Determinants of HIV Testing Uptake among Undergraduate Students Aged 17-26 Years at the University of Nairobi, Kenya

BACKGROUND: The human immunodeficiency virus infection among young people remains a public health concern around the global. To reduce HIV incidences among the young people. To reduce the HIV incidences among the group of young people, the identification of the determinants that influence the uptake of HIV testing especially students are mandatory. Hence help to prevent and control the epidemic. OBJECTIVE: The aim of this study was to identify the determinants that associated with the uptake of HIV testing among undergraduate students at the college of Health Sciences. METHODS: Analytical cross-sectional study was conducted at the University of Nairobi among undergraduate students aged 17- 26 years. Stratified proportionate sampling technique was used to select participants for each school within a college. Data was collected using a closed ended questionnaire and STATA version 11.2 developed by Stata Corp was used to analyse data in which multivariable logistic regression analysis were performed. Confidence interval and level of significance were set at 5% and 20% respectively.  RESULTS: Determinants associated with the HIV testing uptake among the young students were as follows; privacy of the location of Testing center (AOR:8.1; 95%Cl:2.7-24.6; p<0.01), peer influence (AOR:1.6; 95%Cl:1.0-2.4; p=0.05), duration in the academic programme (AOR:0.77; 95%Cl:0.25-2.28; p=0.03), and whether the participants were sexually active or not (AOR:2.1; 95%Cl:1.3-3.2; p<0.01). CONCLUSION: The uptake of HIV testing was increased by, privacy of Testing location, sexually active and peer influence.

Patterns and Predictors of Elevated Blood Pressure Among Primary School Children in Two Urban Settings in Kenya

Objectives

We conducted a cross-sectional study to examine the prevalence of elevated blood pressure (BP) among primary school children of different socio-economic status in two urban settings in Kenya and explored the association between elevated BP and children's dietary behaviors and overweight/obesity status.

Methods

The research study was conducted in Nairobi and Kisumu cities in Kenya. Three public schools, catering to children from households at low, medium and high socio-economic status were purposively selected to participate in the study in each city. Data was collected among children within the ages of 10–12 years enrolled in grades 4–6 at each school. Certified clinicians read children's BP readings using an aneroid sphygmomanometer and age-appropriate child BP cuffs. Trained enumerators measured children's weights, heights, waist circumferences and skinfolds. We calculated children's BP percentiles, BMI-for-age percentiles, waist circumference-for-height ratio (WHtR) and total skinfold values as recommended. Parents, with the help of their respective children, completed questionnaires on children's consumption of fruits, vegetables, red meats and processed meats, fries/crisps, fried/baked wheat products, confectioneries and beverages. Complete data were available for 390 children. We utilized prevalence ratio regression analysis to examine the association between children's BP and dietary practices and obesity.

Results

Over, 20% of the school children had pre-hypertension and 14% had hypertension, giving an overall elevated BP prevalence of 34%. Overweight and obese children were significantly more likely to have elevated BP and hypertension compared to children with healthy BMI-for-age percentiles. Children with WHtR > 0.5 and children with high total skinfold values were significantly more likely to have elevated BP and hypertension compared to children with lower waist circumference and skinfold values. Children who consumed high amounts of fries/crisps were significantly more likely to have elevated BP compared to children who consumed lower amounts.

Conclusions

This study increases our understanding BP patterns and determinants among school children in Kenya, and informs non-communicable disease prevention efforts.

Funding Sources

Saff Family.

Schoolchildren's Body Mass Index and Dietary Practices Vary Across Socio-Economic Status in Kenya

Objectives

We conducted a cross-sectional study to examine the prevalence and determinants of overweight and obesity among schoolchildren at different levels of socio-economic status in Kenya. We explore children's weight status and dietary practices in the current analysis.

Methods

The research study was conducted in Nairobi and Kisumu, the largest and the third-largest cities in Kenya. Three public schools, catering to children from households at low, medium and high socio-economic status were purposively selected to participate in the study in each city. Data was collected among children within the ages of 10–12 years enrolled in grades 4–6 at each school. Trained enumerators measured children's weights and heights. Parents, with the help of their respective schoolchildren, completed questionnaires on schoolchildren's dietary practices including consumption of fruits, vegetables, snacks foods, confectioneries, beverages and restaurant foods. Completed sets of body measurements and dietary practices data were available for 390 children. We used Wilcoxon-Mann Whitney, Kruskal Wallis and chi-square tests to compare schoolchildren's weight status and dietary practices across cities and school income status.

Results

Over 15% of the schoolchildren were overweight, 5.5% were obese and 3% were stunted. Schoolchildren's weight status did not significantly differ across cities. However, % of overweight or obese children were significantly higher among children attending high-income schools compared to those in middle- and low-income schools. Frequency of consumption of red meats, fries and take-away foods, and amount of fruit juice consumed per week were significantly higher among children enrolled in high-income schools. Frequency of consumption of breakfast, eating meals in front of a screen and amount of milk consumed per week were significantly lower among children enrolled in low-income schools.

Conclusions

This study increases our understanding of dietary practices and overweight and obesity patterns among schoolchildren, and contributes to obesity prevention efforts in Kenya. Additional analysis will explore the relationship between dietary practices, and overweight and obesity.

Funding Sources

John Hopkins University.

Relationship between functional capacity and health-related quality of life of patients with type-2 diabetes

AIMS

Physical function is a determinant of survival in chronic diseases, however, little is known about functional capacity (FC) and self-reported health status of patients with type-2 diabetes (T2D). This study investigated the relationship between FC and health related quality of life (HRQoL) of patients with T2D.

MATERIALS AND METHODS

This cross-sectional survey recruited 150 patients with T2D from a Nigerian university teaching hospital using purposive sampling technique. Socio-demographic and physical characteristics were assessed. FC and HRQoL including physical and mental health component summary (PCS and MCS) were assessed using the six minute walk test (6MWT) and Short-Form (SF-12) questionnaire respectively. Maximum oxygen consumption (VO₂ max) was estimated, pre and post 6MWT cardiovascular parameters and fasting blood glucose (FBG) were assessed. Data were analyzed using descriptive and inferential statistics. Alpha level was set at p<0.05.

RESULTS

There were 83(55.3%) women, means of age and FBG of participants were 64.2±8.7years and 7.4±2.4mmol/L respectively. The means of 6-min walk distance (6-MWD) and estimated VO₂ max were 341.55±41.82m and 9.2±0.7mL/kg/min respectively. Significant differences were found between pre and post HR (t=-44.71; p=0.001), SBP (t=-38.38; p=0.001) and DBP (t=-38.58; p=0.001) following 6MWT. The means of PCS and MCS of HRQoL were 48.67±5.51 and 58.39±2.86 respectively. There were significant correlations between FC and each of PCS (r=0.678; p=0.001) and MCS (r=0.211; p=0.009).

CONCLUSION

Patients with T2D demonstrated low functional capacity and reduced HRQoL. Significant relationship exists between FC and physical and mental component summary of HRQoL. Exercise intervention to improve FC and HRQoL were recommended.

Knowledge, attitude and practice of exercise for plasma blood glucose control among patients with type-2 diabetes

AIMS

Exercise plays significant role in the health outcomes of patients with diabetes, however, little is known about patients' knowledge of exercise for plasma blood glucose control among patients with type-2 diabetes (T2D). This study investigated knowledge, attitude and practice (KAP) of exercise for plasma blood glucose control among patients with T2D.

MATERIALS AND METHODS

This cross-sectional study recruited 299 patients with T2D (male=105; female=194) from selected government hospitals in Osun State, Nigeria using purposive sampling technique. Validated questionnaires were used to assess of exercise for plasma blood glucose control and socioeconomic status (SES) of the patients. Data were analysed using descriptive and inferential statistics. Alpha level was set at <0.05.

RESULTS

The mean age of respondents was 51.9±9.8 years. A majority, 245(81.9%) were married individuals and more than half, 195(65.3%) were in the low SES. One hundred and forty-eight (49.5%) had good knowledge of exercise whilst 269(90.0%) had negative attitude to exercise practice. Less than a third, 82(27.4%) engaged in exercise practice for plasma blood glucose control. There was significant association between knowledge and practice of exercise ((2)=12.535; p=0.002). Furthermore, significant associations were found between knowledge and gender ((2)=11.453; p=0.003), and socioeconomic status ((2)=29.127, p=0.001) but not associated with attitude towards exercise (p>0.05).

CONCLUSION

Patients with demonstrated good knowledge of exercise for plasma blood glucose control but reported negative attitude and poor practice of exercise.

Healthcare Providers' Level of Involvement in Provision of Smoking Cessation Interventions in Public Health Facilities in Kenya

Healthcare providers can play a major role in tobacco control by providing smoking cessation interventions to smoking patients. The objective of this study was to establish healthcare providers' practices regarding smoking cessation interventions in selected health facilities in Kiambu County, Kenya. This was a descriptive cross-sectional study carried out among healthcare providers working in public health facilities in Kiambu County, Kenya. Self-administered questionnaires were distributed to 400 healthcare providers selected using a two-stage stratified sampling technique. Only 35% of the healthcare providers surveyed reported that they always asked patients about their smoking status. Less than half (44%) reported that they always advised smoking patients to quit. Respondents who had received training on smoking cessation interventions were 3.7 times more likely to have higher practice scores than those without training (OR = 3.66; 95%CI: 1.63-8.26; P = 0.003). Majority of the healthcare providers do not routinely provide smoking cessation interventions to their patients. Measures are needed to increase health worker's involvement in provision of smoking cessation care in Kenya.

Comparative functional exercise capacity of patients with type 2-diabetes and healthy controls: a case control study

Introduction

Functional Exercise Capacity (FEC) is a valid measure of physical fitness in health and disease. However, there is paucity of studies on FEC in African patients with Type-2 Diabetes (T2D). This study compared FEC between patients with T2D and healthy controls.

Methods

Thirty five patients with T2D (18 men, 17 women) and 35 (16 men, 19 women) age-sex matched healthy controls participated in this case-control study. Anthropometric and demographic characteristics and cardiovascular parameters were measured following standard procedures. A glucometer was used to determine the Fasting Blood Glucose (FBG) level following at least 8 hours of overnight fasting. FEC was assessed using the Six-Minute Walk Test (6MWT) while Hand Grip Strength (HGS) test was measured with an electronic dynamometer. Data were analyzed using descriptive and inferential statistics. Alpha level was set at p< 0.05.

Results

Patients with T2D and controls were similar in age (p > 0.05). There were significant differences in the distance covered during 6MWT between patients and controls (t= 0.329; p =0.03), exercise capacity (t = 0.329; p = 0.03), FBG (t = 7.403; p = 0.001), systolic and diastolic blood pressure (t = 12.56; p = 0.001 and t = 27.23; p = 0.001) respectively. There were significant inverse relationships between 6MWD and Body mass index (r = -0.39; p = 0.02) and FBS(r = -0.51; p = 0.02) in patients with type-2 respectively. No significant association was found between exercise capacity and HGS (p > 0.05).

Conclusion

Patients with type-2 diabetes demonstrated lower functional exercise capacity than healthy controls. High body mass index and fasting blood glucose were significantly associated with lower functional exercise capacity.

Sharing perspectives and experiences of doctoral fellows in the first cohort of Consortium for Advanced Research Training in Africa: 2011-2014

Background

Resolution of public health problems in Africa remains a challenge because of insufficient skilled human resource capacity. The Consortium for Advanced Research Training in Africa (CARTA) was established to enhance capacity in multi-disciplinary health research that will make a positive impact on population health in Africa.

Objective

The first cohort of the CARTA program describes their perspectives and experiences during the 4 years of fellowship and puts forward suggestions for future progress and direction of research in Africa.

Conclusions

The model of training as shown by the CARTA program is an effective model of research capacity building in African academic institutions. An expansion of the program is therefore warranted to reach out to more African academics in search of advanced research training.