Allan Ogomo Amulabu, Dr. Alice Lakati, Dr. Josephat Nyagero

Background: Soil-transmitted helminths (STH) refer to the intestinal worms infecting humans that are transmitted through contaminated soil (Cdc; 2022). STH infections are common infections worldwide and affect the poorest communities, especially pre-school and school aged children. WHO’s strategy for control of STH infections is through the periodic mass drug administration treatment with dewormers. Objective: The general objective of this study is to find out the determinants of soil transmitted helminthiasis (STH) control practices at the household level. Methods: This was a cross-sectional study conducted in Bondo subcounty, Siaya county in Kenya. 530 households were randomly selected and include in the study. A Questionnaire was administered to respondents at the household level and an FGD guide was also used to gather more insights on the subject. Results: The result of this study indicates that 28.3% of respondents were able to correctly identify at least one of the three types of STH. 40.3% and 78.4% of respondents were able to correctly identify transmission routes and control practices respectively. The most reported practice in the control of STH was deworming (38.1%); household factors found to be significantly associated with STH control practices were as follows, Maternal education, Mother’s Occupation, Participation in previous programme, Household income, availability of handwashing facilities. Conclusions: The knowledge and practices of STH control was found to be low despite the socio-economic status of the study area being medium. Most homesteads reported to have above minimum wage income, high literacy level, adults in gainful income generating activities, latrine in the homestead, houses of concrete finished floors and good access to water. Our findings suggest that to effectively develop an STH control program, maternal, household socio-economic and WASH factors need to be put into consideration.

Tabitha Chepkemoi

Esophageal cancer staging is an important determinant of prognosis. Staging helps the physicians in determining the best treatment approach for their patients. The aim of the study was to document the stage at diagnosis of esophageal cancer at Moi Teaching and Referral Hospital MTRH, Kenya. A cross-sectional study was done where the medical records of patients with esophageal cancer were reviewed and the stage of the cancer, histological type and grades retrieved. Semi- structured questionnaire was also used to interview patients on their socio-demographic characteristics. A total of 104 patients were interviewed and their files reviewed. Descriptive statistics was done using R-4.1.0-win, where percentages of cancer stages, histological type, and grades were calculated, for continuous variables, mean was used. A majority of participants 87.1% were diagnosed with squamous cell carcinoma. On histological grading, 42.4% were at G3, poorly differentiated. The study revealed that esophageal cancer is common among the older population, and males are more affected than females. Squamous cell carcinoma (SCC) accounted for higher esophageal cancer cases in the population than adenocarcinoma (ADC). A large proportion of patients are diagnosed at an advanced stage of esophageal cancer.

Md. Shahariar Khan, Md. Rahimullah Miah, Tania Hussain, Syed Moosa M. A. Quaium, Azizur Rahman

An explorative study assesses on hospital admitted indoor patients at the Paediatric Department of Northeast Medical College and Hospital of Bangladesh with neonate and general patients of both sexes with common diseases. This prospective observational study was shown in the department of Paediatrics in Private Medical College Hospital over three years. Hundred admitted indoor patients of common diseases were included for interviews. Data were collected in respect to the patient’s profile, diagnosis and death records. Indoor Hospital Admitted Patients in total was 10737 from 2017 to 2019, but admitted patients were more in 2019 than other years. ARI was more prevalent in September, October and November but diarrhea in November, December and January and febrile convulsion in June round the year. The study found the ARI infected via touching, sneezing, coughing and also even breathing in connection with corona effect. The study illustrated the common diseased patients were more in 2017 but it was reduced in 2019. The death records were gradually reduced in the consecutive year. A scientific model was developed to recover the common diseases with hospital admitted indoor patients’ management. The high authority can take earlier preventive measures to provide high quality, training, safe health care with appropriate policies, equipment, facilities and personnel then the mortality and morbidity can be reduced significantly linking with Sustainable Development Goals 2030.

Winnie Rabera Makokha, Jackim Matara Nyamari, Isaac K. Makau

Occupational injuries, though preventable, have been described as a major public health problem. In artisanal and small-scale gold mining (ASGM), little is known about the risk factors to injuries. In 2018, we examined injuries and the potential risk factors among ASGM workers in Rosterman, Kakamega County, Kenya. A descriptive cross-sectional survey was conducted and three hundred and thirteen (313) ASGM workers were interviewed regarding their occupational injuries experiences over the preceding 1 year. Data was collected using structured interviewer administered questionnaires with the aid of open data kit (ODK) platform. Injury rates were estimated at 44.7 injuries per 100 person years. The most affected body parts were hands, upper and lower limbs at 62.14%, 30% respectively. The risk factors associated with injuries included; having an alternative source of income (p=0.027), an individual personal safety culture (p=0.021) and use of hammer or mallet as tools (p=0.022). In conclusion, injuries are prevalent among ASGM workers with several body parts being affected, the upper limbs being the most commonly affected. The study also demonstrated that there are various risk factors associated with injuries in ASGM. In view of those findings, the study recommends that injury prevention should be made a priority in ASGM intervention programs in order to reduce the burden of occupational injuries and also sensitize the workers on the risk factors they are exposed to.

Irine Chepng’etich, Wesley Bor, Wesley Too

Majority of the patients use various types of Dietary Supplements (DS) to manage diseases even though only a third of the DS users realize desirable effects. The documentation on the patterns of DS use by patients is limited in Kenya. There is reportedly high non-disclosure to the healthcare providers and high concomitant use of DS with drugs. Randomly selected 94 participants took part in this cross-sectional study. The aim of this study was to describe the patterns associated with the use of DS by the Adult outpatients. The DS used were single mineral (35.1%), single vitamin (14.9%), multivitamins (12.8%), multiple minerals (18.1%) and unspecified supplements (19.1%) majority of the respondents (63.7%) used any of the supplement on a daily basis and 20.4% used them occasionally. The cited reasons for DS use included to aid in the management of an existing illness (57.4%), recommendation by a health specialist (22%), desire to maintain general body wellness (15%), for bone health and mitigation of reproductive health problems (4% and 1% respectively). Furthermore, less than half (46.8%) of the DS users informed their healthcare provider (HCP) about their dietary supplement use with 65.1% of the DS users reporting usage of DS together with the prescribed medication. In conclusion, non-disclosure of DS use to the health care provider and concomitant use of DS with drugs were notably high hence need to ensure probing on DS use during history taking by health care providers and patient education on relevance of DS use were recommended.

Sawsan A. Omer, Mohammed I. Malik, Fawkia E. Zahran, Sadiq M. Sharaf

Background: Malaria is one of the most common diseases affecting humans worldwide. It remains a major global public health and a major cause of morbidity and mortality in tropical and subtropical countries. Plasmodium falciparum malaria is the most dangerous and fatal form of illness, and it is the most common species prevalent in Sudan throughout the year. Gastrointestinal manifestations are common in malaria endemic areas. Malaria occasionally presents with both typical and atypical symptoms and signs, and there is an increase burden on health services in hospitals, due to large spectrum of falciparum malaria presentation and outcome, especially in Gezira area in Sudan. Objectives: To assess the trend, manifestations and outcome of falciparum malaria infection in patients admitted to medical wards. Methods: This is descriptive, prospective, cross sectional hospital-based study, conducted in Wad Medani Teaching Hospital in the central region of Sudan in the period of December 2014 to May 2015. Results: A total of 160 patients were admitted with severe malaria during period from December 2014 to May 2015. The age of study populations ranged from 15 - 80 years, with mean age (43.11), with the most affected patients in age group 15 - 45 years. Males were 86 (53.8%) and females 74 (46.3%). The main manifestations and complication of severe falciparum malaria in this study were: hyperparasitemia which present in 90 (56.3%), then Hypotension or circulatory collapse was observed in 52 (32.5%), hyperpyrexia was seen in 35 (21.9%), prostration and weakness seen in 33 (20.6%), cerebral malaria with loss of consciousness seen in 19 (11.9%), acute kidney injury (AKI) was seen in 18 (11.3%), hypoglycemia was seen in 18 (11.3%), repeated convulsions ≥ 3 frequency occurred in 14(8.8%), severe anemia was seen in 10(6.3%), abnormal bleeding occurred in 10(6.3%), and hyperbilirubinemia also in 10 (6.3%). Pulmonary oedema was found in 2 cases (1.3%), and disseminate intravascular coagulation (DIC) in 2 (1.3%), blackwater fever in one case (0.6%). Other complications like acute respiratory distress syndrome (ARDS) and acidosis were not reported in this study. Patients who received quinine hydrochloride salt via intravenous infusion were 153 (95.6%), and who received artemether injection were 7(4.4%). Some patients received supportive management according to their presentation. The main duration of hospital stay was 3-5 days in 87 (54.4%). The outcome was as follows: 154 (96.3%) improved and were discharged in a good condition, and Six patients (3.8%) died. Conclusion: Falciparum malaria is more among younger adult age group and male. The main manifestations and complications of severe falciparum malaria infection were hyperparasitemia, hypotension, hyperpyrexia, prostration and weakness, cerebral malaria, AKI then hypoglycemia and repeated convulsions, severe anemia. Most of the patients treated with quinine with very good response, and the mortality rate was 3.8%.

Doaa SE Zaky, Amany M. Abdallah

Background/aims: Sarcopenia is a generalized loss of skeletal muscle mass combined with reduced strength and/or physical performance that has been associated with adverse clinical outcome in older individuals. The accelerated process of protein catabolism in patients with end stage renal disease (ESRD) on maintenance hemodialysis (HD) can lead to sarcopenia. The aim of the present study was to assess the prevalence of sarcopenia and its correlates among adult patients with ESRD on maintenance HD. Methods: This was a prospective cross-sectional study carried out for 1 month in dialysis unite of the internal medicine ward in a University hospital in Cairo, Egypt. Patients were diagnosed for sarcopenia by the European Working Group on Sarcopenia (EWGS). Skeletal muscle mass was measured using bioimpedance analysis (BIA), muscle strength measured by a handheld dynamometer and physical performance measured by 4-meter gait speed test. Different clinical and pre-dialysis biochemical parameters were collected. Results: A total of 37 patients on maintenance HD were participated in the study (median age of 50 years and interquartile range (IQR) between 35 to 60.5 years; 54.1% were males). The prevalence of sarcopenia in the study participant was 35.1% (45% in men and 23.5% in women). Skeletal muscle index (SMI) showed significant positive correlation with age (r=0.406, P= 0.013) and BMI (r=0.631 and P< 0.001). Conclusions: Sarcopenia was highly prevalent among ESRD patients on maintenance HD. Young age and low BMI were among factors that increased the risk of sarcopenia. Screening for sarcopenia in the HD sitting is mandatory to increase clinical diagnoses and ultimately, care for people with sarcopenia.

Doaa SE. Zaky, Abeer AF. Ali, Sabah E. Abd-Elraheem, Suzan H. Abdel-Moniem

Background: Obesity is a major worldwide health hazard with adult mortality as high as 2.8 million per year. It is the second most common cause of preventable death after smoking. Obesity and bone metabolism are interrelated as both osteoblasts and adipocytes are derived from a common mesenchymal stem cell. Osteoprotegrin (OPG) is one of the bone regulator proteins (tumor necrosis factor (TNF)-related family) that regulates the differentiation and activation of osteoclasts. Objectives: The aims of the present study were to determine the circulating OPG serum level in adult middle-aged premenopausal obese females (in comparison to lean age matched females) and its relation to anthropometric measurements, lipid parameters and bone mineral density (BMD) in those females. Methods: A prospective cross-sectional observational study was carried out on 30 adult middle aged premenopausal females with simple obesity (without concomitant diseases) diagnosed by body mass index (BMI) ≥ 30 kg/m² according to WHO criteria 2012 and 20 age matched lean healthy females as control group. The obesity related anthropometric measurements was recorded. Bone mineral density (BMD) was measured using DEXA and serum OPG concentration was assessed using the ELISA immune-enzymatic method. Results: The current study reported significantly lower level of OPG in obese females in comparison to lean age matched females (9.54 ± 4.26 Vs13.1± 1.7 respectively, P = 0.001). There was a significant positive correlation between OPG serum concentration in obese females and waist hip ratio (WHR), however, no correlation was reported with BMI, waist circumference (WC), lipid parameters or BMD. Conclusion: OPG concentration was low in obese middle aged females and probably cannot play a protective role in bone metabolism in those females.

Ndawa Ancent Ndonye, Nyamari Jackim Matara, Ireri Anthony Muriithi

Background: Musculoskeletal disorders refer to a broad range degenerative and inflammatory conditions that affect the joints, muscles, ligaments, tendons, bones, nerves, and the localized blood circulation systems. Despite there being significant literature about musculoskeletal disorders among teachers in other parts of the world, Kenya lags behind in research. The current studies point out to high workloads and stress levels among primary school teachers because of an increase in the teacher-pupil ratio. The objective of this study was to explore the prevalence as well as person and work-related predictors to musculoskeletal disorders among Kenyan primary school teachers in Machakos County. Methods: This study adopted a cross-sectional design to collect data from 302 randomly selected teachers. Data was collected using a questionnaire and an observation checklist. It was analyzed using chi-square and logistic regression analysis and expressed as odds ratio. Results: The prevalence at any site of the body was 85.10% with lower back, knees, neck, and ankles being the most affected body sites at 58.60%, 57.6%, 53.3%, and 53% respectively. The least affected body part was the elbows at 25.2%. The positively associated risk factors were age, teaching for over four hours while standing, teaching for over four hours while sitting, working on a head-down posture, and lack of back support on chairs. MSDs prevented teachers from carrying their normal activities with lower back trouble topping in this respect at 23.8%. Conclusion: Generally, this study reveals that musculoskeletal disorders are very common among primary school teachers in Machakos County, Kenya. Among the recommendations is the need to regulate the number of lessons per teacher, number of pupils per class, and provide chairs and benches for teachers among others.

Ireye Faith, Ejiyere Harrison, Aigbiremolen Alphonsus O., Famiyesin Olubowale Ekundare, Rowland-Udoh Eloho A., Ogeyemhe Charles O., Okudo Ifeanyi, Onimisi Anthony B.

Good adherence to standard precautions and infection prevention and control (IPC) practices in healthcare settings has been identified as an important factor in the control of potential outbreaks of Lassa fever within the hospital setting. Poor health care workers’ (HCWs) knowledge of the disease and infection control techniques is a major contributing factor to hospital-acquired Lassa infection. A cross sectional study to assess the knowledge, attitude and IPC practices was conducted among 294 HCWs in Edo State, Nigeria. Data was collected using an interviewer-administered questionnaire and the assessment was done using defined scoring systems. Data was analyzed using SPSS version 21. Associations between variables were assessed using Chi-square test with a significance level set at p<0.05. The proportions of respondents with good knowledge, good attitude and good IPC practices among HCWs were 4.4%, 63.3% and 41.2% respectively. Type of facility and cadre of HCW were significantly associated with knowledge of IPC. IPC practices were found to be poor among over 50% across all cadres of study participants. Type of facility, cadre and duration of work were all significantly associated with practice of IPC. Majority of health workers had fair knowledge of and good attitude towards Lassa fever prevention and control. Conclusively, this study found that IPC practices were generally poor among HCWs in the study area. Information, education and communication on Lassa fever prevention and control should be enhanced and sustained in all public and private health facilities across Edo State.