About
37
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Introduction
Additional affiliations
January 2005 - November 2007
Malindi District Hospital
Position
- Medical Doctor
Publications
Publications (37)
Globally, mental health problems have been reported to be more common in youth living with HIV (YLWH) than in the general population, but routine mental health screening is rarely done in high-volume HIV clinics. In 2019, YLWH in a large HIV clinic in Botswana were screened using the Generalized Anxiety Scale-7 (GAD-7) and Patient Health Questionna...
Background:
This case study describes and analyses an action research initiative undertaken by management, staff and WHO at the St. Orsola-Malpighi Polyclinic in Bologna, Italy. The initiative utilised staff engagement approaches developed during the COVID-19 pandemic to rethink and reshape future development plans. The initiative provides a 'how-...
The 2014–2016 West Africa Ebola Virus Disease (EVD) Epidemic devastated Guinea’s health system and constituted a public health emergency of international concern. Following the crisis, Guinea invested in the establishment of basic health system reforms and crucial legal instruments for strengthening national health security in line with the WHO’s r...
In countries with high human immunodeficiency virus (HIV) prevalence, up to 30% of pregnant women are living with HIV, with fetal exposure to both HIV and antiretroviral therapy during pregnancy. In addition, pregnant women without HIV but at high risk of HIV acquisition are increasingly receiving HIV preexposure antiretroviral prophylaxis (PrEP)....
In 2012, there were 2,454 cases and 1,676 deaths from cervical cancer in Kenya. Human Papilloma Virus (HPV) is responsible for 99% of all cervical cancers. National cervical cancer prevention guidelines recommend HPV vaccination among HPV-naïve pre-adolescent girls' prior to onset of sexual activity preferably through school-based interventions. Si...
Contact investigation is recommended for close contacts of TB patients to identify undiagnosed cases of active and latent TB to initiate them on curative and preventive therapy respectively. Because contact invitation is conducted in Kenya, the value of TB contact investigation in childhood TB control is unknown. To compare the yield of contact inv...
Contact investigation is recommended for close contacts of TB patients to identify undiagnosed cases of active and latent TB to initiate them on curative and preventive therapy respectively. Because contact invitation is conducted in Kenya, the value of TB contact investigation in childhood TB control is unknown. To compare the yield of contact inv...
Isoniazid Preventative Therapy (IPT) is recommended for children aged less than 5 years that have been in contact with an open case of TB, and screen negative for TB, to prevent the risk of TB progression. We examined IPT uptake among child household contacts of TB index cases, within a TB case detection study, in a high TB burden region. A cross-s...
Condom effectiveness is compromised by user errors. We set out to examine the rates of condom use and condom errors among sexually active persons living within a Health Demographic Surveillance this high HIV prevalence area in Western Kenya. We analyzed data from the second round of a longitudinal bio-behavioral survey that was conducted in Gem, Si...
Background: Physical intimate partner violence (IPV) is an important risk factor for sexually transmitted infections, including HIV. We set out to determine the prevalence and correlates of IPV among youth aged 15 to 24 years – in a community with a high HIV prevalence – with a view to recommending strategies to address IPV. Methods: We analysed da...
Background:
Physical intimate partner violence (IPV) is an important risk factor for sexually transmitted infections, including HIV. We set out to determine the prevalence and correlates of IPV among youth aged 15 to 24 years - in a community with a high HIV prevalence - with a view to recommending strategies to address IPV.
Methods:
We analysed...
Background Isoniazid Preventative Therapy (IPT) is recommended for children aged less than 5 years that have been in contact with an open case of TB and screen negative for TB to prevent the risk of TB progression. We examined IPT uptake among child household contacts of TB index cases within a TB case detection study in a high TB burden region.
M...
Background
Postexposure prophylaxis (PEP) with antiretroviral therapy (ART) and vaccination against hepatitis B virus (HBV) aides in preventing human immunodeficiency virus (HIV) infection and HBV, respectively, from accidental or occupational exposure. We assessed compliance to guidelines for HIV and HBV prevention after occupational exposure amon...
Background
The former Nyanza Province of Kenya bore the brunt of HIV-driven tuberculosis (TB); 62% of the 19,152 cases in 2010 were HIV co-infected. The use of laypersons to improve TB case finding in community settings has shown rewarding results in other countries. We have no documented Kenyan experience in health facility settings. We evaluated...
Background
Persons in close proximity with Tuberculosis (TB) patients are at risk of TB infection. Contact investigation (CI) has not been scaled up to full implementation by the National Tuberculosis Program in Kenya. As part of a TB household CI study, we documented key concerns that the TB program in Kenya need to consider when transitioning fro...
Background:
The delivery of public health policies may be in conflict with individualism.
Objectives:
To propose measures to ethically provide routine HIV testing services to persons visiting a funeral home.
Research design:
A document analysis of study documents and presentations made to an institutional review board. Participants and researc...
Background
An optimal number of health workers, who are appropriately allocated across different occupations and geographical regions, are required to ensure population coverage of health interventions. Health worker shortages in HIV care provision are highest in areas that are worst hit by the HIV epidemic. Kenya is listed among countries that exp...
Background and objectives: The emerging resistance of Candida species to antifungals routinely used to treat candidiasis in HIV patients and in patients with diabetes mellitus (DM) has resulted in the frequent isolation of non-albicans Candida species. This study aimed to establish the prevalence and fluconazole resistance profiles of yeasts other...
Objective
To assess the performance of symptom-based screening for tuberculosis (TB), alone and with chest radiography among people living with HIV (PLHIV), including pregnant women, in Western Kenya.
Design
Prospective cohort study
Methods
PLHIV from 15 randomly-selected HIV clinics were screened with three clinical algorithms [World Health Orga...
Estimating causal inferences in observational studies with time varying covariates require methods that can address complexities such as non-random allocation of patients' to treatment groups, possible censoring of, exposure variables e.g., time to antiretroviral therapy (ART) initiation, and outcome variables e.g., mortality. Marginal Structural C...
The quantification of CD4 T-lymphocytes, an important marker of HIV disease progression, signals initiation of or regulation of antiretroviral therapy. The study assessed the accuracy of CD4 tests results generated at five public health laboratories in Kisumu County-Kenya. Samples from HIV positive patients that had been tested for CD4 at five high...
Funeral homes in health facilities are accessed by persons who may not visit other parts of the hospital to access HTC services. Between November 2014 and February 2015, all persons visiting the Jaramogi Oginga Odinga Teaching and Referral Hospital funeral home were offered HTC and grief counseling services and interviewed to determine the acceptab...
Background:
Diagnosis followed by effective treatment of tuberculosis (TB) reduces transmission and saves lives in persons living with HIV (PLHIV). Sputum smear microscopy is widely used for diagnosis, despite limited sensitivity in PLHIV. Evidence is needed to determine the optimal diagnostic approach for these patients.
Methods:
From May 2011...
Setting:
Fifteen human immunodeficiency virus (HIV) clinics in Nyanza Region, Western Kenya.
Objective:
To describe routine tuberculosis (TB) screening and diagnostic practices among newly enrolled people living with HIV (PLHIV) prior to the implementation of World Health Organization recommended TB intensified case finding.
Design:
Retrospect...
This retrospective cohort analysis was conducted to describe the association between adherence to clinic appointments and mortality, one year after enrollment into HIV care. We examined appointment-adherence for newly enrolled patients between January 2011 and December 2012 at a regional referral hospital in western Kenya. The outcomes of interest...
Females in low and middle income countries (LMICs) have difficulty coping with menstrual needs, but few studies have examined the social or health implications of these needs.
Responses from 3418 menstruating females aged 13-29 years were extracted from an HIV and behavioral risks cross-sectional survey conducted in rural western Kenya. We examined...
