Nursing
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Item Infant and young child feeding practices associated with nutritional status among children attending child welfare clinic in Kericho County, Kenya(IBOM MEDICAL JOURNAL, 2025-03-25) Daniel Kipngeno Cheruiyot*; David Kamau; Willy Kiboi Kahanya3Background: Breastfeeding is widely recognized as the gold standard for infant feeding in the first six months of life, providing essential nutrients and antibodies for optimal growth and development. However, suboptimal breastfeeding practices and inadequate complementary feeding can contribute to malnutrition. This study assessed complementary feeding practices associated with nutritional status in breastfed children. Materials and methods: The study population were children aged 6 to 59 months in Kericho County. The study was designed as an institutional based cross-sectional survey of children seen in Kericho County Referral Hospital and Kakaptet Sub- County Hospital. Simple random sampling was used to select 172 study participants across these hospitals. Descriptive statistics, chi square and Fischer’s exact tests were carried out. Additionally, both unadjusted and adjusted odds ratio were obtained using multinomial regression analysis. Ethical standards were strictly adhered to throughout the study. Results: Findings revealed that 75 (43.6%) children were aged between 24 and 59 months, 55 (32%) were aged 9 to 23 months and 42 (24.4%) were aged 6 to 8 months. Approximately two-thirds of caregivers had attained secondary education (n=77, 44.8%). Stunting was prevalent in 25% of the children, while both wasting and underweight affected 23.8%. Approximately 39% of caregivers introduced their children to complementary feeds before six months of age. Only 39.2% of children aged 6 to 23 months consumed five or more food groups for minimum dietary diversity (MDD). In the study, 95.9% of the children met the recommended minimum meal frequency (MMF), but only 39.2% had the minimum acceptable diet (MAD). Conclusion: Introduction of complementary food after 6 months reduced the likelihood of wasting and stunting. Implementing targeted nutrition interventions for children aged 6 to 59 months in Kericho County is imperative.Item Stress management techniques as an intervention for prevention of burnout among nurses in public hospitals in Tharaka-Nithi County, Kenya(World Journal of Biology Pharmacy and Health Sciences, 2024-09-20) Victoria Waithera Kimani; Monicah Buyatsi Oundo; Grace Gatune MurithiThe nursing profession as a social career offers multifaceted services in terms of medical care, social support and emotional attention to patients and their families. The multifaceted services and complexity of contemporary medical conditions as well as job demands often culminate in burnout of nurses. This study sought to examine stress management techniques as an intervention for prevention of burnout among nurses in public hospitals in Tharaka-Nithi County in Kenya. The study adopted the descriptive survey research design on a population of 206 nurses, 2 psychologists and 3 nurses in charge in three public hospitals. Purposive, stratified, proportionate and random sampling techniques were used to determine a sample size of 165 respondents. Data was collected by means of questionnaires and interview guide. The validity of the research instruments established through expert opinion of University supervisors while reliability was estimated by use of Cronbach Alpha coefficient. Data analysis utilized descriptive statistics necessitated through SPSS version 28.0. Thematic techniques were applied to qualitative data. The findings indicated that stress management techniques prevented burnout among nurses. It was recommended that policy makers in the ministry of health optimize comprehensive and mandatory stress management techniques for all nurses in an attempt to prevent burnout.Item A Machine Learning Approach for Prediction of Surgical Outcomes in Elective Surgery(American Journal of Theoretical and Applied Statistics, 2024-08-20) Dennis Muriithi; Virginia MwangiThe aim of this research was to design a Machine Learning (ML) approaches to predict surgical outcome associated with perioperative risks factors among patients undergoing elective surgery. The research employed descriptive cross-sectional survey and a sample size of 292 patients. Only adult patients undergoing elective surgery were considered. Machine Learning (ML) Algorithm such as Logistic regression, Support vector machine, k-nearest neighbors and random forest were used to provide insights into how different factors such as patient related perioperative risk, procedure related perioperative risk and health system related perioperative risk influence the likelihood of successful surgical outcome. The study found that Random Forest model achieved the highest cross validation accuracy of 100%, which means it correctly classified all data points in the test set. It implies that the random Forest model was the most suitable for classifying surgical outcome among elective surgery patient at Chuka County Referral Hospital. It had a Kappa of 1 indicating a perfect agreement between its predictions and the ground truth in comparison with other algorithms. In addition, Random Forest model achieves a perfect score (1.0) for sensitivity, precision, F1-Score, and balanced accuracy. This suggests that the model is doing extremely well at correctly classifying both positive and negative cases. Availability of main surgical supplies (health system related perioperative risk factors) had the highest score indicating that it was more important factor for the models predictions than other perioperative risk factors. In this study, the Machine Learning analysis identified unknown parameters associated with successful surgical outcome. An application of Machine Learning algorithms as a decision support tool could enable the medical health practitioners to predict the surgical outcome of patients undergoing elective surgery and consequently optimize and personalize clinical management of patient.Item Evaluation of Effectiveness of Continuous Professional Development in Clinical Practice among Nurses and Midwives in Meru County, Kenya(International Journal of Professional Practice, 2024-12-16) Odhiambo Roselyne Akinyi; Gitonga Lucy Kawira; Marwa Immaculate NyasebaThe global Maternal Mortality Rate (MMR) is 223 per 100,000 live births, with hemorrhage being the leading cause of death. In Sub-Saharan Africa, the need for nurses and midwives is increasing. Incidentally, only 3.5% of the world's health staff are accountable for 27% of the disease burden. The depicted heavy workloads have largely contributed to poor participation in Continuous Professional Development activities among nurses and midwives. Meru County’s MMR burden, which exceeds the global MMR, remains a concern. However, the Nursing Council of Kenya stipulates a total of 20 CPD hours to be met annually for all nurses. The aim of the study was to evaluate the effectiveness of CPD in clinical practice among nurses and midwives in Meru County. This study seeks to inform the public on the gaps in the uptake and implementation of CPD, and provide recommendations to improve its effectiveness. The study utilized both the qualitative and the quantitative techniques, and adopted Randomized Clinical Trial design. A sample of 78 nurses and midwives was obtained from a target population of 98. Quantitative data was collected using questionnaires and case studies, and analyzed using SPSS version 26, to derive descriptive statistics, while qualitative data was collected through interview schedule checklists and observation, and was analyzed thematically. Pearson’s chi square tested the relationship between knowledge and CPD uptake in clinical practice (p=0.00) at 95%CI. Paired t-test compared means within the control and intervention groups (t=1.000). Despite the provision and use of BEmONC guidelines, major gaps were observed in Active Management of Third stage of labour (17.9%) and also in completion of the patograph (mean=1.7). Despite the efforts to maintain competence levels in clinical practice, gaps pertaining to standardization still exist. The study recommended continuous training to bridge quality gaps and need in clinical practice among nurses and midwivesItem An X-ray image-based pruned dense convolution neural network for tuberculosis detection(Computer Methods and Programs in Biomedicine Update, 2024) Edna Chebet Too; David Gitonga Mwathi; Lucy Kawira Gitonga; Pauline MwakaAccording to the Ministry of Health in Kenya, tuberculosis (TB) is the fifth greatest cause of death and the main infectious disease killer in Kenya and across the world. In Kenya and throughout Africa, TB continues to wreak havoc on many vulnerable populations, homes, and communities despite being preventable and treatable. Common TB diagnostics, like blood and skin tests, frequently fail to identify the precise kind of TB. As a result, the World Health Organization (WHO) advises expanding the use of X-rays, for screening. In TB-prevalent re- gions of Kenya, a shortage of radiologists hampers effective screening and diagnosis, highlighting the need for scalable solutions for accurate X-ray analysis. Recent advancements in deep learning techniques have shown promise in the healthcare sector, particularly in radiology. However, many deep convolutional neural network (CNN) architectures are computationally intensive due to their size and resource requirements. This study designed and developed a Pruned CNN to address this issue by applying pruning techniques to baseline architectures. This approach significantly reduced model sizes while maintaining accuracy levels. Specifically, the pruned version of the DenseNet model achieved an impressive 99 % accuracy with a reduction rate of 65.8 %. These results highlight the potential of this pruned CNN as an effective and efficient tool for TB detection, particularly in resource-constrained environments. This study addresses the shortage of radiological expertise in many regions by providing a tool that can assist in the interpretation of X-ray images. This capability can help healthcare providers deliver timely and accurate di- agnoses, thereby improving patient care.Item Medication Adherence and Associated Factors among Adult Patients with Hypertension Attending Two County Referral Hospitals in Kenya(African Journal of Health Sciences, 2024-09-18) Stephen Kainga M’Kiunga; Albanus Mutisya; Lucy GitongaInadequately controlled hypertension increases risks of morbidity and mortality associated with damage to cardiovascular, cerebrovascular or renal systems. Sub-optimal adherence to antihypertensive medications significantly contributes to inadequate hypertension control rates among the majority of the patients. This study assessed medication adherence (MA) and associated factors among adults with hypertension attending two county referral hospitals in Kenya.Item NULM 812: LEADERSHIP AND MANAGEMENT IN NURSING(Chuka University, 2024-12-16) Chuka UniversityItem HRIM 366: DISASTER MANAGEMENT FOR HEALTH INFORMATION MANAGERS(Chuka University, 2024-12-19) Chuka UniversityItem HRIM 366: DISASTER MANAGEMENT FOR HEALTH INFORMATION MANAGERS(Chuka University, 2024-12-19) Chuka UniversityItem HRIM 355: COMMUNITY-BASED HEALTH MANAGEMENT INFORMATION(Chuka University, 2024-12-16) Chuka UniversityItem HRIM 224: MEDICAL TERMINOLOGIES(Chuka University, 2024-12-16) Chuka UniversityItem HNDS 424: FUNCTIONAL FOODS AND NUTRACEUTICALS(Chuka University, 2024-12-16) Chuka UniversityItem HNDS 332: GENERAL DIETETICS(Chuka University, 2024-12-16)Item HNDS 332: GENERAL DIETETICS(Chuka University, 2024-12-16) Chuka UniversityItem HNDS 332: GENERAL DIETETICS(Chuka University, 2024-12-16) Chuka UniversityItem Patient and Health System Related Factors Associated with Non-Adherence to Antihypertensive Medication among Patients at Chuka Referral Hospital, Kenya(Scientific Research Publishing Inc., 2021) Gikunda, C.; Gitonga, L.; Kamweru, P.Background: Non-adherence to hypertensive medication continues to be- come a contributing factor to hypertensive complications like stroke, heart attacks, kidney disease heart failure. Associated factors to non-adherence are complex, are both internal and external to the patient and are difficult to extrapolate. Reports from Chuka referral hospital records showed that in 2016 there were 140 patients with hypertensive complications from 560 pa- tients who attended the medical clinic that year. Objective: This study sought to explore the patient’s related factors that are associated with non-adherence to hypertension medication. Methods: This is a descriptive study design of (N = 575) people among them doctors, pharmacists, nurses, record officers and hypertension patients. Simple random sampling for patients (n = 81) and census sampling for health care workers was done and data collected using questionnaires and interview schedules between April 4th-May 30th 2019. In- ferential and descriptive statistics were used for data analysis, aided by SPSS version 25. Results: 64% of the patients stated that they had missed medica- tion. A significant negative correlation (rpb = −0.23, p < 0.05) between age and non-adherence, significant positive correlation with monthly income (rpb = 0.24, p < 0.04), non-significant relationship between non-adherence and ma- rital status (rpb = −0.13, p = 0.25) and patients’ level of education (rpb = −0.06, p = 0.57). The overall model of health system related factors were found to be significant (p < 0.05) and this included; quality of health service, physician patient relationship, stock out, health education, and availability of medicine (p = 0.012). Conclusion: Lacks of funds, unavailability of drugs are the lead- ing factors to regimen completion. This could be easily be addressed by the government.Item Knowledge and Attitude of Nurse-Midwives Regarding Maternal Health Care Quality Standards in Two Regional Teaching and Referral Hospitals in Kenya(Scientific Research Publishing Inc., 2022) Impwii, D.K.; Kivuti-Bitok, L.; Karani, A.Maternal mortality remains a major health concern in Sub- Saharan Africa and Kenya in particular. Providing quality maternal health care has the potential of preventing over 75% of maternal deaths. The quality of maternal health care requires the utilization of maternal health care quality standards. Objectives: The objective of this study was to determine the nurse-midwives knowledge and attitude toward the use of maternal health care quality standards. Methodology: This study was a descriptive cross-sectional survey carried out at Embu and Meru teaching and referral hospitals in Kenya, between August and December 2021. Eighty-five nurse-midwives working in the maternity unit participated in the study. Data was collected using a self-administered semi-structured questionnaire and analyzed using SPSS version 27.0. Pearson’s correlation coefficient and Chi-square at Alpha level of 0.05 were used to test the relationship between the variables which were the nurse-midwives knowledge, attitude, and use of the quality stan- dards. Result: Most (84.7%, n = 72) nurse-midwives were female and 44.7% (n = 38) were aged 20 - 29 years. Majority (64.7%, n = 55) were diploma holders and almost half (44.7%, n = 38) had practiced for 1 - 9 years. The av- erage score for knowledge was 5.0 with 69.4% (n = 59) having a score of <7. Most nurse midwives (88.2%, n = 75) supported the use of the standards even though only 67.1% (n = 57) indicated that they use them. The support for the standards is significantly related to the gender of the respondents and their duration in maternity. There was no significant association between know- ledge and use of maternal health care quality standards (X2 = 0.433, r =−0.085). There is no association between support for the standards and theiruse (X2 = 0.008). Knowledge and attitude toward the maternal health care quality standards are not significantly associated (X2 = 0.156). Conclusion: The knowledge and attitude of the nurse-midwife neither influence each oth- er nor do they influence the use of maternal health care quality standards.Item Cardiocurative effects of aqueous leaf extracts of Ximenia americana (linn.) and Pappea capensis (eckl. and zeyh.) against myocardial infarction in rats(Journal of advanced biotechnology and experimental therapeutics, 2022-12-21) Gaichu, Daniel Muthee; Patricia Mathabe; Mathew Piero NgugiDifferent plants are traditionally applied in the treatment of different diseases, including chest pains, hypertension, and inflammation, among others. This study scientifically evaluated the curative treatment effects of X. americana and P. capensis leaf aqueous extracts in rats induced with myocardial infarction. The rats were randomly distributed as follows: Normal control group, consisting of rats treated with oral normal saline; Negative control group, comprising rats induced with MI and treated with normal saline; Positive control group, consisting of rats induced with MI and orally treated with propranolol (10 mg/Kg bw); and three experimental groups consisting of rats induced with MI and treated with plant extracts at dose levels 150, 200 and 250 mg/Kg bw. This study’s findings demonstrated that there was a significant reduction in the amounts of cTnT, LDH-1, CK-MB, T-cholesterol, triglyceride, LDL-c, and malondialdehyde, as well as a significant increase in levels of HDL-c, catalase, SOD, and glutathione peroxidase among rats treated with propranolol and plant extracts as compared to the negative control rats. Additionally, LC-MS analysis revealed the presence of flavonoids, tannins, and phenolics, which could explain the observed cardiocurative effects. This study concluded that aqueous leaf extracts of X. americana and P. capensis possess cardiocurative activities in rats with myocardial infarction. However, further studies on isolated fractions of the phytochemicals present are recommended. This study provides preliminary data useful in the development of pure and safe cardioactive compounds.Item Medicinal Plants Used for Treatment of Gastrointestinal Infections in Tharaka-Nithi County(International Journal of Pathogen Research, 2022-08-22) Kiteme M. Purity; Onyango O. Benson; Njagi C. Eric; Ogolla O. FredrickHealth care is a basic need to humans which can only be achieved with medicines with high efficacy against disease causing pathogens. Globally, gastrointestinal infections are major health concern particularly to travelers since over 60% visiting tropical and subtropical regions develop diarrhea. Herbal plants have been used for decades to treat gastrointestinal infections globally including Tharaka-Nithi County in Kenya. However, there is little information on the demography of herbalist and the plants used in treatment of gastrointestinal infections such as typhoid, cholera and shigellosis. A cross sectional survey was carried out involving thirty herbalists to assess their demographic data and to establish herbs commonly used to treat typhoid, cholera and shigellosis in Tharaka-Nithi County. Data collected was subjected to Chi square test of association and descriptive statistics and presented in percentages. There were more male herbalists (65.52%) in the study than female herbalist (34.48%). Most of the herbalist (65.52%) were aged above 70 years. There was a significant (p < 0.05) association between herbalists’ level of education and age (X2 (6, N = 30) = 17.349, p = 0.008). Most herbalists were found to have below primary education level 58.62%. Aloe vera, Aspilia pluriseta, Ficus sycomorus and Physalis peruviana were identified as commonly used plants for treatment of cholera with Aspilia pluriseta being most preferred (27%) by herbalist above the age of 70 years. Vangueria infausta, Eucalyptus globulus, Carissa edulis and Erythrina abysinnica were commonly used for treatment of shigellosis with Eucalyptus globulus being most preferred (58.6%) by herbalist above the age of 70 years. Erythrina abysinnica, Carissa edulis, Vangueria infausta and Eucalyptus globulus were commonly used for treatment of typhoid while 50.0% of herbalist above the age of 70 preferred Erythrina abysinnica. Most of the herbalists had below primary education level. In conclusion, herbal medicine is mostly dispensed by older people in Tharaka-Nithi County in Kenya. Different herbal plants are used in the treatment of cholera, shigellosis and typhoid.Item Complementary and Alternative Medicine Use and Adherence to Conventional Cancer Treatment in Meru County, Kenya(Open Access Health Scientific Journal, 2023-02-26) Kiraki Monicah Wambui1,2*, Gabriel Mbugua2 , Robert Kei Mburug2 , Catherine GichungBackground: Non-communicable diseases (NCDs) are the leading cause of global mortality with cancer ranking among the top cause of death. Unfortunately, most of these deaths occur in developing countries due to delays in the diagnosis of the disease. Consequently, the use of complementary and alternative medicine (CAM) among cancer patients is on an upward trend hence adherence to conventional cancer treatment (CCT) is a major health concern. Methods: A cross-sectional study was carried out in a conventional cancer centre in Meru County. A researcher-administered questionnaire was used to obtain data from 117 consenting patients. Demographic data, clinical data, history of any use of CAM before and after cancer diagnosis and any side effects were obtained from the study participants. Data were analyzed using the Statistical Package of Social Sciences (SPSS). Results: There were more female (53.8%) participants, mainly married (59.8%), Christians (97.4%) with primary education and above (69%). Almost half of the participants (47.9%,) were using CAM. Most of the participants (85.7%) started using CAM after a cancer diagnosis. More than half of the respondents using CAM (52%) had disclosed to the HCP mainly to find out about drug-drug interaction risk (41.4%). Only one (1.8%) CAM user had withdrawn the CCT to use CAM due to dissatisfaction with conventional medicine. Conclusion: The use of CAM is complementary and not alternative to CCT and hence may not influence adherence to CCT among cancer patients in Meru County. However, there is a need to provide health education to cancer patients on the use of complementary medicine and analyze the outcomes of patients who use complementary medicine while on CCT.