Background: Clinical practice guidelines (CPGs) play a significant role in informing clinical decision-making and improving the quality of health care. Kenya, a lower-middle income country, is faced with a high disease burden amidst a shortage of health workers. Well-developed and implemented CPGs are essential in guiding quality healthcare practices.Objective: We aim to assess the quality of available and accessible national CPGs in Kenya, make recommendations on their development, adaptation and implementation to improve health outcomes. Methods: We will use the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool to assess the methodological quality of available and accessible CPGs. Our focus will be guidelines on diseases or conditions under the broad categories of maternal disorders, neonatal disorders, nutritional disorders, injuries, communicable and non-communicable diseases in Kenya. We will search websites and databases of the Kenyan Ministry of Health, health associations of Kenya and contact relevant experts or personnel in these organizations. We will also use the google search engine to identify any eligible guidelines. Three reviewers will independently conduct data extraction and quality assessment of the guidelines using the English version of AGREE II tool with six domains (scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, applicability, and editorial independence). Analysis: We will use descriptive statistics to analyse the results and present findings as quality scores. The results of the 23 items and the six domains in the AGREE II tool will be presented in mean and standard deviations.Dissemination: We will disseminate the findings of this study through publication in a peer-reviewed journal, presentations at scientific conferences and relevant healthcare stakeholders meetings.

ObjectiveTo assess the quality of available and accessible national Clinical Practice Guidelines (CPGs) in Kenya using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool.MethodsWe searched the websites of the Kenyan Ministry of Health, professional associations and contacted experts in relevant organisations. Our scope was guidelines on maternal, neonatal, nutritional disorders, injuries, communicable and non-communicable diseases in Kenya published in the last 5 years until 30 June 2022. Study selection and data extraction were done by three independent reviewers with disagreements resolved via discussion or with a senior reviewer. We conducted a quality assessment using the online English version of AGREE II tool across six domains. Descriptive statistics were analysed using Stata software V.17. The primary outcome was the methodological quality of the included CPGs assessed by the AGREE II tool score.ResultsWe retrieved 95 CPGs and included 24 in the analysis after screening for eligibility. The CPGs scored best in clarity of presentation and least in the rigour of development. In descending order, the appraisal scores (mean and CI) per domain were as follows: Clarity of presentation 82.96% (95% CI 78.35% to 87.57%) with all guidelines scoring above 50%. Scope and purpose 61.75% (95% CI 54.19% to 69.31%) with seven guidelines scoring less than 50%. Stakeholder involvement 45.25% (95% CI 40.01% to 50.49%) with 16 CPGs scoring less than 50%. Applicability domain 19.88% (95% CI 13.32% to 26.43%) with only one CPG scoring above 50%. Editorial independence 6.92% (95% CI 3.47% to 10.37%) with no CPG scoring above 50% and rigour of development 3% (95% CI 0.61% to 5.39%) with no CPG scoring at least 50%.ConclusionOur findings suggest that the quality of CPGs in Kenya is limited mainly by the rigour of development, editorial independence, applicability and stakeholder involvement. Training initiatives on evidence-based methodology among guideline developers are needed to improve the overall quality of CPGs for better patient care.

Street-vended foods are a major threat to public health because of their microbial contamination. This study investigated hygiene practices and microbial contamination of street foods in Kenyatta University’s environs. Both cross-sectional and experimental designs were adopted. Four (4) major vending stalls at the main entrance to Kenyatta University, gate (A) and at the hind gate at KM shopping center were identified for this study. Twelve (12) food samples were collected from these stalls; sausages, samosas and kachumbari. The foods were collected and transported in cooler boxes to the Microbiology Laboratory at Kenyatta University within 3 hours for analyses. Standard microbiological methods were used for enumeration of Salmonella, coliforms and Escherichia coli. No Salmonella was detected per 25g in all food samples tested. Fifty percent (50%) of kachumbari samples tested positive for E.coli whereas samosas and sausages tested negative. Kachumbari, from all vending stalls, had total coliform levels 4.12 log10 cfu/g, 4.26 log10 cfu/g and 4.21 log10 cfu/g, that did not meet the quality standards (4.00 log10 cfu/g) for ready-to-eat foods. Total coliform counts were below detection limits in samosas and sausages. All (100%) the stalls were exposed to potential contaminants: 75% of the vendors did not wear protective clothing, they handled money and sold food simultaneously, and polythene bags exposed to open air, were used for packaging take away rations. All the foods evaluated were safe for human consumption except kachumbari. Policies on safe street food to be enforced and education and training of vendors on environmental and personal hygiene to be strengthened.

Background: Access to rapid diagnostic tests for malaria (mRDTs) has significantly increased in sub-Saharan Africa, but this region still bears the largest burden of Malaria. Assessing the impact of mRDTs on patient-important outcomes is essential in effectively guiding their future evaluation and programmatic scale-up.Objective: We aim to critically assess the study designs, outcome measures, methodological quality and implementation challenges of studies that evaluate the impact of mRDTs compared to other malaria diagnostic tests on patient-important outcomes among persons suspected of malaria in sub-Sahara Africa through a systematic review of the literature.Methods and Analysis: We will search MEDLINE, EMBASE, Cochrane Library, African Index Medicus and clinical trial registries from inception until June 2022. We will include a primary randomized or non-randomized study that compares the impact of mRDTs to clinical diagnosis, microscopy and polymerase chain reaction (PCR) on patient-important outcomes such as time to diagnosis/turn-around time, time to initiation of therapy, time to resolution of malaria-associated symptoms, morbidity and mortality in both adults and children. We will also include quantitative studies with an additional qualitative component (mixed methods studies) to assess the implementation challenges of mRDTs. We will assess the methodological quality of included studies using National Institutes of Health (NIH) quality assessment tools for experimental and observational studies. We will use the Mixed methods appraisal tool (MMAT) version 2018 for mixed methods studies. We will analyse our results through descriptive statistics and thematic content analysis and present our findings narratively, graphically and by quality ratings.Registration: This protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42018083816.Dissemination: We intend to publish the outcome of our review in a peer-reviewed journal and develop a valuable and accessible result summary.