Faculty of Health Sciences (FHS)

Glycemic Indices Of Foods In Association With Diabetes Among Rural Women Of Kenya: Case Of Amagoro In Busia County

2019-09-16T12:46:47Z

Glycemic Indices Of Foods In Association With Diabetes Among Rural Women Of Kenya: Case Of Amagoro In Busia County Ebere, Rebecca Aya Diabetes mellitus is a chronic medical condition in which a person’s sugar level rises above the normal. This disease has become quite prevalent worldwide. In the year 2018, more than 500 million people were suffering from diabetes mellitus type-2 (DM2) worldwide. In 2010, an estimated seven million cases of diabetes were found in Africa. This figure was predicted to rise to over 18 million by the year 2030. In Kenya, an estimated 1.2 million Kenyans suffer from the disease. This has been projected to rise to 1.5 million by the year 2025. Although DM2 is determined primarily by genes and lifestyle, it has been strongly linked to dietary patterns. However data linking DM2 and Glycemic index (GI) in Kenya remain scarce. Generally, foods with high GI are more likely to lead to a high prevalence of DM2 than foods with low GI. Some studies done in Kenya have indicated relationship between local diets and diabetes. However these studies were hospital-based and not community-based and they did not identify the GI of locally consumed foods and link with DM2. The objective of this study was therefore to assess the glycemic indices of the staple foods consumed by women in a rural population and establish the association of the glycemic load (GL) of foods with DM2. The study was cross sectional in design with analytical components that generated both qualitative and quantitative data. The survey involved 260 women participants aged 15-90 years, GI, focus group discussions (FGDs) and key informant interviews (KIIs) involved a total of 12, 45 and 15 participants respectively. Initially, FGDs and KIIs were conducted to establish community’s knowledge and selfperceptions to foods associated with diabetes and to generate a food list that was used in designing a structured food frequency questionnaire (FFQ). The survey was conducted using a pre-tested questionnaire; FGD and KII guide were used to guide the FGDs and KIIs while the GI and proximate composition of foods were determined using standard procedures. The xii analytical components included proximate analyses of the foods and determination of glycemic indices (GIs). The GI of various foods was used to calculate the glycemic load (GL). Data were analysed using Microsoft Excel and Statistical Package for Social Sciences. Descriptive statistics were used to analyze and characterize the sample. The data was presented by absolute frequencies and percentages. A chi-square analysis was used to compare the categories of DM2 with other variables. Multivariate logistic regression was used to identify the magnitude of independent variable. Linear regression with mixed-effects was used to establish the differences between GIs of different foods. Results showed that the prevalence of DM2 was 16.9%. The GI of the foods followed the order: Cassava and sorghum Ugali with silver fish > rice plain > cassava > whole maize ugali with beef > whole maize ugali with silver fish = cassava-sorghum ugali and cowpea leaves = rice with beef > sweet potato > whole maize ugali = rice and beans > whole maize ugali with cowpea leaves > beans plain. The glycemic indices of various ugali meals were significantly different (p<0.05). Women consuming a GL of >840 were 1.36 times more likely to suffer from DM2 as opposed to those who consumed a moderate load although this association was not significant (p>0.05). The study concluded that there was no significant association between glycemic index and diabetes among rural women of Amagoro. Cowpea leaves and beans have the potential of lowering the GI of staple foods consumed alongside. Alcohol consumption and physical activity were the strongest independent risk factors for DM2 in this study population. This calls for need to create awareness and sensitize the population on these predisposing factors.

Prevalence Of HIV Associated Dementia Among HIV/AIDS Adults Attending Comprehensive Care Centre-Kapsabet Referral Hospital

2017-12-11T17:17:34Z

Prevalence Of HIV Associated Dementia Among HIV/AIDS Adults Attending Comprehensive Care Centre-Kapsabet Referral Hospital Tiparo, Joshua K Introduction HIV associated dementia is the most devastating central nervous system consequence of HIV infection which invades the brain directly. Progression into HIV associated dementia (HAD) has is associated with a number of bio-psychosocial factors. Despite the high prevalence of HIV infection, there are no adequate data on HIV associated dementia both internationally and locally especially in Africa. The aim of this study was to establish the prevalence of HAD, the associated socio-demographic factors, and the association between International HIV Dementia Scale Score and viral load among HIV/AIDS adult patients attending the Kapsabet Comprehensive Care Centre, Nandi County. Methodology The study design was descriptive cross-sectional study and the study population was 4,100 HIV positive adults who were drawn from various locations within the county. Sample size was 352 patients who came for their routine clinic appointment. Sampling method used was simple random sampling where the potential participants randomly picked numbers in a container at the triage nurse desk. Those who picked odd numbers from 1 to 31 and met inclusion /exclusion criteria participated in the study. International HIV dementia scale and Socio-demographic questionnaire was used to collect socio-demographic characteristic and HIV related information. Data Analysis The data collected was analyzed using SPSS Version 20 and the results were presented in tables, graphs, Charts and narratives. Study results The prevalence of HIV associated dementia was 65.6% among HIV patient attending Kapsabet Comprehensive Care Centre, There was no association between viral load and International HIV dementia score with a chi-square of 3.96 and p-value of 0.267 Conclusion The results indicated that HIV associated dementia is common among HIV patients attending Kapsabet comprehensive Care Centre and is not associated with viral load

Breast‐feeding and human immunodeficiency virus infection: Assessment of knowledge among clinicians in Kenya

2019-07-21T13:48:11Z

Breast‐feeding and human immunodeficiency virus infection: Assessment of knowledge among clinicians in Kenya Ogeng'o, Julius; Migiro, Santau; Tsikhutsu, Isaac; Musoke, Rachel; Obimbo, Moses M; Murila, Florence In Kenya,human immunodeﬁciency virus(HIV)prevalence ranks among the highest in the world.Approximately60000 infections yearly are attributed to vertical transmission including the process of labour and breast-feeding.The vast of the population affected is in the developing world. Clinical ofﬁcers and nurses play an important role in provision of primary health care to antenatal and postnatal mothers. There are a few studies that have explored the clinicians’ knowledge on breast-feeding in the face of HIV and in relation to vertical transmission this being a vital component in prevention of maternal-to-child transmission. The aim of this study was to evaluate clinicians’ knowledge on HIV in relation to breast-feeding in Kenya. A cross-sectional survey was conducted to assess knowledge of 161 clinical ofﬁcers and nurses serving in the maternity and children’ wards in various hospitals in Kenya. The participants were derived from all district and provincial referral facilities in Kenya. A preformatted questionnaire containing a series of questions on HIV and breast-feeding was administered to clinicians who were then scored and analyzed. All the 161 participants responded.

Influence of provider training on quality of emergency obstetric care in Kenya

2016-11-29T00:34:11Z

Influence of provider training on quality of emergency obstetric care in Kenya Olenja, Joyce; Godia, Pamela; Kibaru, Josephine; Egondi, Thaddaeus In addition to infectious diseases, maternal and neonatal conditions account for a substantial part of the health gap between rich and poor countries. For example, more than 99 percent of maternal deaths occur in the developing world. The majority of the deaths are caused by direct obstetric complications, including haemorrhage, sepsis, eclampsia, obstructed labour, and unsafe abortion practices. In Kenya, complications related to pregnancy and childbirth are leading causes of morbidity and mortality, translating to 414 maternal deaths per 100,000 live births. Although 88 percent of Kenyan women attend antenatal care, only 40 percent deliver in the health facilities, and only 42 percent of all deliveries have skilled attendance at delivery. In the Kenyan context, access to and use of quality emergency obstetric care (EmOC) are essential to efforts aimed at reducing maternal morbidity and mortality. We examine data from the 2004 Kenya Service Provision Assessment (KSPA) to assess the availability of EmOC services in Kenya, and to demonstrate the importance of health worker training in the delivery of these life-saving services. We find that less than 20 percent of maternal health workers interviewed had received training in focused antenatal or postnatal care in the last three years. Among caregivers providing delivery services, only 18 percent had received training in lifesaving skills, and only 37 percent had received training in the prevention of mother- to -child transmission of HIV during the last three years. Our analysis also demonstrates that training is a critical element in the detection and management of complications. Recent training in relevant subject matter was found to be significantly and positively associated with the ability to provide quality care in the event of unsafe abortion and postpartum haemorrhage. Training was also positively associated with the ability to provide appropriate care in the event of a retained placenta.