Background: Kenya is home to an estimated 1.7 million people living with HIV/AIDS. According to the Kenya AIDS Indicator survey KAIS 2012, HIV prevalence in the age group 15-24 stood at 2.2%. Globally, young people aged 15-24 are a highly vulnerable population with respect to HIV/AIDS infection and transmission. HIV testing and counseling services play a critical role as an entry point to care and treatment. However, uptake of HIV testing and counseling services among the youth in Kenya has been reportedly low. Youths at Universities are among the priority populations in HIV/AIDS programs.Objectives: This study aimed to determine the barriers to uptake and utilization of institution-based voluntary counseling and testing VCT services among students aged 18-24 in selected public universities in Kenya. The specific objectives were to determine the factors associated with uptake and utilization and the association between various socio-demographic factors and service uptake in institutional VCT facilities.Methods: This research utilized a descriptive cross-sectional study design where primarily, data was collected using semi-structured questionnaires and through focus group discussions held with the students in the sampled Universities. Data available at Jomo Kenyatta University of Agriculture and Technology JKUAT Hospital VCT were reviewed for the period 2010 and 2016 to give an insight into service utilization rates among students. Multi-stage sampling technique was utilized to reach a student sample size of 305 from the selected public Universities in Kenya.Results: Uptake of institutional VCT services among University students sampled stood at 45% from a population where 84.4% were aware of the presence of these services on their campuses. More males than females utilized the services. Emerging themes from the study indicated that participants utilized the services for different reasons. Accessibility to test site, testing hours, fear to be seen at site and fear of test result were also identified as factors affecting service uptake. These factors also were also reported when students were asked about their desired characteristics of a VCT facility on campus.Conclusion: This study has unraveled the factors that are associated with testing and counseling in institutional facilities. University students seem to seek and utilize VCT services for different reasons. It is also clear that patterns of services utilization vary from group to another as observed in the case of year of study, gender and age category.Recommendations: It is necessary for policy makers in institutions of higher learning together with those tasked with managing healthcare services in these institutions to adopt approaches that will overcome the barriers to utilization of VCT services among students. With knowledge of the factors associated with uptake and utilization of VCT services in institutional facilities, efforts to tackle the barriers and maximize on enhancers should be utilized fully in order to improve uptake and utilization of services. More research should also focus on the persisting risky sexual behaviors among University students despite the high knowledge they have on HIV/AIDS.Keywords: Higher learning institutions, voluntary counseling and testing, HIV, barriers and uptake.
Background: Hypertension remains the global challenge and the leading causes of worse cardiovascular event with 7.5 million toll deaths. The 2010 WHO estimate was 1.3 billion representing 31.1% of all adults with an astounding increase in low and middle-income countries including Sab-Saharan Africa.Methods: This cross-sectional study was undertaken in two beverage industrial workplaces with a sample of 440 employees and their spouses during the period of 2016 to 2018. WHO stepwise questionnaire was used to collect data and biomedical samples were taken for predicting the 10-year cardiovascular risk by Cox regression model and multivariate logistic regression was run to determine the key factors associated with both Hypertension (HTN) classifiers. The data were coded and analyzed by SPSS 16.0 version.Results: Overall HTN prevalence was 32.27%, male with 37.8% and female with 25.2% by previous HTN classifier. Whereas the updated classifier showed an overall prevalence of 61.81%, male with 67.1% and female with 55%. The findings showed a huge difference of 29.54% with p<0.001 between the two prevalence of previous and updated blood pressure classification. Employees had a relatively high HTN prevalence of 35.92% to 65.18%, compared to the spouses with 26.47% to 56.47%, p<0.001 by previous and updated classification, respectively.Conclusions: The relatively rise prevalence of the HTN revealed by this study suggests new and combining health promotion tactics, cultural theories to fight this rampant silent killer.
Background: Cardiovascular diseases (CVD) are the world leading causes of death in non-communicable diseases. The aim of this study is to predict cardiovascular risk and compare two prediction models.Methods: This cross-sectional study involved 440 sample size of beverage industrial participants. The 10-year prediction was processed by World Health Organization/International Society of Hypertension (WHO/ISH) score chart and Framingham general risk score. WHO stepwise questionnaire and biomedical forms was used. Data was collected and analyzed by SPSS 16.0 version.Results: The overall CVD low risk prediction (<10%) by Framingham general risk score (FGRS) and WHO/ISH score chart was 74.5%, 95.4%, respectively while the CVD elevated risk (≥10%) was 25.5%, 4.6%, respectively. Gender CVD risk (≥10%) was 16.1% of male versus 9.3% of female by FGRS while 2.7% of male versus 1.5% of female classified by WHO/ISH. CVD risk increases in both of the models with age but very much in FGRS. 8.4% of employees versus 5.2% of spouses was classified as having the risk of 10-20% by FGRS while WHO/ISH classified 2.5% of employees and 0.9% of spouses as having the risk of 10-20%. FGRS classified 11.7% of all participant as having the risk above 20% while WHO/ISH classified only 1% as having the risk above 20%. Two model’s kappa agreement level was fair or minimal interrater reliability with 0.25 with p value <0.001 and the correlated receiver operating characteristic curve (ROC) curve of FGRS and WHO/ISH of 0.887 area under the curve (AUC), 0.847AUC all with a p value <0.001, respectively.Conclusions: FGRS predicted more risk in participants than WHO/ISH and was with minimal kappa agreement.
Major advancements have been made in the field of prosthetics, but devices remain largely out of reach for the amputee population domiciled in the developing nations, which makes up 80% of the entire amputee population of the world. The amputees are left to contend with low function prosthetics that do not mimic the behavior of the natural lost limb, with the long-term use of such devices leading to physical injury to the user. This work was aimed at developing a low-cost ankle-foot prosthesis that affords the user the opportunity to manually alter the stiffness of the ankle, as well storing energy in a forefoot section to aid push-off in late stance. In this paper, the design and results of structural analysis performed on critical parts of the prosthesis are presented, as well as the future direction of the work.
Background: High burden of anaemia due to high prevalence and its impacts in children's health especially in growth and development especially, makes anaemia an important public health concern. The difficulty in implementing effective measures for controlling anaemia remains a concern, World Health Organization (WHO) is implementing new strategies for the integrated management of the sick child in the primary care set ups, these includes algorithms based on clinical signs observed by health care workers. We aimed to assess the healthcare-seeking behaviour, economic, and social factors affecting anaemia management among caregivers of sick children who had severe anaemia and are five years and below in Western Kenya. Methods: Descriptive cross-sectional study design was used. Systematic random sampling was used in selection of study subjects. Data on factors associated with anaemia management in Kisumu County hospitals was collected using a structured questionnaire and clinician desk review charts. Association of factors measured using a Chi-Square test of association and odds ratio used for likelihood tests. Results: Results revealed that Anaemia factors, Number of children <5 years of age, and type of food were major determinants for anaemia management. Children fed on non-rich iron foods were less likely to practice good anaemia management as compared to those who eat iron-rich food and prone to increase likelihood of developing anaemia. Conclusions: Anaemia management in Kisumu County Hospital is satisfactory. However, there is a need to address finding gaps and as well conduct further studies on home and hospital management outcomes to inform policy.
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