BackgroundMetabolic syndrome refers to a cluster of interrelated disorders which occur together causing an increase in the risk of developing cardiovascular disease and diabetes. The university population is an understudied group despite the increase in the frequency of related disorders and metabolic risk factors e.g. obesity and diabetes, majorly due to the assumption that they are in their most active phase of life therefore healthy. This study looked at metabolic syndrome, the sedentary lifestyles and dietary habits present among university students attending Mount Kenya University, main campus.MethodsStratified sampling was used to select participants. Self-administered questionnaires were issued to participants after a signed consent had been obtained following which clinical assessments and biochemical measures were performed. They included blood pressure, fasting blood glucose, triglycerides, high density lipoprotein-cholesterol, anthropometric measurements; height, weight, BMI and waist circumference. Pearson’s chi-square tests and non-parametric independent t-test were used to analyze the prevalence of metabolic syndrome criteria per gender, the number of metabolic syndrome criteria per BMI and prevalence of metabolic syndrome criteria per BMI category.ResultsThe study established that 1.9% of the participants met the criteria for diagnosis of metabolic syndrome according to HJSS criteria. Among the elements, there was statistical difference in gender BMI and waist circumference. 11.8% of subjects had two metabolic syndrome components while 3.1% had three components while none of the subjects had all six components. Elevated triglycerides was the most prevalent defining component for metabolic syndrome. There is a statistically significant relationship between sedentary lifestyle and dietary habits as risk factors to metabolic syndrome.ConclusionYoung adults in university have begun developing metabolic syndrome and the risk of developing the syndrome continues to increase with the components being reported in early age. Educational initiatives to encourage healthy eating should be conducted within school premises in order to reinforce the message on healthy diets and physical exercise. Pre-admission screening to identify at risk students should be conducted. Targeted interventions development through a mandatory extra co-curricular program should be enforced to positively engage those at risk.

The COVID-19 pandemic has created a need to rapidly scale-up testing services. In Kenya, services for SARS-CoV-2 nucleic acid amplifying test (NAAT) have often been unavailable or delayed, precluding the clinical utility of the results. The introduction of antigen-detecting rapid diagnostic tests (Ag-RDT) has had the potential to fill at least a portion of the ‘testing gap’. We, therefore, evaluated the cost-effectiveness of implementing SD Biosensor Antigen Detecting SARs-CoV-2 Rapid Diagnostic Tests in Kenya. We conducted a cost and cost-effectiveness of implementing SD biosensor antigen-detecting SARS-CoV-2 rapid diagnostic test using a decision tree model following the Consolidated Health Economic Evaluation Standards (CHEERS) guidelines under two scenarios. In the first scenario, we compared the use of Ag-RDT as a first-line diagnostic followed by using NAAT assay, to the use of NAAT only. In the second scenario, we compared the use of Ag-RDT to clinical judgement. We used a societal perspective and a time horizon of patient care episodes. Cost and outcomes data were obtained from primary and secondary data. We used one-way and probabilistic sensitivity analysis to assess the robustness of the results. At the point of care, Ag-RDT use for case management in settings with access to delayed confirmatory NAAT testing, the use of Ag-RDT was cost-effective (ICER = US$ 964.63 per DALY averted) when compared to Kenya’s cost-effectiveness threshold (US$ 1003.4). In a scenario with no access to NAAT, comparing the Ag-RDT diagnostic strategy with the no-test approach, the results showed that Ag-RDT was a cost-saving and optimal strategy (ICER = US$ 1490.33 per DALY averted). At a higher prevalence level and resource-limited setting such as Kenya, implementing Ag-RDT to complement NAAT testing will be a cost-effective strategy in a scenario with delayed access to NAAT and a cost-saving strategy in a scenario with no access to NAAT assay.

BackgroundReproductive health knowledge is vital in the growth and development of young people and this impact greatly on their educational and personal outcome as they proceed to adulthood. There has been an increasing occurrence of sexually transmitted infections in institutions of higher learning. The study sought out the strategies used by university students to prevent unplanned pregnancy and determined their knowledge of contraception methods and sexually transmitted infections in Mount Kenya University, main campus.MethodsStratified sampling was employed. After a signed consent was obtained, a self-administered questionnaire was used to collect data. Data were explored, analyzed and percentages used to quantify the level of knowledge. Pearson’s chi-square was used to measure associations between categorical variables and independent t-test used to measure the means and relationships of continuous variables.ResultsCondom use was established as the most prevalent strategy in prevention of unplanned pregnancy at 48.5 and 46.4% in prevention of STI and HIV/AIDS. Almost two thirds (58%) of respondents reported that they were conversant with only one method of contraception, 60% had knowledge of more than two types of STIs, and 62.4% indicated that they were conversant with only hospitals as facilities providing reproductive health services.ConclusionYoung people in college require educational initiatives to sensitize them on STI, methods of contraception and positive social behaviors. There is need to improve the accessibility of reproductive health services through strengthening of services provided at campus health clinics.

BackgroundUnderstanding the perceptions of quality of care given to sick young infants in primary healthcare settings is key for developing strategies for effective uptake and utilisation of possible severe bacterial infection guidelines. The purpose of this study is to assess families and providers’ perceptions of care given to sick young infants at primary healthcare facilities in four diverse counties in Kenya.MethodsA cross-sectional qualitative design involving 37 in-depth interviews and 39 focus group discussions with very young (15–18 years), young (19–24 years) and older (25–45 years) caregivers of young infants aged 0–59 days; and key informant interviews with community-based and facility-based front-line health providers (14) in primary healthcare facilities. Qualitative data were captured using audio tapes and field notes, transcribed, translated and exported into QSR NVivo V.12 for analysis. A thematic framework approach was adopted to classify and analyse data.ResultsPerceived care given to sick young infants was described around six domains of the WHO framework for the quality of maternal and newborn healthcare: evidence-based practices for routine and emergency care; functional referral systems; effective communication; respect and preservation of dignity; availability of competent, motivated human resources; and availability of physical resources. Views of caregivers and providers regarding sick young infant care in primary healthcare settings were similar across the four sites. Main hindrance to sick young infant care includes stockout of essential drugs, limited infrastructure, lack of functional referral system, inadequate providers which led to delays in receiving treatment, inadequate provider skills and poor provider attitudes. Despite these challenges, motivation and teamwork of health providers were key tenets in care provision.ConclusionThe findings underscore the need to prioritise improving quality of sick young infant services at primary healthcare settings by building capacity of providers through training, ensuring continuous supply of essential medicines and equipment and improving infrastructure including referral.

Background Antimicrobial resistance is a significant public health concern with the establishment of antimicrobial stewardship in hospitals being increasingly obligatory. Perspectives and insights of health managers on antimicrobial stewardship (AMS), complementary health services and building blocks are imperative towards implementation of robust AMS programs. This study aimed to understand perspectives of hospital managers on AMS and identify areas of management engagement while addressing potential blockades to change. Methods A cross-sectional, qualitative, multicenter study was conducted in three hospitals in Kenya. Key-informant interviews on perspectives on AMS were administered to hospital managers. Qualitative data was captured using audio tapes and field notes, transcribed and managed using NVivo 12 software. An iterative process was used to develop the thematic framework and updated in two rounds of iteration analysis. Analysis charts for each emergent theme were developed and categorized across all participants. Results Perspectives on AMS are described in five thematic categories; Importance of antimicrobial stewardship and the role of medicines and therapeutics committee, availability of antimicrobial formulary and usage surveillance systems, laboratory competency and recommendations for infection prevention and management, educational resources and communications channels available, building blocks and low-lying fruits for Antimicrobial Stewardship Committees. The role of stewardship collaboration in diagnosis and antimicrobial prescription was alluded to with managers indicating a growing rise in occurrence of antimicrobial resistance. There lacked contextualized, hospital specific antimicrobial formulary and adequate laboratory competency. Staff training and communication channels were available in varying capacity across the three hospitals. Building blocks identified include medicines and therapeutics committee, education, and training platforms (Continuous Medical Education and Continuous Professional Development activities) and hospital leadership commitment. Conclusions The practice of antimicrobial stewardship is not implemented and well developed as demonstrated by lack of core AMS complementary health services. However, the health managers are aware of the fundamental importance of antimicrobial stewardship programs and the vast benefits of implementation and institutionalization of AMS to hospitals and their clients. The findings underpin the importance of understanding and incorporating perspectives of health managers on existing contextual mechanisms that can be leveraged on to establish robust AMS programs in the fight against antimicrobial resistance.