Characterisation of Tuberculosis Mortality in Informal Settlements in Nairobi, Kenya: Analysis of Data Between 2002 and 2016

Abstract

Background: Tuberculosis (TB) remains one of the key public health problems in Africa. Due to multifaceted challenges, its burden is poorly described in informal settlements. We describe tuberculosis mortality in informal settlements of Nairobi, Kenya. Methods: This is a secondary analysis of 2002-2016 verbal autopsy data from the Nairobi Urban Health Demographic Surveillance System (NUHDSS). A descriptive analysis of deaths assigned as caused by TB was done. Pearson chi-square tests were used to determine differences between background characteristics. Logistic regression was carried out to examine the risk of death from TB within the background characteristics.Results: There were 6,218 deaths in the NUHDSS within the period of analysis, of which 930 (14.96 %) were deaths from TB. There was a downward trend of TB deaths while the average number of TB deaths per year was 62(SD 23.9). Males had 1.39 higher odds of dying from TB than females (AOR 1.39; 95% CI 1.18-1.64; p-value <0.001). Compared to those aged 30-39 years, the ≥50-year-olds had a 42 % lower chance of dying from TB (AOR 0.57; 95% CI 0.47-0.73; p-value <0.001). Those dying at home had 1.39 odds of dying from TB as compared to those who died in a health facility(AOR 1.93; 95% CI 1.17-1.64; p value<0.001).Conclusion: There was a reduction in TB deaths over the study period. Males had the highest risk of death. There is a need to strengthen TB surveillance and access to TB diagnosis and treatment within informal settlements to enhance early diagnosis and treatment.

Effectiveness of Online Training in Improving Primary Care Doctors’ Competency in Brief Tobacco Interventions: A Cluster Randomised Controlled Trial of WHO Modules in Delta State, Nigeria

“…This study employed a self-administered structured questionnaire adapted from previously validated instruments by Gichuki. 5 The questionnaire was pretested among twenty primary care medical practitioners in a neighbouring state and revised for clarity. The questionnaire was sent to participants electronically via WhatsApp before the training and six months after.…”

“…They last less than 10 minutes. 5 Intensive interventions are more comprehensive and individualised, offered by Tobacco Treatment Specialists through individual/group counselling, cessation support groups, and telephone counselling in the setting of addiction treatment/mental health centres or social service agencies. 1 Intensive interventions are more effective but more time- and cost-demanding, and, therefore, far less available, particularly in developing countries.…”

“…20 Various studies have highlighted the contributory factors in the performance of brief cessation interventions by healthcare personnel (Figure 2). 5,21–23 The behaviour change theories applied in health promotion, each with its own explanatory variables, can also be used to understand changes in the clinical practices of healthcare professionals. 24 One of such theories is the Social Learning Theory (SLT).…”

Influence of Agricultural Practices and Activities on Conservation of the Ol-Bollosat Wetland in Kenya

“…Wetlands are rich ecosystems, which provide essential livelihood products and services such as fish, water and moderation of climate. At the regional level, communities living around wetlands have continued to exploit them in total disregard of whether such exploitation is sustainable in the long run or not (Gichuki, 2003). This issue is compounded further by the lack of legal instruments or their enforcement to provide adequate protection for wetlands.…”

Situation analysis model of hospital emergency department promotion in Iran: A cross‐sectional study

“…On the other hand, organizations' performance is changing rapidly due to the influence of internal and external factors. Furthermore, managers have to prioritize situation analysis for the development and progress of their organization 12 . It is evident that the hospital and its various departments, especially the ED, should be evaluated and analyzed in sync with other units and, of course, at the top of them 13…”