PublicationHepatitis E Virus Prevalence amongst Blood Donors in Selected Regions of Kenya(Mount Kenya University, 2023-01) Mutai,Alex KiprotichCurrently, Kenya is carrying out mandatory tests for four transfusion-transmissible infections for the provision of safe adequate blood as required by the World Health Organization. These mandatory tests include HIV 1 and 2, hepatitis B and C viruses and syphilis. Hepatitis E Virus is a transfusion-transmissible virus that can cause lasting liver illness and therefore, an important public health concern. Presently, there is no scientific documentation on Hepatitis E Virus prevalence of voluntary blood donors in Kenya. The objective of the present study was to evaluate Hepatitis E Virus prevalence of voluntary blood donors in Kenya. The findings from this study will aid in the development of safe blood transfusion policy, hence mitigate transfusion-transmissible Hepatitis E Virus via blood and blood products. Blood samples were obtained from voluntary blood donors upon consenting in six regional blood collection centers in Kenya. The blood samples were transported under cold chain to the national central testing laboratory in Nairobi, Kenya to test for IgG and IgM seroprevalence using ELISA. Confirmatory test was done using RT-PCR for 19 blood samples which tested seropositive for Hepatitis E Virus IgM and/or IgG antibodies. The present study recorded a Hepatitis E Virus seroprevalence of 4.9% which is similar to non-endemic countries. There was no association between Hepatitis E Virus seroprevalence and gender, age or region of blood collection. This study also recorded Hepatitis E Virus IgM and IgG seroprevalences of 3.4% and 2.6% respectively. There was an association between age and Hepatitis E Virus IgG seroprevalence. No Hepatitis E viremia was detected among IgM and/or IgG seropositive blood samples. This study confirmed for the presence of Hepatitis E Virus IgM and/or IgG seropositive blood samples among blood donors in Kenya and therefore, recommends screening of blood products to mitigate transfusion-transmissible Hepatitis E Virus infection. PublicationFactors Associated With Malaria Occurrence in Narok Town Ward, Narok County, Kenya(Mount Kenya University, 2023-06) Wanja,George KahwaiDespite malaria being a life threating but preventable disease, it is the foremost cause of disease and death in Kenya; over 25 million individuals are at risk with estimated 6.7 million new clinical cases and 4,000 deaths each year. It is approximated to cause 20% of all deaths in children under the age of five. This study was aimed at identifying factors associated with malaria occurrence in Narok Town Ward, Narok County, Kenya, so as to generate evidence to be used to enhance efforts for focused malaria control in Narok Town and similar urban areas in Kenya. The data was collected by administering structured questionnaire to household heads of the 480 randomly selected households and capturing mosquitoes in 36 randomly selected households. There were 2010 inhabitants in the 480 selected household, majority of the residents were aged 1-14 (34.1%) and 25-44 (34.6%); the proportion of females was 58.8% (1182). Pregnant females were 2.9% (58/2010). The literacy rate was 93.9%. Majority of the households (79.0%) reported having a monthly income of Kshs. 20,000 and above. About 97.92 % (470/480) of the total responders recognized that malaria was spread by mosquitos. Fever, vomiting, headache and chills were reported by majority of the respondents 99.56% (478/480) as the main symptoms of malaria. 68.33% (328/480) of respondents rated malaria as an ordinary disease while 24.58% (118/480) rated malaria as a deadly disease; 86.0% (413/480) reported to have sought malaria treatment in public hospitals while 74.4% (367/480) of the responders reported purchasing drug over the counter. The study revealed 1.04% (21/2010) prevalence rate of malaria disease. The most frequent mosquito breeding site was water held in garbage 85.4% (410/480) and stagnant dirty water 81.0% (389/480). 31.7% reported to have been clearing stagnant water and 67.1% (322/480) covered water holding containers to prevent mosquito breeding. The most reported mosquito bite time was at night 100% (480/480) and morning 53.3% (246/480). 91.0% (437/480) of responders reported to have been using mosquito net in their beds. Most people 96.5% (463/480) indicated that they had learned about malaria on TV and radio advertisements. Out of the total 2257 mosquitoes that were collected, Anopheles mosquitoes (malaria vector) were 8.4% (190/2257), 4.7% (9/190) of anopheline mosquitoes tested positive for Plasmodium sporozoites. Regardless of high level of literacy, knowledge on malaria cycle, and presence of plasmodium infected anopheline species. a significant gaps relating to diagnosis, treatment and control was evident. There were high percentage (74.4%) of people preferring to purchase drugs without a prescription and failure by community members to carry out outdoor vector control and prevention measures. This study presents proof that point to the need by the relevant agencies to establish regular public health awareness and trainings, cultivate community based environmental hygiene, maintain regular mass LLITN distribution, regular training of health care workers and CHV and establishment of the county based mosquito surveillance and research center in order to keep track of the mosquito borne pathogens. PublicationFactors Associated With Foodborne Pathogens among Food Handlers in Thika, Kiambu County, Kenya(2023-06) Kimemia,Joseph MainaIncreasing 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 food establishments in Thika, Kiambu County, Kenya. Random sampling was used to enrol respondents in the survey. A single stool specimen was collected from each study participant. Laboratory analysis of the specimen was done to test for 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 binary 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 to 0.315, p< 0.001); having a valid medical examination certificate (AOR 0.141 (95% CI 0.141 to 1. 0.439, p = 0.001)); 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 to 7.577, p = 0.017)). 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 reducing the duration of regular screening of food handlers for foodborne illnesses in addition to training them on safe food handling practices, hand hygiene practices with provision of running water should be mandatory, regular monitoring of the food handling practices and policies on antimicrobial resistance of foodborne pathogens should be included in food safety control. PublicationKnowledge and Risk Factors of Hepatitis B Disease Among Women Attending Antenatal Care at Arua Regional Referral Hospital, Arua, Uganda(Mount Kenya University, 2023-05) Atwine,BenjaminHepatitis B is a highly infectious disease with a prevalence of 4.3% among people aged 15-64 years, with a prevalence of 5.6% in men compared to 3.1% in women in Uganda. Mother-to-child transmission accounts for nearly 50% of new cases per year, and infants who acquire hepatitis B disease before 5 years have a 90% chance of progressing to chronic hepatitis B infection. The study assessed the knowledge and risk factors of hepatitis B disease among women attending antenatal care (ANC) at Arua Regional Referral Hospital (ARRH), Uganda. A cross-sectional study was carried out at Antenatal care unit of Arua Regional Referral Hospital. Convenience sampling was used, and a sample size of 384 was calculated. Each participant was screened for HBsAg using commercial rapid test kits and evaluated using a structured questionnaire and. A hepatitis B basic knowledge summary score was used to assess the of knowledge of the participants on hepatitis B. Data analysis was carried out using MICROSOFT EXCEL-2013 and STATA version 14 packages. Poor knowledge levels of hepatitis B disease stood at 17.9%, while 82.1% of the pregnant women had adequate knowledge. A prevalence of 2.05% was obtained from the participants in the study. None of the assessed risk factors was significantly associated with HBsAg positivity. The study participants were knowledgeable to a great extent about hepatitis B disease, with 82.1% exhibiting good knowledge of hepatitis B disease. There are gaps in knowledge, especially among the low educated groups, which need to be addressed to improve knowledge levels of hepatitis B disease among these categories in the community. The results show a relatively healthy population given the low prevalence of 2.05% seen in the participants of the study. The absence of a risk factor associated with hepatitis B disease in this study does not imply that there are no risk factors in the community around Arua Regional Referral Hospital. Further studies are recommended to assess more risk factors for hepatitis B disease in the community PublicationAssessment of Factors Influencing Effective Staff Performance in Improving Data Management in Selected Facilities in Mombasa County, Kenya(Mount Kenya University, 2023-03) Kayanda,Sarah MajalaPreceding studies in upcoming nations have shown a diversity of reasons that may endanger data value in HIS. Some of these issues are related to the facility's setup and the technical knowledge of the healthcare providers. Conferring to study, many upcoming nation's well-being info systems are unable to offer essential support info. The lack of preferment of info culture harms the enactment of Health Info Systems (HIS). This research aimed at assessing reasons influencing effective staff actions in improving data management in designated amenities in Mombasa County, Kenya. The aspects to be explored were divided into three categories: organizational reasons, individual/team reasons, and external environmental reasons. The study was conducted in Mombasa County and used a cross-sectional research strategy with a mixed methods tactic. The 2080 healthcare workers formed the study's target population. In addition, the researcher targeted source documents, Ministry of Health (MOH) 711 reporting tools, and the Kenya Health Info System (KHIS) in 53 public health facilities, 172 private health facilities, and 17 FBO/NGO health facilities. The sample size for the study was 242 healthcare workers, 57 source documents, 24 MOH 711 reporting forms, and 24 KHIS in 24 levels 5, 4, and 3 private, Public, and FBO/NGO health facilities in Mombasa County. Both stratified and purposive sampling methods were employed in this research. Questionnaires, interviews, focus group debates, and data verification tools were employed to obtain quantitative and qualitative data for this research. Quantitative data were examined using incidences, proportions, mean, std, variation of coefficient, cross-tabulations, coefficient Phi correlation, and binary logistic regression (at 0.05 significance level). Qualitative data were analyzed using content analysis. The results indicated that organizational aspects (ϕ = 0.268, OR = 0.284, p > 0.05), staff effectiveness (ϕ = 0.408, OR = 0.056, p > 0.05), and individual attributes (ϕ = 0.141, OR = 0.424, p > 0.05) did not have a significant impact on improvement in data administration, while knowledge and skills (ϕ = 0.535, OR = 0.031, p < 0.05) was found to have a significant effect on improvement in data organization. The study concluded that the awareness and skills of healthcare employees are substantial predictors of enhancement in data management at the well-being amenities in Mombasa County. The study recommends that the Ministry of Healthiness at the nationwide level and the department of Healthiness in Mombasa County should ensure that(Human Resources for Health) HRH norms on Healthiness Management Info System (HMIS) officers are adhered to and ensure that all health employees are adequately competent in data management which will improve their competency. PublicationFactors Affecting the Compliance with Standard Infection Prevention Precaution among Community Health Practitioners in Bayelsa State, Nigeria.(Mount Kenya University, 2022-10) Dotimi, Doris AtibinyeStandard infection prevention precautions are measures taken to protect healthcare providers and patients. The research aimed at investigating factors affecting community health practitioners’ compliance with standard infection prevention precautions in Bayelsa State, Nigeria. Three hundred and fifty-four community health practitioners consented and were recruited through multistage sample procedure, data was collected using a questionnaire, key informant interviews, and three focus group discussions. Quantitative data was analyzed with descriptive statistics with a criterion mean set at 2.5 and 2.0, and inferential statistics of multiple linear regression with 95% confidence interval using SPSS version 21. Findings indicated that community health practitioners in Bayelsa State are aware of standard infection prevention precaution (x=3.7, 95%), but their compliance level is low (x=2.2, 44%) due to individual factors such as difficulty to feel veins when on PPE (x=2.7), they experience some level of discomfort while performing skills using the PPE (x=2.0), and lack of knowledge on how to use the PPE (x=2.9), work-related factor such as workload due to shortage of staff (x=2.6), and PHC system factors such as unavailability of supervision on the use of standard infection prevention precautions (x=2.8), No accessibility to available PPE (x=2.9) , Personal Protective Equipment (PPE) in unavailable (x=3.0), and no training programme on the use of PPE (x=2.9). There was a statistically significant relationship between sex and level of compliance with standard infection prevention precaution (p-value=.000); years of service and level of compliance with standard infection prevention precaution (p-value=.000). However, there was no statistically significant relationship between age and level of compliance with standard infection prevention (p-value=.296); religion and level of compliance with standard infection prevention precaution (p-value=.504), and marital status and level of compliance with standard infection prevention precaution (p-value= .168). There was also a statistically significant relationship between level of awareness and compliance with standard infection prevention precaution (p-value= .000). It is recommended that the government should make PPEs available in the health facilities, PHC Boards should conduct supportive supervision on the use of PPE and community health practitioners should be willing to use the PPE when discharging their duties in primary health care facilities. PublicationAssessment of Compliance with Iron and Folic Acid Supplementation among Anc Women Attending Pumwani Maternity Hospital, Nairobi County(Mount Kenya University, 2022-08) Roble,Mohamed AliOut of three mothers, one has anaemia and lack folic acid, signifying that iron and folic acid (IFA) deficiencies make up the major micronutrient deficiencies among women in the world. Iron insufficiency is a serious health problem due to its increased prevalence and potential negative outcome. Iron insufficiency may lead to many adverse consequences like preterm births, stillbirth, underweight births, and maternal and neonatal deaths. The main aim of the research was to establish the determinants of the utilization of Iron & Folic Acid Supplements (IFAS) among pregnant women visiting free maternity services in Pumwani Maternity Hospital (PMH), Nairobi-Kenya. The research focused on socio-demographic factors; knowledge among expectant mothers; and the prevalence of IFA use amongst expectant mothers visiting Antenatal Care (ANC) in PMH. A cross-sectional design was used. The primary data was collected from the expectant mothers visiting PMH for ANC services by administering questionnaires and key informant interviews. The researcher used both probability and non-probability sampling methods. The researcher used random sampling approach to determine equal chance among the pregnant women in PMH. All expectant mothers that consented to the research were interviewed with the aid of a written questionnaire targeting a sample size of 341 participants. The data was collected, edited, coded and put into Epi-Data after which it was exported to SPSS. Descriptive analysis was utilized to establish the use of IFAS amongst expectant mothers. Distribution of the variables was analyzed via the use of frequency tables. Bivariate analysis was completed to establish the factors related with IFAS used amongst expectant mothers by using P-value and Pearson’s Chi-Square. Binary Logistic regression was used to establish predictors of use of iron and folate supplements. Ethical clearance to conduct this study was obtained. Findings from the study show that 70% of respondents used IFAS during pregnancy. Close to 52 % respondents had good knowledge on the use of iron and folate supplementation. Bivariate analysis illustrates that level of education χ2 (df=3) (15.15, N=341), p=0.02 and level of knowledge χ2 (df=1) (22.6, N=341) p=0.001 were significantly associated with uptake of iron and folate supplementation. Regression analysis shows that the level of education A.O.R=3.331 (CI 2.0119-5.496) p=0.0001, level of knowledge A.O.R=1.886 (CI 1.317-2.701) p=0.001 and the number of pregnancies A.O.R=0.154, (CI 0.010-1.413) were strong predictors of iron and folate supplementation. Social demographic factors that significantly influenced use of IFAS were household income and number of children. Formal education and mothers’ knowledge on use of IFAS significantly increased the odds three folds using IFAS. Use of IFAS reduced the chances to experience of anaemia in life or during pregnancy. Majority mothers were able to access health facilities and IFAS whenever needed. IFAS was affordable. The health facilities were operational and met health care needs. Health care workers hospitability and provision of satisfying prescription of IFAS increased use of IFAS by 9.5 and 2.8 times respectively. To achieve desirable coverage level on the use of iron-folate supplementation, policy makers should develop novel strategies to educate expectant women. All stakeholders should take a further step on promoting IFAS use to ensure 100% compliance. PublicationAssessing the Influence of Community Health Workers on Uptake of Maternal Health Services in Musanze District, Northern Province, Rwanda(Mount Kenya University, 2023-01) Eric,Niyongabo LivingstoneBackground: Community-based initiatives are a worldwide policy that guarantees that key health services are available and accessible closer to the community. CHWs are an important element of healthcare services in Rwanda. Community health workers integrate individuals of their communities to provide preventive, habitual, and emergency maternity healthcare requirements. The aim of this research was to assess the influence of community health workers ' on the uptake of maternal health services in Musanze District. Methods: The study design used was an analytical cross-sectional study design utilizing both quantitative and qualitative methods. This research was cross-sectional because it examined the exposure and outcome at a time. In this study, a simple random sample approach was employed to choose 208 CHWs and 16 CHWs’ supervisors were interviewed for qualitative data (KII). The statistical tool for social sciences (SPSS) Version 26, was used to examine the data. Categorical variables were summarized with descriptive statistics for frequencies and percentages. Bivariate analysis with the Chi-square test of independence was used to check the association between both dependent and independent variables. Ordinal logistic regression was used as the most suitable inferential statistic because the predictor variables and the dependent were ordinal variables. Qualitative data were analyzed by NVIVO version 10. CHWs 208 participated in the study and all were female. Results: This study found that the uptake of maternal health services was regarded as very high. Among those services, deliveries at the Health Facility were at 73.6%, Antenatal care at 65.9%, Family planning at 54.3%, and the rate of Postnatal care was at 45.7%. The results also showed that Sending red Alert SMS by CHWs for pregnant mothers’ emergencies by CHWs towards maternal health services with chi-square test result p* =.001. CHWs' enrolment of girls and ladies of reproductive were significant with p* =.011. CHWs' follow-up to the pregnant has improved maternal health services with chi-square p* =.001). Health education has improved maternal health services where chi-square test was significant with p* =.014. This study assessed the influence of sociodemographic factors on uptake of maternal health services, level of education with p* <.001 , and working experience p* = .005 were associated with uptake of maternal health services. 85.1% of CHWs were knowledgeable on the warning signs of an emergency among pregnant mothers, and 89.4% reported that they would act based on these warning signs. CHWs had necessary training to provide care to pregnant mothers with p* =.001.Skills that CHWs have on administration of misoprostol to prevent post-partum hemorrhage was significant with p* <.001. Factors that influenced uptake of maternal health services were CHW’s regular supervision with p*=.001, provision of transportation p*=.001, regular refresher training p* =.002, and motivation/incentives p*=.001, as they were associated with the performance of CHWs towards uptake of Maternal Health care services. The research recommends improvement of maternal health services through access to contraception, antenatal care, and postnatal care, with particularly scale-up key motherly health services, regular training and supervision for CHWs, governmental support in terms of motivations of CHWs PublicationDeterminants of Non-Compliance to Hepatitis B Vaccination among Students of Kenya Medical Training College in Machakos Sub County, Kenya(Mount Kenya University, 2023-06) Silla,Nthambi WinfredIn Sub-Saharan Africa, the prevalence of Hepatitis B Virus (HBV) is high, with an estimated 70 to 90% of the population becoming infected before the age of 40. Healthcare workers (HCWs), including healthcare students (HCSs), face an increased risk of HBV infection due to their occupational exposure. HCSs, in particular, are vulnerable to the disease due to their limited experience with infection control measures and insufficient knowledge about the risks associated with treating patients. This study aimed to assess the level of awareness of HBV vaccination among students in KMTC in Machakos Sub County, determine the compliance with the Hepatitis B vaccination schedule among students in Kenya Medical Training Colleges in Machakos County, evaluate attitudes towards Hepatitis B immunization among students in KMTC in Machakos Sub County, and establish the existence of institutional measures to ensure the implementation of HBV vaccination policies for students in KMTC in Machakos County. The research utilized a cross-sectional descriptive study design, employing a mixed approach with both quantitative and qualitative data collection among KMTC students to identify the factors influencing noncompliance with the HBV vaccine. The study was conducted at the Kenya Medical Training Colleges in Machakos County, specifically at the Machakos and Manza campuses. The majority of the respondents in the study reported being aware of Hepatitis B virus infection, with 301 (76.1%) indicating they had heard about it, while 93 (23.6%) had not. Among the KMTC students, the primary mode of Hepatitis B virus transmission identified was contact with the blood of an infected person, as reported by 98 (24.9%) respondents. Contact with body fluids contaminated by the blood of an infected person and sexual transmission were also recognized as significant modes of transmission, with frequencies of 74 (18.8%) and 71 (18.0%) respectively. The findings indicate a high level of awareness of HBV vaccination among students in KMTC in Machakos Sub County, with the majority of students possessing sufficient knowledge on the subject. Needle stick injuries were identified as the most likely route of disease transmission, highlighting the risk that medical students face when attending to patients in hospitals. Therefore, it is crucial for medical students to diligently adhere to the Hepatitis B vaccination schedule. Encouraging a culture of mutual support among medical students to get vaccinated as a preventive measure against acquiring the disease is recommended. Furthermore, KMTC should establish standardized guidelines and policies to ensure the implementation of HBV vaccination measures. PublicationFactors Influencing The Prevalence of Khat Chewing Among The Youth in Eastleigh, Nairobi, Kenya(Mount Kenya University, 2023-03) Jama,Mohamed AbdulkadirThe consumption of khat has a significant health and financial impact to the nation, as well as an increasing public health hazard. khat usage reduces users' effectiveness, makes them more sensitive to health issues, and increases their chance of committing crimes. In this sense, they pose a risk to society and place a strain on the health system. As such, the current study examined factors attributing to the prevalence of khat effects of Khat chewing on well-being among the youth in Eastleigh, Nairobi, Kenya. The following objectives guided the study; to find out factors that contribute to Khat chewing to determine the prevalence of khat chewing, to assess the effects of khat consumption awareness on health, and to assess the effects awareness of khat consumption on social-economic life among youth in Eastleigh, Nairobi County, Kenya. The research was led by Social Learning and Reference Group theories, which were critical in understanding why individuals engage in Khat intake and other Khat-related behaviour. The study used a survey research approach in which a questionnaire was used to collect information from a sample of participants. The research focused on 200 teenagers from Section I, 150 from Section II, and 100 from Section III, which has a smaller population than the other sections. The research also targeted (2) two people from each Division who were above the age of 35. As a result, the study's target population was 456 people. The research sample included 384 youth and six Key Informants, totaling 390 individuals. The three Divisions in this research were chosen on purpose since they represent Eastleigh's three major Divisions. As a result, their findings most likely mirrored the real situation in the targeted group. A pilot study was conducted prior to data collection to evaluate the questionnaire utilized in this investigation. To ensure validity, the researcher sent the questionnaire results to specialists who determined if the questions were acceptable. In assessing consistency for multi-item measures, a cut-off of more than 0.7 was considered adequate. Chi-square inferential statistics were employed to establish a one-to-one link between the independent and dependent variables. This served as the foundation for either rejecting or accepting the null hypothesis. To examine qualitative data, the researcher used the content analysis approach. Graphs, tables, and pie charts were used to present a result. NACOTSI, MKU, and consent from respondents were consulted on ethical considerations in this sstudy. According to the report, 36.06% of respondents were introduced to Khat by their neighbours or peers. According to the research, 70% of youngsters ingest Khat, indicating that khat usage is widespread in EightLeigh. The study discovered that 66.67% were aware of the negative consequences of khat intake on health yet continued to use it. According to the survey, the rate of khat use is high, and most youngsters are aware of the effects of khat consumption on health and social-economic life. As a result, the research advised that the government and stakeholders educate the people about the health risks associated with Khat PublicationDeterminants of Covid-19 Vaccine Uptake among Adults in Mwala Subcounty, Machakos County, Kenya(Mount Kenya University, 2023-07) Kimolo,KilonzoCOVID-19 has had immense negative effects on different populations both economically and socially. Since the pandemic started in 2019, it has caused numerous deaths and lowered quality of life among various victims and survivors. In efforts to contain the pandemic, virologists and vaccine manufacturers have worked and invented different COVID-19 vaccine variants with diverse but remarkably good levels of efficacy against the disease. Despite the Kenyan government’s efforts to make the vaccines available to the eligible population, vaccine hesitancy and refusal has brought about poor uptake hence slowing down the vaccination process. In this regard, the broad objective was to investigate the determinants of COVID-19 vaccine uptake among adults. The specific objectives were to identify the individual, administrative, social, and demographic factors that influence COVID-19 vaccine uptake among adults in Mwala Sub-county. It engaged the adult population residing in Mwala sub-county, Machakos County, Kenya as the study participants only. Analytical cross-sectional study design was used to achieve these objectives. Ethical clearance was issued by Mount Kenya University Ethical Review Committee and NACOSTI before data collection. The study targeted residents of Mwala Sub-county aged above 18 years of age. Data collection was carried out by means of structured questionnaires administered to 384 respondents and key informant interview guides that engaged six informants. The questionnaire respondents were sampled using systematic random sampling method from individuals visiting the six vaccination centres in the Sub-county. The process adhered to ethical considerations of informed consent, confidentiality, and anonymity. Data analysis was done with the aid of the SPSS software version 26. Descriptive analysis was conducted to describe the socio-demographic findings of the study as well as COVID-19 vaccine uptake of the respondents. Uptake of the first dose was 46.60% while fully vaccinated individuals were 11.70% of the total number of respondents. The association between some variables was identified through Chi-square test of association at significance level p=0.05. There were statistically significant associations between the outcome variable (COVID-19 vaccine uptake) and demographic predictors of age (χ2=15.524, df=3, P=0.001), sex (χ2=5.250, df=1, P=0.022), education level (χ2=107.556, df=3, P<0.001), and marital status (χ2=35.328, df=3, P<0.001). Additionally, social factors such as dependence on unreliable sources of information (χ2=32.904, df=3, P<0.001), collective responsibility of getting vaccinated to protect others (χ2=292.931, df=3, P<0.001), and religious teachings (χ2=11.763, df=1, p=0.001) also exhibited significant associations. Among predictors of low vaccine uptake was individual factors of susceptibility perception (χ2=189.471, df=1, p<0.001), severity perception (χ2=234.515, df=3, P<0.001), safety concerns (χ2=277.624, df=3, P<0.001), and perception that the vaccine benefits did not outdo associated side effects (χ2=277.624, df=3, P<0.001). Administrative factors of vaccine stock-outs (OR = 0.86, 95% CI 0.82 – 0.90) and long queues (OR=0.87, CI 95% 0.83–0.90) were not significantly related to the outcome variable. The study concludes that the vaccine uptake in Mwala is generally low. To overcome the low vaccine uptake, the government should incorporate COVID-19 vaccination into the existing routine vaccination schedule and address conspiracy theories revolving around the vaccine in various social media sites during health education and awareness vaccination campaigns. PublicationDeterminants of Blood Donation Practice among Selected Tertiary College Students in Homa Bay County Kenya(Mount Kenya University, 2023-07) Okuthe,James OchiengGlobally, most countries are struggling with inadequacy of blood. The enthusiasm of a population to give blood determines donation rate of a country. Most Kenyans are still not willing to donate with only less than 10 percent of adult Kenyans donating. Unfortunately, the country is struggling with perennial shortage of blood and KNBTS is only able to collect 16% of the one million units needed by the country way below the target. Their statistics shows blood is mainly donated by secondary school students, college and university students and 80 percent of the donors aged between 16 and 25 years. Blood donors of younger age have the potential of longer donor careers and good health, consequently directing recruitment efforts toward them is strategic to achieve universal access. Kenya has an estimated population of 47million, to claim sufficiency; 470,000 units of blood need to be collected annually. To increase adequacy of blood supply, locally relevant evidence is needed to understand the characteristics, motivators and barriers of tertiary college students. Numerous studies have been undertaken to understand the characteristics, barriers and motivators of potential donors more so in developed countries with few studies done locally in other parts of the country but not in Homa bay County. This was a descriptive cross sectional study which mixed method approach (qualitative and quantitative) for triangulation purposes. It was carried out from April 2021 to July 2021 in three public tertiary institutions and one private tertiary institution in Homa Bay County. The county is situated in western part of Kenya bordering Lake Victoria. A total of 424 participants were recruited in the study. The institutions were purposively sampled and systematic random sampling on the spot without a population list was used to sample the students. The numbers of students sampled in each institution was proportionately based on the total study population of 2627. SPSS software version 21.0 was used to conduct statistical analysis. Reliability was analyzed using test retest method and Pearson’s correlation calculated. In addition to reliability, simple percentage agreement was also calculated with values from 75% to 90% demonstrating acceptable level of agreement. Descriptive statistics (arithmetic average and standard deviation) and Chi square (x2) test for association was conducted for quantitative data while transcripts coded thematically and similarities identified for qualitative data. Logistic regression was carried out for all significant independent variables and Odds Ratio (OR) and 95% Confidence Interval (CI) used to estimate the strength of association. The study revealed that sex OR-0.493 p =.013 and blood type A-(OR) 8.597 p=.0.009, and O+ (OR) 2.189 p=0.012 of the students were significant socio- demographic characteristics associated with blood donation, while collectivism and altruism main motivating factors. Selling of blood was the lead barrier to blood donation. Homa Bay County satellite blood bank, should come up with customized blood donation messages targeting female donors, and all donors should be motivated with non-monetary incentives like donor’s card and Community strategy should be used to share key customized massages through community health volunteers (CHVs) regarding blood donation. PublicationA Thesis Submitted in Partial Fulfilment if The Requirement For The Award of Master of Public Health Degree of Mount Kenya University(Mount Kenya University, 2023-03) Jama, Mohamed AbdulkadirThe consumption of khat has a significant health and financial impact to the nation, as well as an increasing public health hazard. khat usage reduces users' effectiveness, makes them more sensitive to health issues, and increases their chance of committing crimes. In this sense, they pose a risk to society and place a strain on the health system. As such, the current study examined factors attributing to the prevalence of khat effects of Khat chewing on well-being among the youth in Eastleigh, Nairobi, Kenya. The following objectives guided the study; to find out factors that contribute to Khat chewing to determine the prevalence of khat chewing, to assess the effects of khat consumption awareness on health, and to assess the effects awareness of khat consumption on social-economic life among youth in Eastleigh, Nairobi County, Kenya. The research was led by Social Learning and Reference Group theories, which were critical in understanding why individuals engage in Khat intake and other Khat-related behaviour. The study used a survey research approach in which a questionnaire was used to collect information from a sample of participants. The research focused on 200 teenagers from Section I, 150 from Section II, and 100 from Section III, which has a smaller population than the other sections. The research also targeted (2) two people from each Division who were above the age of 35. As a result, the study's target population was 456 people. The research sample included 384 youth and six Key Informants, totaling 390 individuals. The three Divisions in this research were chosen on purpose since they represent Eastleigh's three major Divisions. As a result, their findings most likely mirrored the real situation in the targeted group. A pilot study was conducted prior to data collection to evaluate the questionnaire utilized in this investigation. To ensure validity, the researcher sent the questionnaire results to specialists who determined if the questions were acceptable. In assessing consistency for multi-item measures, a cut-off of more than 0.7 was considered adequate. Chi-square inferential statistics were employed to establish a one-to-one link between the independent and dependent variables. This served as the foundation for either rejecting or accepting the null hypothesis. To examine qualitative data, the researcher used the content analysis approach. Graphs, tables, and pie charts were used to present a result. NACOTSI, MKU, and consent from respondents were consulted on ethical considerations in this sstudy. According to the report, 36.06% of respondents were introduced to Khat by their neighbours or peers. According to the research, 70% of youngsters ingest Khat, indicating that khat usage is widespread in EightLeigh. The study discovered that 66.67% were aware of the negative consequences of khat intake on health yet continued to use it. According to the survey, the rate of khat use is high, and most youngsters are aware of the effects of khat consumption on health and social-economic life. As a result, the research advised that the government and stakeholders educate the people about the health risks associated with Khat. PublicationMaternal Factors Associated With Preterm Births at Thika Level 5, Kiambu County, Kenya.(Mount Kenya University, 2022-05) Awino,Abongo MelanieA preterm birth is defined as those that occur before 37 weeks of gestation, common symptoms of babies born prematurely include immature lungs, difficulty regulating body temperature, poor feeding and slow weight gain. Premature babies ay need intense nursery care, medication and sometimes surgery. Preterm birth is one of the leading causes of neonatal mortality it contributes to 60-80 per cent of all neonatal deaths. The causes of preterm birth are unknown in over 50% of spontaneous preterm labor, and mechanisms of preterm labor remain poorly understood .Child birth outcomes have become the focus of achieving MDG 4 that aims to reduce child mortality and reduce the less than 5 mortality rate by two thirds. The main objective of the study was to determine the factors associated with birth outcomes among post-natal mothers at Thika Level V Hospital, Kiambu County. The specific objectives aligned with the main objective included: to investigate the maternal socio demographic factors associated with preterm births at Thika Level V Hospital; to assess the health seeking behaviours associated with preterm births at Thika Level V Hospital; to establish the maternal health obstetric factors associated with preterm births at Thika Level V Hospital.This was a descriptive cross-sectional study. Quantitative approach was used in collection of data using structured interviewer administered questionnaire. Simple random sampling technique was used to sample the participants; and analysis performed using STATA. Chi square test of independence was used to determine significance of the variables; it revealed that the iron and folic acid supplementation (IFAS) in pregnancy (p=0.035) and number of antenatal visits (p=0.001) were the significant factors associated with preterm births. Bivariate logistic regression was used to determine the factors independently associated with preterm births. This confirmed the outcome of the prior findings; Antenatal visits odds ratio p=.459, OR=.1.359 (95% CI; .385, .1.537). And the odds of IFAS supplements are p=.103, OR= 1.694(95% CI: .899, .3.192). IFAS supplements and antenatal visits are significant factors associated with preterm births. PublicationA Thesis Submitted in Partial Fulfillment of the Requirements for the Award of Master of Public Health Degree in Monitoring and Evaluation of Mount Kenya University(Mount Kenya University, 2022-10) RUTO,PATRICK KIPLANGATNon-communicable diseases are the leading cause of morbidity as well as mortality. In 2020 about 19.3 million newly cases diagnosed and 10.0 million people die of cancer annually worldwide. In Kenya cancer come second cause of mortality besides cardiovascular diseases accounting for 7% of total mortality thus making it a public health concern. In the 2020 GLOBOCAN report, National cancer estimates stand at 42,116 new cancer cases diagnosed and a mortality of 27,092. In Thika level five Hospital cancer cases are unknown. The main objective of this study was to assess cancer morbidity and mortality between the years 2013-2017 at Thika level five Hospital, Kiambu County, Kenya. The primary target for this study was all cancer patients attending Thika hospital. A descriptive, cross-sectional design was employed to gather data presented in all cancer patients. A sum of 261 cancer patients’ records observed from patients treated between January 2013 and December 2017. An interview was done using a structured questionnaire with 98 patients from the department of cancer pain management in the hospital. Data on independent variables including age, sex, primary anatomical sites of cancer origin. Data were analyzed, and summarized into frequencies and proportions, because of a small number of cancer cases only the top five were considered. The proportionate cancer frequency for incidence rate, and prevalence, as well as mortality, were calculated. The frequency recorded was absolute, and the proportions were in percentages. Data were presented in graphs and tables. The questionnaire interviews were analyzed using SPSS version 21. Proportionate cancer morbidity for five years and proportionate mortality rate since 2017 was analyzed Approval acquired from Mount Kenya Institutional Research Ethics Committee and a license was obtained from the National Commission of Science, Technology, and Innovation (NACOSTI). Permission to collect data obtained at Thika level five Teaching and Referral Hospital. The data were abstracted from 261 records out of which 179 (69%) female while 82 (31%) males. Primary data were obtained from a questionnaire for 98 cancer patients out of which 79 (77.6%) were alive while 22 (22.4%) die in combined gender. The top five cancer by sites were cervix 59 (22.6%), breast 40 (15.3%), esophagus 37 (14.2%), stomach 31 (11.9%), and prostate 13 (5 %). The proportionate cancer morbidity for five years for all ages was 73.9 per 100, population. The proportionate mortality rate for 2017 is 8.4 per 100 populations. In conclusion, major cancer in females and males were cervical and prostate, respectively. Recommendation, there is a need to emphasize provider-initiated cervical and prostate cancer screening during triage at the health facility as this may facilitate documentation of unseen cases. PublicationImplementation of possible severe bacterial infection guidelines in selected counties in Kenya(Mount Kenya University, 2022-10) Mbugua, Samuel MungaiSevere bacterial infections fall among the leading causes of neonatal mortality (0-59 days) globally. One in every five neonates in Kenya will die due to these infections. This situation is aggravated by poor health care seeking behaviors by caregivers, poor supply chain management, low health provider staffing, low care giver and community health volunteer knowledge of PSBI presentation and management, dysfunctional referral pathways among others. The purpose of this study was the implementation of PSBI guidelines and generation of evidence aimed at addressing challenges in neonatal and young infant care in hard-to-reach resource-limited settings. The objective of this study was to demonstrate feasibility, acceptability, and sustainability of PSBI implementation within the revised IMNCI guidelines where referral is not feasible in selected counties in Kenya. The study employed implementation research where an initial formative context mapping and assessment was conducted with routine quarterly follow up assessments. Data collection entailed a capacity assessment in each of the four counties on various health system domains, facility audits in 12 purposively selected facilities to assess preparedness of facilities to manage PSBI, partner mapping to identify potential stakeholders for collaboration in each county, mapping of past, current and planned staff trainings, social costs analysis, Policy/stakeholder analysis, assessment of community/provider perceptions and practices regarding newborn care using in-depth interviews and focus group discussions. This was followed by six monthly case studies and narratives. Quantitative data was analyzed using independent T test and Pearson’s chi-square. Qualitative data was described using themes and narratives. Ethical clearance was sought from Mount Kenya University Institutional Scientific Ethics Review Committee. The data was reported using tables, graphs, pie charts and narratives. Dissemination of findings was through stakeholder forums, advocacy, local and international conferences, and publications in peer-reviewed journals. The health systems capacity assessment indicated average score of 70% across counties and service delivery domain where Turkana, Mombasa and Kilifi scored a green, but Bungoma scored amber of 65%. Only 29.2% of the facilities reported having a functional newborn unit/area for neonates from the facility assessment. Qualitative data alluded to several cultural contextual factors that predisposed young infants to infections. The data also revealed that most caregivers were able to identify danger signs of PSBI and roles of other household members were identified in line with influencing factors on care seeking behaviors. The interventions and decision support tools developed and tested to. facilitate integration of PSBI include a Job aid chart for health providers to aid in assessment and classification of sick young infants, informational pamphlets for caregivers and health providers, and a PSBI/IMNCI Assessment and Follow up tool for appropriate documentation of management of sick young infants. The findings on implementation research outcomes showed that indeed the PSBI guidelines are acceptable, adoptable, with clear indication of their fidelity, feasibility, and sustainability as public health interventions in low resource settings where referral for sick young infants is not feasible. Consideration of contextual variation, appropriate resource allocation, and training of health providers is necessary for sustainable integration of PSBI guidelines in Kenya’s healthcare system. PublicationKnowledge, tools, utilisation and sources of brucellosis surveillance data among animal health workers in Nairobi County, Kenya(Mount Kenya University, 2022-10) Muriithi, PeterBrucellosis is a neglected zoonosis considered as reemerging in several countries including Kenya. Globally Brucellosis affects over 500.000 humans and several thousands of livestock annually. Live animals and animal products are the key sources of human infection, which has been on the increase in urban populations. This is associated mainly with increasing raw milk trade and consumption in urban settings. The purpose of the study was to evaluate knowledge, tools, utilization and sources of brucellosis surveillance data among animal health workers in Nairobi County, Kenya. The specific objectives of the study were to determine data sources for brucellosis surveillance among animal health workers in Nairobi County, to assess tools available for brucellosis surveillance among animal health workers in Nairobi County, to determine levels of knowledge on brucellosis surveillance data management among animal health workers in Nairobi County and to establish utilization of brucellosis surveillance data among animal health workers in Nairobi County. This research was being guided by Health Belief Model, Knowledge Attitude Practice Theory and Epidemiological Triad Model. The study used applied cross-sectional study design to determine data sources knowledge, tools, utilization and sources of brucellosis surveillance data among animal health workers in Nairobi County, Kenya. Study area will be the administrative County of Nairobi. The approach used quantitative and qualitative study approach. Data was collected by the use of structured questionnaire, key informant interview and focus group discussions. Data was systematically entered and analyzed using SPPS software for analysis. The target population in this research was comprised of animal health workers in Nairobi County in Kenya. The study used a census survey procedure that included all the 101 animal health care workers in the County. Data was cleaned, entered, and analyzed using SPSS versus 20 packages. A bivariate logistic regression was used to determine factors associated with Brucellosis surveillance data management knowledge and practice. Quantitative data was presented in form of graphs, tables and pie charts. In addition, information collected from key informants interviews and focused group discussions was analyzed in terms of themes and sub -themes using quotes from the findings, data sources and data collection mechanism had significance effect on brucellosis surveillance data management practice among animal health workers in Nairobi County. Availability of tools, level of knowledge practice and data utilization has a significant effect on brucellosis surveillance data management practice among animal health workers in Nairobi County. The study recommended that animal health workers should be trained equipped supported with logistics and regularly supervised. The results of this study will be shared to both the veterinary and public health authorities and relevant stakeholders and it was expected to contribute towards an improved health information systems and an integrated human-animal brucellosis control strategy in urban settings of Kenya. PublicationAssessment of health insurance schemes uptake by the informal sector workers at Matuu, Machakos County, Kenya(Mount Kenya University, 2022-06) Asindua, FaridaHealth insurance is a social protection against the possibility of incurring medical expenditure among individuals. It is therefore, the critical pillar of Health care financing and the main driver in achieving Universal Health coverage in most nations. The core objective of the study was to assess the level of current uptake of Health Insurance among informal sector workers in Matuu Ward within Machakos County. The specific objectives were to determine the proportion of informal sector workers that enrolled for Medical Insurance Scheme in the past three year; to establish the sources of money paid for Health services at the point of use among the informal sector workers and to identify factors that influence uptake of Health Insurance Schemes among informal sector workers. The study site was Matuu Ward, Machakos County and the target population was informal workers. The study design was analytical cross sectional study which applied a mixed method approach in data collection and analysis. The inclusion criteria was employers and employees in the informal sector. The exclusion criteria was minors below 18 years of age. A sample of 202 respondents was selected for this study and primary quantitative data was obtained from sampled individuals involved in enterprises by use of questionnaires. Proportionate sampling technique was then employed to establish how many respondents were to be sampled under each stratum/category. Descriptive data analysis was done and categorical variables in form of frequencies and percentages was done; while numerical variables in form mean, standard deviation was done in analyzing and presenting the data. Qualitative data from key informants was analyzed and then grouped into themes and sub-themes. Ethical considerations were observed. The study found that 97% of the respondents were aware of the health insurance and in addition, only 31% of the respondents were aware of the Universal Health Care (UHC), which is being piloted in Machakos County. The major source of information on health insurance schemes was friends as reported by 41.1% of the respondents. The major reason for stopping payments was loss of main source of income as reported by 41.7%. Chi-square results indicated that gender, age, level of education and income level had no significant effect on uptake of insurance. However, marital status (p=0.000) had a significant effect on uptake of insurance. In conclusion, the uptake of health insurance by informal sector workers is high especially with the NHIF. This is because the Government has been aggressively improving the uptake by NHIF by all in the Country to facilitate access to Health Services. Uptake of health insurance offered by private insurance firms was low due to high premiums, bearing in mind that most of the informal sector workers earn very low and irregular incomes. The study recommends that the Government should make health insurance uptake continuity more attractive to the informal sector workers. Government and the private sector should explore public private partnership in provision of health insurance with the aim of promoting the contribution of private health insurance schemes in expanding Universal Health Coverage. PublicationActive tuberculosis case finding on diabetic patients attending diabetic outpatient clinic at JM Kariuki county hospital, Nyandarua county Kenya(Mount Kenya University, 2022-09) Macharia, EverlyneNotwithstanding the concerted efforts to attain the objectives stipulated in tuberculosis (TB) End Strategy by 2035, tuberculosis continues to be one of the principal healthcare concerns globally. Tuberculosis- Diabetes comorbidity accelerates tuberculosis disease and complicates treatment hence aggregating the possibility of poor tuberculosis outcome. The principal objective of this study is to determine missed active tuberculosis disease among diabetic patients enrolled in the outpatient diabetes management clinic at JM Kariuki County Hospital, Nyandarua County. The study investigates the prevalence of tuberculosis, estimates the positive yield of tuberculosis diagnosis by Gene Xpert, X ray and Fluorescent microscopy (FM) diagnostic methods, and explores the socioeconomic factors of tuberculosis infection among patients with diabetes at JM Kariuki County Hospital, Nyandarua. A sample size of 139 study participants was used for the study. Data was collected through carrying out diagnostics tests which included: Fluorescent TB smear microscopy, Gene-Xpert test, Chest X-ray, blood sugar test and face to face interviews which was recorded in a structured interviewer checklist and the clinical data uploaded in various ministry of health laboratory tools. SPSS version 22 was used to analyse the data. A high prevalence rate (2.66%) of missed tuberculosis cases was recorded among diabetics. The results suggested Gene Xpert (with a positive yield of 1.60%) as the test with the highest positivity yield in the diagnosis of tuberculosis among diabetics at JM Kariuki County Hospital, Nyandarua. A notable difference was noted in the prevalence of tuberculosis among different age groups of participants (p = 0.001) suggesting strong statistical relationship between tuberculosis infection and age, emphasizing the established association between tuberculosis and age factor. A p-value of 0.613 suggested the existence of a weak association between the gender of diabetic patients even though a significant statistical association was noted between occupation and tuberculosis occurrence (p = 0.003). A significant statistical association was noted to exist between smoking and alcoholism and tuberculosis infection among diabetics (p = 0.001). The study proposes tuberculosis screening for all new diabetes mellitus (DM) incidences when resources allow, and prioritized screening using chest x-ray for diabetes mellitus patients and gene expert analysis for people who have suggestive symptoms and patients aged 40 above, as well as those engaging in behaviours such as habitual alcohol consumption and cigarette smoking. Additional focus is recommended for tuberculosis infections in the lower lobes of the lungs, since lower lung involvement is one of the common features of tuberculosis infection among people with diabetes mellitus. Patients suffering from both diabetes mellitus and tuberculosis face higher chances of presenting cavitation, smear-positivity during diagnosis, and they may continue being culture positive 8 weeks after the onset of the treatment plan. Additional diagnostic initiative that focuses on continuous monitoring of serum drug concentration and ensuring that the tuberculosis therapy dosage is enough is recommended to enable a sustained advancement of the patient towards tuberculosis eradication. As such, the findings of this study emphasize the need to incorporate active tuberculosis case finding in diabetes mellitus management in Nyandarua County, as a milestone towards the enhancement of the national tuberculosis strategy. PublicationErgonomic-based intervention for musculoskeletal disorders among sugar factory workers in Jinja, Uganda(Mount Kenya University, 2022) Aremu, Abdulmujeeb BabatundeDespite this long-standing awareness, WRMSDs continue to be the main reason among people with a work-related illness. The study aimed at developing ergonomic based interveion among sugar factory workers to reducec the prevalence of Musculoskletal Disorders. A quasi-experimental study of pre-test and post-test was adopted in this study for six months, using a well-structured standardized Nordic Musculoskeletal disorders questionnaire (NMQ) and Quick Exposure Checklist (QEC). A stratified sampling technique was used. A sample size of 402 was divided equally among the two sugar factories as an experimental group and a control group. Ethical approvals were sought from the relevant bodies before conducting the study. The quantitative data were analyzed using IBM SPSS version 26, while the qualitative data was analyzed using Atlas.ti version 9. Descriptive statistics such as mean, standard deviations, percentages, and frequencies were used. While t-test, Chi-square, and multivariate logistic regression were used as inferential statistics. A higher prevalence of 77.1% was reported among the sugar factories workers in 12 months, lower back region 63.7% and Upper back region 46.3% was the most affected body region among the respondents. All the risk factors have a level of association with either one or some of the anatomical regions under bivariate and Level of education (p=0.034), experience (p=0.011), departments (p=0.011), standing for long (p=0.035), and job time (p=0.001) was shown to be a predictor of WRMSDs at multivariate level. The paired t-test analysis of the QEC total score showed a reduction after the post-intervention and was significantly different before and after the intervention. The majority of the study population in both groups were males and at their youthful age, the prevalence of WRMSDs was higher in the experimental group compared to the control group, and this was due to the mechanized system of work in the control group. The ergonomic intervention resulted in a reduction of the prevalence of WRMSDS among the workers in the Experimental group from 77.1% to 37.0%, which is key to the study findings. This study showed how the risk factors are predisposing the respondent to WRMSDs, and lack of ergonomic knowledge or training was highlighted as major reasons for WRMSDs. Recommendation: The results of this study will assist the factories in enhancing the wellness of their workers by reducing the socioeconomic burdens, work-related absenteeism and ultimately increasing factory productivity.