Department of Psychiatry

Determination of reference intervals for common chemistry and immunoassay tests for Kenyan adults based on an internationally harmonized protocol and up-to-date statistical methods

2020-07-09T00:00:00Z

Determination of reference intervals for common chemistry and immunoassay tests for Kenyan adults based on an internationally harmonized protocol and up-to-date statistical methods Geoffrey Omuse, Kiyoshi Ichihara, Daniel Maina, Mariza Hoffman, Elizabeth Kagotho, Alice Kanyua, Jane Mwangi, Caroline Wambua, Angela Amayo, Peter Ojwang, Zul Premji, Rajiv Erasmus Due to a lack of reliable reference intervals (RIs) for Kenya, we set out to determine RIs for 40 common chemistry and immunoassay tests as part of the IFCC global RI project. https://doi.org/10.1371/journal.pone.0235234

Explanatory models, illness, and treatment experiences of patients with psychosis using the services of traditional and faith healers in three African countries: Similarities and discontinuities

2021-12-16T00:00:00Z

Explanatory models, illness, and treatment experiences of patients with psychosis using the services of traditional and faith healers in three African countries: Similarities and discontinuities Olatunde Olayinka Ayinde, Olawoye Fadahunsi, Lola Kola, Lucas O Malla, Solomon Nyame, Roselyne A Okoth, Alex Cohen, John Appiah-Poku, Caleb J Othieno, Soraya Seedat, Oye Gureje As part of formative studies to design a program of collaborative care for persons with psychosis, we explored personal experience and lay attributions of illness as well as treatment among persons who had recently received care at traditional and faith healers’ (TFHs) facilities in three cultural groups in Sub-Saharan Africa. A purposive sample of 85 individuals in Ibadan (Nigeria), Kumasi (Ghana), and Nairobi (Kenya) were interviewed. Data was inductively explored for themes and analysis was informed by the Framework Method. Across the three sites, illness experiences featured suffering and disability in different life domains. Predominant causal attribution was supernatural, even when biological causation was also acknowledged. Prayer and rituals, steeped in traditional spiritual beliefs, were prominent both in traditional faith healing settings as well as those of Christianity and Islam. Concurrent or consecutive use of TFHs and conventional medical services was common. TFHs provided services that appear to meet the therapeutic goals of their patients even when harmful treatment practices were employed. Cultural and linguistic differences did not obscure the commonality of a core set of beliefs and practices across these three groups. This similarity of core worldviews across diverse cultural settings means that a collaborative approach designed in one cultural group would, with adaptations to reflect differences in context, be applicable in another cultural group. Studies of patients’ experience of illness and care are useful in designing and implementing collaborations between biomedical and TFH services as a way of scaling up services and improving the outcome of psychosis. Access journal content via a university, library or employer subscription.

Explanatory models, illness, and treatment experiences of patients with psychosis using the services of traditional and faith healers in three African countries: Similarities …

2021-01-01T00:00:00Z

Explanatory models, illness, and treatment experiences of patients with psychosis using the services of traditional and faith healers in three African countries: Similarities … Olatunde Olayinka Ayinde, Olawoye Fadahunsi, Lola Kola, Lucas O Malla, Solomon Nyame, Roselyne A Okoth, Alex Cohen, John Appiah-Poku, Caleb J Othieno, Soraya Seedat, Oye Gureje As part of formative studies to design a program of collaborative care for persons with psychosis, we explored personal experience and lay attributions of illness as well as treatment among persons who had recently received care at traditional and faith healers’ (TFHs) facilities in three cultural groups in Sub-Saharan Africa. A purposive sample of 85 individuals in Ibadan (Nigeria), Kumasi (Ghana), and Nairobi (Kenya) were interviewed. Data was inductively explored for themes and analysis was informed by the Framework Method. Across the three sites, illness experiences featured suffering and disability in different life domains. Predominant causal attribution was supernatural, even when biological causation was also acknowledged. Prayer and rituals, steeped in traditional spiritual beliefs, were prominent both in traditional faith healing settings as well as those of Christianity and Islam. Concurrent or consecutive use of TFHs and conventional medical services was common. TFHs provided services that appear to meet the therapeutic goals of their patients even when harmful treatment practices were employed. Cultural and linguistic differences did not obscure the commonality of a core set of beliefs and practices across these three groups. This similarity of core worldviews across diverse cultural settings means that a collaborative approach designed in one cultural group would, with adaptations to reflect differences in context, be applicable in another cultural group. Studies of patients’ experience of illness and care are useful in designing and implementing collaborations between biomedical and TFH services as a way of scaling up services and improving the outcome of psychosis. The article can be accessed in full via URL:https://doi.org/10.1177/13634615211064370

Modifying Group Interpersonal Psychotherapy for Peripartum Adolescents in Sub-Saharan African Context: Reviewing Differential Contextual and Implementation Considerations

2022-01-01T00:00:00Z

Modifying Group Interpersonal Psychotherapy for Peripartum Adolescents in Sub-Saharan African Context: Reviewing Differential Contextual and Implementation Considerations Manasi Kumar, Helen Verdeli, Shekhar Saxena, Inge Petersen, Keng Yen Huang, Caleb Othieno, Nancy Grote, Roslyn Law, Jurgen Unutzer, Mary McKay This study describes adaptation and modification of World Health Organization (WHO) recommended group interpersonal psychotherapy (IPT-G) for depressed peripartum adolescents. The adaptation process includes accommodating contextual factors and strategies to address intervention implementation barriers, such as engagement problems with adolescents, caregivers, and providers, and stigma and dearth of mental health specialists. The modifications include and adolescent relevant iterations to the therapy format and content DOI: 10.1177/11795573221075573

Factors Underlying Stigmatization of Epilepsy: Case Study of Abasuba and Ameru Communities, Kenya

2020-01-01T00:00:00Z

Factors Underlying Stigmatization of Epilepsy: Case Study of Abasuba and Ameru Communities, Kenya Tiberry D. O. Nyakwana1*, Jemimah A. Simbauni2 and James O. Jowi3 Aims: To determine factors underlying stigmatization of People with Epilepsy (PWE) among Abasuba and Ameru communities, Kenya. Study Design: Cross sectional design was used in this study. Place of the Study: The study was carried out in Abothuguchi, Miriegameru and Nkuene divisions in Meru Central Sub-counrty and Central, Gwasi and Mbita divisions of Suba Sub-county in Kenya. Methodology: It was a descriptive cross-sectional study. A modified participatory rapid appraisal technique was used which involved the use of questionnaires, interview schedules and focused group discussions. Household heads, medical personnel, members of community-based organizations, patients, parents, administrators, teachers, faith healers and herbalists were interviewed. Results: The study results reveal a significant statistical relationship between negative attitude and fear epilepsy (2 = 43.69354, df=1, p<0.05). The fear of epilepsy is dependent on knowledge about it (2 = 7.41663, df=1, p=0.00646). Occupation was not found to influence fear except among the Meru Central District female respondents (2 = 6.19763, df=2, p=0.04510). However, there was no significant relationship between fear of epilepsy and the level of education (2 = 0.15773, df=2, p=0.092436). The belief that epilepsy results from a curse or witchcraft is transferable and contagious was deeply entrenched in the culture of the two communities and that the society views them with resentment resulting into isolation and social stigma. Conclusion: The pattern of traditional belief systems about epilepsy is similar in the community and it is considered a contagious disease highly associated with witchcraft. Stigma and discrimination of PWE is aptly evident in both study areas cultural beliefs notwithstanding. This has the effect of shaping the expression of stigma and social isolation of PWE. Lack of information is responsible for people’s fear of epilepsy and perception is a driver of negative attitude towards people with epilepsy in the community. The study recommends the provision of effective treatment and a comprehensive community sensitization program with target specific IEC materials to counter the negative beliefs. DOI: 10.9734/bpi/ctmamr/v10

Antimicrobial Assay of Aqueous Extracts of Selected Ethno-pharmacologic Alternatives Used by the Maasai Community of Narok, Kenya

2019-01-01T00:00:00Z

Antimicrobial Assay of Aqueous Extracts of Selected Ethno-pharmacologic Alternatives Used by the Maasai Community of Narok, Kenya Maima, Apollo Odhiambo; Munyendo, Were Aims: Antimicrobial resistance motivates the search for new antimicrobials. Besides Methicillin- Resistant Staphylococcus aureus, Carbapenem-Resistant Klebsiella pneumoniae strain has emerged worldwide over the last decade, posing a great challenge to healthcare. This paper reports a survey of Maasai ethno-pharmacy practices. Study Design: Key informant interviews and utilization of e-questionnaires for data collection. Methodology: Plants were identified, and the applicable parts taken as samples, dried, powdered then subjected to aqueous extraction. Using agar well diffusion method, the extracts were screened against gram positive, gram negative and fungal strains to establish antimicrobial activity. Place and Duration of Study: The study was conducted at the School of Pharmacy & Health Sciences of the United States International University, Africa in Nairobi from January 2017 to December 2018. Results: Out of the 24 different plant samples collected, 33% were leaves while 17%, 12.5% and 37.5% were fruits, stem bark and roots, respectively. The highest extract percentage yields were from the leaves of Biden pilosa (5.11%), Psidium guajava (4.65%) and Tarchononthus comphoratus (4.31%). While the minimum extracts yields were from Solanum incum roots (0.08%) and stem bark (0.09%). The extracts of Toddalia asiatica stem bark and roots; Rhamnus staddo roots; Tarchonanthus camphoratus stem bark and roots; and Zanthroxyleum chelybeum stem bark, all exhibited well defined inhibition diameters against M.R.S. aureus in the range 8mm to 14mm as compared to the standard drug (10mm). All these were extracts of non-leafy samples. The significant antimicrobial activity corresponded to presence of flavonoids and alkaloids as seen on TLC plates during phytochemical screening. Conclusion: The results obtained are a good rationale for utilization of the plants identified as alternatives to antibiotics for management of antimicrobial infections. : http://www.sdiarticle3.com/review-history/46227

Determinants of adherence to tuberculosis chemotherapy in Nairobi City County, Kenya

2021-01-01T00:00:00Z

Determinants of adherence to tuberculosis chemotherapy in Nairobi City County, Kenya A Nderitu, P Karimi, E Guantai, A Maima Tuberculosis (TB) is a leading global cause of death and Kenya is among the top 20 countries with a high burden of the disease. Adherence to drugs used to treat the disease remains a crucial challenge towards the elimination of TB in Kenya. This study evaluated the rate and determinants of adherence to TB chemotherapy among adult patients attending health clinics in Nairobi between April and May 2017. A cross-sectional study was carried out in five randomly selected health centres in the Eastlands area of Nairobi involving 113 respondents who voluntarily consented and met the inclusion criteria. Data was collected using a researcher-administered questionnaire and the level of adherence assessed using participants self-reporting. From the results obtained, the participants exhibited low (11, 9.7%), medium (46, 40.7%), and high (56, 49.6%) adherence to TB therapy. Upon stepwise multivariate regression, the absence of a DOT supporter (p=0.039) and being on other medications (p=0.021) were significantly associated with non-adherence. It is inferred that DOT support enhanced adherence while co-morbidities decreased it.

Alcohol use among khat (Catha) chewers in Kenya

1987-01-01T00:00:00Z

Alcohol use among khat (Catha) chewers in Kenya OE Omolo, MANOHAR DHADPHALE Among one hundred randomly selected outpatients at the Meru District Hospital in Kenya, 29 (28 men and 1 woman) were Khat chewers. Six of these were ‘heavy’ and 23 ‘moderate’ users. Twenty out of 29 Khat chewers also used alcohol heavily. Consequences of this joint misuse of two potentially addictive drugs are discussed.

Prevalence of khat chewers among primary health clinic attenders in Kenya

1987-03-01T00:00:00Z

Prevalence of khat chewers among primary health clinic attenders in Kenya OE Omolo, Manohar Dhadphale In a rural district hospital in Kenya, the authors screened 100 randomly selected outpatients for khat (miraa) chewing. A surprisingly high number of them admitted chewing khat leaves. The implications of this finding and the controversy about whether or not khat is a harmful drug are discussed.

Alcohol use among khat (Catha) chewers in Kenya

1987-01-01T00:00:00Z