Alfred Owino Odongo

Maternal health during pregnancy is critical for favorable birth outcomes and long-term wellbeing of both mothers and infants. Women in rural, malaria-endemic regions face unique biological and socioeconomic challenges that may increase the risk of adverse pregnancy outcomes (APOs). This study investigated the incidence and determinants of APOs among pregnant women attending antenatal care at Webuye sub-County Hospital in Western Kenya, a rural malaria-endemic setting. We conducted a retrospective cohort analysis utilizing previously collected data of 300 women enrolled during early pregnancy and followed through delivery. Maternal demographic, clinical, and infection-related factors were assessed, and associations with APOs were evaluated using chi-square tests and multivariable logistic regression. Maternal age and gestational age at enrollment were significantly associated with malaria history (P<0.001). Maternal BMI abnormality (124.5/1000 pregnancies), anemia (99.3/1000), fetal or neonatal death (81.3/1000), and preterm birth (43.8/1000) were observed (all P<0.001), suggesting a substantial burden. Younger mothers (35 years) were significantly more likely to develop anemia (P =0.026), and prior malaria infection further increased anemia risk (P =0.02). Abnormal urinalysis findings indicative of urinary tract infection were significantly associated with low birthweight (P =0.031). No significant associations were found between APOs and infant sex, parity, gravidity, or maternal ABO blood type. These findings highlight a substantial burden of APOs in this rural population, exceeding national and global estimates. Strengthening malaria prevention, nutritional support, urinary infection screening, and encouraging early antenatal care attendance are critical to improving maternal and neonatal outcomes. Targeted interventions for adolescent and older mothers, along with enhanced point-of-care diagnostics, may reduce preventable complications in similar resource-limited, malaria-endemic settings.

Tuberculosis (TB) remains a major public health concern globally, with suboptimal treatment adherence contributing to continued transmission, morbidity, and mortality. This study assessed factors associated with adherence to TB treatment among adult patients in Igembe North Sub-County, Meru County, Kenya. The Health Belief Model (HBM) is the foundational theoretical framework used to elucidate the determinants of health-related behaviors and treatment adherence. An analytical cross-sectional study design was employed involving 197 patients aged 18 years and above who were receiving TB treatment across 10 purposively selected health facilities. Participants were selected using proportional allocation and systematic random sampling. Data was collected using an interviewer-administered structured questionnaire, and adherence was measured using the Morisky Medication Adherence Scale (MMAS-8). Data was analyzed using Statistical Package for Social Sciences (SPSS) version 26. Descriptive statistics summarized adherence levels, while chi-square tests assessed associations between independent variables and adherence. Overall, 46% of respondents demonstrated moderate adherence, 37% poor adherence, and 17% good adherence. Marital status was significantly associated with adherence (χ² = 20.421, p = 0.002), with married individuals more likely to adhere compared to separated individuals. Knowledge of TB transmission was also significantly associated with adherence (χ² = 40.395, p < 0.001). Health service delivery factors, particularly healthcare provider attitude, showed a strong association with adherence (χ² = 27.777, p < 0.001). Substance use, including smoking (χ² = 18.433, p < 0.001) and alcohol consumption (χ² = 19.811, p < 0.001), was significantly associated with poor adherence. Medicine-related factors, especially perceived impact of side effects, demonstrated a strong association with adherence (χ² = 66.496, p < 0.001). Adherence to TB treatment in this setting remains suboptimal and is influenced by socio-demographic, patient-related, health system, and treatment-related factors. Interventions should prioritize patient education, strengthening provider–patient interactions, and integrated psychosocial and nutritional support to improve adherence outcomes.

Traumatic head injury (THI) is a major cause of death and disability worldwide, especially in resource-limited areas where more sophisticated diagnostics are not available. Empirical data from local clinical settings on the effect of clinical features on THI treatment outcome in Kenyan regional hospitals is still limited. To analyse the association between clinical characteristics and treatment outcome of patients with traumatic head injury at Embu Level 5 Hospital, Kenya. This study was guided by the three-delay model. A descriptive cross-sectional hospital-based study was conducted using a simple random sampling technique of 240 THI patients out of a total population of 600 patients who were treated from July 2022 to June 2023. IBM SPSS Version 27 was used to analyse the data that was extracted from patient medical records. Chi-square test and Pearson's correlation coefficients were used to analyse the relationship between clinical parameters and treatment outcome. Results: 46.4% of the study cohort were mild, 33.9% were moderate and 19.7% were severe THI. There was a significant relationship between severity of injury and longer hospital stays (p < .001). The Glasgow Coma Scale (GCS) scores showed a strong positive correlation with clinical diagnosis (r = .65, p < .001), with 10.8% of the patients having severe neurological impairment (GCS < 8). The proportion of patients who were maintaining oxygen saturation > 90% was suboptimal at 50.2%, with 34.3% of vital sign data not available at all. In addition, a significant lack of documentation of computed tomography (CT) scans was found, with 51.9% of patients not having a documented CT scan. It can be concluded that low GCS scores and physiological instability at presentation are the most important factors associated with poor treatment outcomes. Major systemic challenges, such as delays in accessing neuroimaging and inconsistent recording of vital signs, greatly impact clinical decision-making and continuous patient monitoring. The study recommends that the hospital should improve its initial triage system to quickly recognise high-risk patients, ensure continuous uniform monitoring of vital parameters, and streamline referral pathways to tertiary neurosurgical centres to minimise delays and maximise survival.

The topic is relevant and of public health significance; however, from the content, this is a proposed study, not intended for publication, since it has not been undertaken. The language is in future tense. Has the work been done, or is it proposed? ...

Increasing risks of infections with foodborne pathogens may occur as a result of poor food handling practices. The present cross-sectional study employed a mixed-methods approach to determine the factors associated with foodborne pathogens among food handlers working in the food establishments in Thika, Kiambu County, Kenya. Random sampling was used to enroll respondents in the survey. A single stool specimen was collected from each study participant. Laboratory analysis of the specimen was done to test the selected foodborne pathogens. Overall, 44 out of the 285 food handlers who took part in the study had at least one food-transmitted pathogen, putting the prevalence of foodborne infections among the food handlers at 15.4% (95% confidence interval (CI) 11.7%–20.1%). The findings from multivariate logistic regression indicated the following protective factors for foodborne pathogens among the studied food handlers: being female (adjusted odds ratio (AOR) 0.098 (95% CI 0.0304–0.315, )) ; having a valid medical examination certificate (AOR 0.141 (95% CI 0.141–1. 0.439, )) ; not boiling or treating water before serving the water to customers was a risk factor for having infections with foodborne pathogens (AOR 3.043 (95% CI 1.2225–7.577, )) . The presence of foodborne pathogens among the food handlers in the study area potentially highlights the need to address the spread and transmission of foodborne infections in the study area. There is a need to institute appropriate control measures, including regular screening of food handlers for foodborne illnesses in addition to training them on safe food handling practices, hand hygiene practices, and regular monitoring of the food handling practices.

Background: Rising poisoning incidences worldwide, primarily in developing countries, remain ambiguous due to paucity of data and poison centres. This study evaluates patterns and factors causing poor outcomes in Kiambu County, Kenya. Methods: A records-based retrospective cross-sectional study of poisoning cases who presented to nine facilities between June 2015 and July 2020 was conducted. The data collected was analysed through descriptive, bivariate, and multivariate logistic regression using STATA version 13. Results: Kiambu county has a minimum prevalence of poisoning of 3.2%. A total of 434 cases were studied. Most cases (85.5%) resulted from acute exposures, with 75% being intentional. Pesticides (61.1%), paraffin (18.7%), alcohol (6.5%), and pharmaceutical drugs (4.4%) were the primary poisons used. 3.9% didn't fit these categories, while 5.5% remained unknown. Common presentations at admission were vomiting (35.3%) and unconsciousness (21.6%). Pesticides were responsible for 72.0% of deaths. Sequelae occurred in 7.8%, full but delayed recovery in 17.6%, and 6.0% died. The largest cluster of total cases was found in Thika town sub-county. It also contained the primary clusters of alcohol and pesticide poisoning. Being male (AOR 4.577, 95% CI [1.244–16.842]) was significantly associated with adverse outcomes. Regardless of the poison, the majority 78.8% made a full recovery. Conclusion: Due to the lack of standardized poisoning data tools, patient records lack vital information reflecting the quality of care that the patient received, reflecting a lack of structures to collect, analyse and utilise poisoning data for decision making. This study underpins the need for the establishment of a PC in Kiambu county, Kenya.

Health information is a powerful vehicle for enhancing community health and it highlights both the problems and opportunities that exist for development. In Uganda, there are cases where decisions have been made without using health information in primary health care units. The existing capacity inadequacy to efficiently utilize information to track service use patterns over time to determine the impacts of policy and service delivery improvements in Uganda is one of the key weaknesses. With the support of the Ministry of Health, the government of Uganda is implementing projects to build and enhance the nation's web-based national health information system (DHIS2), which collects data from all health systems and allows for making decisions based on evidence on the delivery of health services. The broad study objective was to establish the factors influencing the utilization of routine health information for decisions making among the health workers. The research design was based on an analytical cross-sectional design. The target population for this study was 260 health workers specifically targeting those involved in the use of routine utilization of health information. Purposive sampling was used to select the key informants and other respondents were selected using simple and stratified random sampling. The self-administered structured questionnaire and key informants' interviews were used to collect data from respondents. The analysis of the quantitative data was done using descriptive statistics consisting of tables, bar graphs, pie charts, frequency, percentages, mean and standard deviations. Logistic regression analysis was conducted for establishing the association amongst the variables. The study established that technical factors (χ2=801.069; p=0.001), organizational factors (χ2=895.224; p=0.000), and behavioural factors (χ2=994.559; p=0.000) had a significant influence on utilization of routine health info

Background: Previous research in developing countries has revealed a variety of issues that may jeopardize data quality in HIS. According to research, many developing countries health information systems are unable to provide the necessary support information. The information produced is of low quality and the information processed is not made good use of to inform decisions. The lack of promotion of information culture harms the performance of HIS. The general objective of the study was to assess factors influencing effective staff performance in improving data management in selected facilities in Mombasa County, Kenya. Methods: The study adopted a cross-sectional research design with a mixed methods approach. Quantitative data were analyzed using frequencies, proportions, mean, standard deviation, coefficient of variation, cross-tabulations, Phi correlation coefficient, and binary logistic regression (at a significance level of 0.05). Qualitative data were analyzed using content analysis. Results: The results indicated that organizational factors (ϕ=0.268, p>0.05), staff effectiveness (ϕ=0.408, OR=0.056, p>0.05) and individual attributes (ϕ=0.141, p>0.05) did not have significant influence on staff performance in improving data management, while knowledge and skills (ϕ=0.535, OR=0.031, pConclusions: The study concludes that the knowledge and skills of health care workers are a significant predictor of improvement in data management at the health facilities in Mombasa County.

Lead poisoning is an emerging worldwide public health concern, especially in the developing countries. Occupational tasks such as spray painting and welding in informal automobile repair enterprises present risks of exposures to lead generally through inhalation and ingestion. The artisans therefore risk high blood lead (BPb) levels, which is critical to chronic adverse health effects of lead. The study aimed at assessing the influence of occupational tasks on personal airborne lead exposures and to evaluate the association between these exposures with blood lead (BPb) levels among the artisans. A cross-sectional study was conducted in ten informal automobile repair workshops. Task-specific personal inhalable air samples and blood samples were collected concurrently for 20 participants performing five distinct occupational tasks. Lead levels were analysed using inductively coupled plasma atomic emission spectroscopy and data analysed by analysis of variance, simple and multiple linear regressions. The results indicated significant differences in airborne lead (PbA) exposure levels in different occupational tasks (p = 0.000). Lead–acid battery repairs recorded mean PbA exposure level of [76.11 ± (10.81 SE) µg/m³] exceeding the WHO 50 µg/m³ airborne lead permissible exposure limit. The average (PbA) exposure level was 22.55 ± (5.05 SE) µg/m³, while the mean (BPb) level was 25.08 ± (3.48 SE) µg/dl. A significant positive correlation between task-based airborne lead with blood lead levels was observed (r = 0.68, p = 0.001). In conclusion, the occupational tasks influenced personal airborne lead exposure levels, which in turn was an important predictor of blood lead levels. The study recommends lead exposure assessments, medical screening and intervention measures to minimize the risk and consequences of occupational exposures to lead among the study population.

Geophagia is defined as deliberate consumption of earths’ materials, e.g. soil, clay and soft stones. The practice is widespread among pregnant women, and there are conflicting views as to whether it is beneficial to health or not. Geophagic materials may be a source of micronutrients though the materials may bind the micronutrients thus reducing or hindering their bioavailability in the body. Geophagia is closely associated with geohelminthic infections among pregnant women and heavy metal poisoning, which constitute significant public health problem in many developing countries such as Kenya. In our research, the geophagic materials consumed by the pregnant women were studied. A total of 38 geophagic materials in the possession by different pregnant women were analysed. The collected samples were subjected to standard digestion procedures and analysed for zinc, lead and iron by atomic absorption spectroscopy. Results indicated that the geophagic materials contained elevated levels of Fe at mean concentration value of 80.10 ppm, Pb at 3.28 ppm and Zn 1.81 ppm for a 1.00 g sample. An average of 20 g of the geophagic materials was being consumed per day. Based on the average consumption, the pregnant women were exposed to 65.52 ppm Pb per day, 36.2 ppm Zn per day and 1602 ppm Fe per day. Lead exceeded the WHO-lead exposure limits of 25 ppm/day for pregnant women. The materials were also subjected to microscopic examination for Ascaris lumbricoides, Trichuris trichiura, Taenia Spp., Necator americanus and Ancylostoma duodenale. In conclusion, the women were exposed to heavy metals—iron, zinc and lead, but there was no observable eggs, larvae or adult species of the geohelminths. The key recommendation was that there is need to integrate public health education on geophagia, lead screening and testing with antenatal support care systems. This will enhance maternal and child health, thus reducing infant and maternal morbidity and mortality rates.