Introductionhigh risk HPV is the perpetrator of cervical cancer disease, however screening and vaccination is not included in cervical cancer prevention program within public hospitals in Kenya. This descriptive study assessed the association of specific microbial STI and socio-demographic characteristics and practices with cervical cytomorphologic presentations in regards to pre cervical cancer grades amongst health seeking patients attending the reproductive health clinic of Nakuru County referral hospital, a public hospital under newly devolved health services governance.Methodsa total of 142 patients (AGC/AIS, n=8; HSIL, n=59; LSIL, n=35; controls, n=40) whose median age ranged between 20-70 years were purposively sampled. A structured questionnaire with closed and open ended entries was administered and STI screening including Pap smear examination for cytomorphological profiling done according to revised 2014 Bethesda classification. Associations were established using chi-square and multivariate logistic regression model to determine prediction of cervical atypia manifestations.Resultsa majority of the study participants had only primary education or no education in AGC/AIS (63%) and HSIL (73%) relative to LSIL (49%) and controls (53%) (P=0.017). Koilocyte rates were higher in AGC/AIS (25%), HSIL (52%) and LSIL (77%) compared controls (12.5%) (P<0.0001). ASCUS predominated in HSIL (61%) and LSIL (86%), while almost all AGC/AIS had AGCUS (88%). HR HPV 16/18 infection rates were higher in AGC/AIS (100%), HSIL (80%) and LSIL (83%) relative to controls (10%) (P<0.0001), and was associated with higher risk of having AGC/AIS (OR, 2.0; 95% CI, 1.940-1.947; P<0.0001); HSIL, (OR, 36.3; 95% CI, 9.5-139.5; P<0.0001); and LSIL (OR, 50.1; 95% CI, 12.0-209.0; P<0.0001).Conclusionaltogether, pre-cervical cancer in Kenyan women is characterized by koilocytosis and ASCUS probably from the high rates of HPV 16/18 infections. Promoting cancer education and screening for high risk HPV infections and pre-cancerous lesions will improve women's reproductive health.
Background: Globally blood donation rate is low. 31.5 donations per 1000 people in high income countries and 5.0 donations per 1000 people in low-income countries. Donors aged 16-25 years are ideal target for recruitment efforts. The study aimed to assess determinants of blood donation among students of selected tertiary institutions of Homa Bay County Kenya.Methods: Cross-sectional study using both quantitative and qualitative methods was used to collect data from 424 study participants, three focused group discussions and three key informants between April 2021 and July 2021.Data collection tools included structured questionnaire and interview guide. Data analysed using statistical package for social sciences version 21.0, Pearson’s correlation calculated for reliability. Percentage agreement calculated with values>75% being acceptable. Chi square (X2) test and Logistic regression were used to determine association and strength, while qualitative data coded thematically.Results: Most respondents were male 221 (60.5%) and 159 (43.6%) of respondents were of 19-21 years age group. Majority were blood donors 199 (54.5%). Reliability result was significant, r (39)=(.82), p=(.000) with simple percentage agreement of 78%. The study revealed that sex OR=0.493 p=0.013 and rare blood type, A (OR) 8.597 p=0.0.009, and O+ (OR) 2.189 p=0.012 of the students were significant socio- characteristics factors associated with blood donation.Conclusions: Sex and blood type were significant socio-demographic characteristics associated with blood donation.
Background: Cervical cancer is a leading cause of cancer in women, accounting for 68% of cancer-related deaths among women in developing countries. Several reproductive, lifestyle and demographic risk factors are associated with increased risk for cervical cancer. This study examined the association of risk factors with precancerous cervical lesion grade in women attending Nakuru County Referral Hospital. Methods: This hospital-based, case-control study was conducted among women aged 20 to 70 years from January to December, 2017. A total of 142 women were recruited into the study and stratified based on precancerous cervical lesion grades based on the Bethesda System as: atypical glandular cells or adenocarcinoma in situ (AGC/AIS, n=8), high-grade squamous intraepithelial lesions (HSIL, n=59), low-grade squamous intraepithelial lesions (LSIL, n=35), and controls (n=40). Structured questionnaires were used to collect information on demographic, reproductive health, and lifestyle characteristics; anthropometric assessments were conducted. Endocervical swabs and scrapings were obtained from the study participants and used for human papillomavirus (HPV)-16/18, and Pap smear screening. Results: Age differed significantly among the study groups, with age rising with higher grade of precancerous lesion. Higher rates of HPV 16/18 infection was associated with presenting with AGC/AIS (n=8, 100.0%), HSIL (n=47, 79.7%), and (n= 29, 82.9%), compared to controls (n=4, 10.0%; P<.001). History of concomitant lower abdominal pain, vaginal bleeding and discharge was associated with higher risk of precancerous lesion in the HSIL group (odds ratio [OR] 8.9; 95% confidence interval [CI], 2.6 to 30.6) and the LSIL group (OR 5.8; 95% CI, 1.8 to 18.8). Bust circumference <99 cm was associated with higher risk of having AGC/AIS (OR 17.4; 95% CI, 1.1 to 276.0), HSIL (OR 5.9; 95% CI, 2.0 to 17.1), and LSIL (OR 2.7; 95% CI, 0.9 to 7.8). Waist circumference <86 cm was associated with higher risk of HSIL (OR, 5.4; 95% CI, 1.9 to 15.4) and LSIL (OR 2.9; 95% CI, 0.9 to 8.2). Having a healthy diet was associated with higher odds of LSIL (OR, 4.2; 95% CI, 1.4 to 12.9), but was not associated with HSIL or AGC/AIS. Conclusion: This study suggests that high-risk HPV 16/18 infection, chronic lower abdominal pain with vaginal bleeding, and decreased upper and lower trunk body mass, are associated with higher risk of precancerous cervical lesions. Integrating targeted cervical cancer screening in routine reproductive health-care services may reduce the risk of developing cervical cancer.
Background: Hepatitis B virus (HBV) causes acute and chronic liver disease hepatitis B is an alarming population health concern affecting approximately 10% of the globe. In mortality ranking it is number ten global cause of death for an estimated one cases globally. Hepatitis B is the most important infectious occupational hazard which medical students and healthcare workers encounter. The magnitude of the problem can be gauged from the fact students/HCWs have the high prevalence of HBV carrier state in the population.Methods: The research examines determinants of noncompliance to Hepatitis B vaccination among students of the KMTC Machakos sub county. This research was conducted in KMTC campuses in Machakos Sub County in Kenya. Cross-sectional study design was employed in study where both quantitative and qualitative data amongst KMTC students on determinants of noncompliance to HBV vaccine by these KMTC students stratified random sampling technique was employed. A target of 384 was achieved by use of Fischer’s et al formula. Cronbach alpha coefficient was computed to find the validity and reliability. The data gathered was cleaned, organized, coded, and analysed through the use of SPSS, version 21.0 for quantitative data. Descriptive statistics. e.g., graphs, percentages, means and standard deviation while qualitative data was analysed using narratives based on themes and sub-themes. A chi square test was used to test the hypothetical statement by establishing the differences between the observed and expected outcomes on study variables.Results: Most of the students in KMTC indicated that they agree that they are confident in counselling patients about the prevention of HBV where 191 (48.5%) agreed while 74 (18.8%) strongly agreed that they can counselling patients while 70 (17.8%) were not sure that they can counselling patients while 14.0% and 1% they disagreed and strongly disagreed on the counselling patients on prevention of HBV. High number of respondents were confident in prescribing treatment for a patient with chronic hepatitis B where 155 (39.3%) agreed, while 69 (17.5%) were strongly agreed. R square of 99.6% of the data was achieved indicating that there was goodness in fit of the data used in assessment of on the relationship between the studied dependent and independent variables i.e. the attitudes towards Hepatitis B vaccination among students in KMTC.Conclusions: From the findings of the study, it is apparent that the level of awareness on HBV vaccination amongst students in KMTC in Machakos Sub County is high. Majority of the students have sufficient knowledge concerning it. It was found that needle stick injury is the most probable route of the disease transmission. Further, the respondents indicated sexual abstinence and vaccination as the preventive measures against the disease.
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