the disclosure was planned, and 11% suspected being HIV positive before the disclosure. Overall, 198 (75%) AYLH reported that they were ready for disclosure when it happened, and 86% were satisfied with the process. During both pre-disclosure (67 and 70%, respectively) and post-disclosure (>75% for each), AYLH felt supported by the clinic and caregivers. Factors associated with higher satisfaction with the disclosure process were pre-disclosure clinic support (aMD: 0.19 [95%CI: 0.05-0.33]) and pre-disclosure (aMD: 0.19 [0.06-0.31]) and post-disclosure (aMD: 0.17 [0.03-0.31]) caregiver support. AYLH who suspected they were HIV positive before they were disclosed to tended to have lower satisfaction when compared to those who never suspected (aMD: -0.37 [-0.74-(-0.01)]). Overall, they reported that disclosure positively influenced their ART adherence (78%), clinic attendance (45%), and communication with caregivers (20%), and 40% reported being happier after disclosure.

2023-01-01T00:00:00Z Kemboi, David Antonissen, Gunther Ochieng, Phillis Croubels, Siska De Baere, Siegrid Scippo, Marie-Louise Okoth, Sheila Kangethe, Erastus Faas, Johannes Doupovec, Barbara Lindahl, Johanna Gathumbi, James http://erepository.uonbi.ac.ke/handle/11295/163988 2023-11-16T06:58:42Z 2023-01-01T00:00:00Z

Efficacy of Bentonite and Fumonisin Esterase in Mitigating the Effects of Aflatoxins and Fumonisins in Two Kenyan Cattle Breeds Kemboi, David; Antonissen, Gunther; Ochieng, Phillis; Croubels, Siska; De Baere, Siegrid; Scippo, Marie-Louise; Okoth, Sheila; Kangethe, Erastus; Faas, Johannes; Doupovec, Barbara; Lindahl, Johanna; Gathumbi, James The objective of the study was to investigate the efficacy of bentonite and fumonisin esterase, separately or combined, in mitigating the effects of aflatoxins (AF) and fumonisins (FUM) in Boran and Friesian-Boran crossbreed cattle. These effects were studied by measuring mycotoxins, their metabolites, and biomarkers that relate to animal health, productivity, and food safety. The study was divided into three experiments each lasting for 2 weeks. Cows in experiment 1 received in random order aflatoxin B1 (AFB1) [788 μg/cow/day (69.7 μg/kg dry matter intake (DMI)) for Borans and 2,310 μg/cow/day (154 μg/kg DMI) for crossbreeds], bentonite (60 g/cow/day), or both AFB1 and bentonite. Boran cows in experiment 2 received in random order FUM (12.4 mg/cow/day (1.1 mg/kg DMI)), fumonisin esterase (120 U/cow/day), or both FUM and fumonisin esterase. Boran cows in experiment 3 received in random order AFB1 (952 μg/cow/day (84.2 μg/kg DMI)) + FUM (30.4 mg/cow/day (2.7 mg/kg DMI)), bentonite (60 g/cow/day) + fumonisin esterase (120 U/cow/day), or both AFB1 + FUM and bentonite + fumonisin esterase. Feeding AFB1 and/or FUM contaminated feed with or without the addition of the detoxifiers for 14 days did not affect DMI, milk composition, hematology, and blood biochemical parameters. The addition of bentonite in a diet contaminated with AFB1 led to a decrease in milk aflatoxin M1 (AFM1) concentration of 30% and 43%, with the carry-over subsequently decreasing from 0.35% to 0.20% and 0.08% to 0.06% for crosses and Borans, respectively. No significant change was observed in the sphinganine/sphingosine (Sa/So) ratio following feeding with FUM alone or in combination with fumonisin esterase; however, the ability of fumonisin esterase to hydrolyze FUM into less toxic fully hydrolyzed FUM and partially hydrolyzed FUM was evident in the rumen fluid and feces. These results indicate bentonite was effective in decreasing AFM1 concentration in milk, and AFB1 and AFM1 in plasma, while fumonisin esterase can convert FUM into less toxic metabolites and can be a suitable addition to feed cocontaminated with AFB1 and FUM.

2023-01-01T00:00:00Z Hummel, Alyssa D Ronen, Keshet Amritha, Bhat Wandika, Brenda Choo, Esther M Osborn, Lusi Maneesh, Batra Kinuthia, John Manasi, Kumar Unger, Jennifer A http://erepository.uonbi.ac.ke/handle/11295/163712 2023-06-20T07:19:54Z 2022-01-01T00:00:00Z

Perinatal depression and its impact on infant outcomes and maternal-nurse SMS communication in a cohort of Kenyan women Hummel, Alyssa D; Ronen, Keshet; Amritha, Bhat; Wandika, Brenda; Choo, Esther M; Osborn, Lusi; Maneesh, Batra; Kinuthia, John; Manasi, Kumar; Unger, Jennifer A Background: Perinatal depression is broadly defined as depressive symptoms during pregnancy or within the 12 months following delivery, affecting approximately 20-25% of pregnant and postpartum women in low- and middle-income countries. The wide accessibility of mobile phones allows mobile health (mHealth) interventions to be considered a solution to identify perinatal depression and provide appropriate referrals for treatment. This study, nested in a larger SMS communication project, examined the prevalence and correlates of perinatal depression, determined the association between antenatal depression and infant morbidity and mortality, and compared SMS communication patterns between women with and without perinatal depression. Methods: This was a prospective longitudinal cohort study of pregnant women seeking antenatal services at two public sector health clinics in Kenya. SMS messages were sent to participants with educational content related to their pregnancy and infant health and two-way SMS communication occurred with a nurse. Sociodemographic and obstetric characteristics, SMS messaging behaviors, infant health status, and depressive symptoms were assessed by a standardized questionnaire administered at enrollment (30-36 weeks gestation) and follow-up (14 weeks postpartum). Generalized estimating equation (GEE) with Poisson link was used to evaluate correlates of perinatal depressive symptoms, infant outcomes, and frequency of SMS messaging. Results: Of the 572 women with complete follow-up information, 188 (32.9%) screened positive for elevated depressive symptoms (≥10 by EPDS scale) at some time point during pregnancy or postpartum. The strongest predictors of any depressive symptoms included interpersonal abuse during pregnancy, fewer years of schooling, and maternal unemployment. Antenatal depressive symptoms were associated with an increased risk of infant illness or hospitalization (RR = 1.12, 95% CI: 1.11, 1.13). Women with antenatal or persistent perinatal depressive symptoms sent fewer SMS messages during the study period than their counterparts without depression. Conclusions: Prevalence of elevated perinatal depressive symptoms was high in this cohort of Kenyan women. Our findings highlight the importance of screening perinatal women for experiences of symptoms of depression as well as abuse. Differences in messaging frequency between women with vs. without depressive symptoms presents an opportunity to provide more tailored support for those perinatal depression.

2022-01-01T00:00:00Z