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  • 1
    In: Progress in Cardiovascular Diseases, Elsevier BV, Vol. 63, No. 2 ( 2020-03), p. 149-159
    Type of Medium: Online Resource
    ISSN: 0033-0620
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2041627-1
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  • 2
    Online Resource
    Online Resource
    IPR Journals and Books (International Peer Reviewed Journals and Books) ; 2023
    In:  International Journal of Psychology Vol. 8, No. 2 ( 2023-04-13), p. 1-7
    In: International Journal of Psychology, IPR Journals and Books (International Peer Reviewed Journals and Books), Vol. 8, No. 2 ( 2023-04-13), p. 1-7
    Abstract: Purpose: The aim of this study was to explore the levels of non- adherence to tuberculosis treatment among TB patients in selected chest clinics in Mombasa County, Kenya. Methodology: The research adopted correlational design. The study was conducted in selected three chest clinics in Mombasa County. All tuberculosis patients diagnosed with active tuberculosis disease who are registered and collect their medicines from selected chest clinics in Mombasa County was the targeted population. Convenience sampling and simple random sampling was used. The sample size involved 200 TB patients. The research adopted questionnaire which consisted of both open ended and closed ended questions. The study adopted a questionnaire in collection of data. The questionnaire contained both open ended and close ended questionnaire. The researcher used descriptive statistics to help in organizing of data and it would also be helpful in summarizing of data for ease of making interpretations. Statistical Package for Social Science version 25 aided in data analysis. Frequency, percentages and moment was used in data analysis. Findings: Data analysis from this study that was summed and transformed into categories revealed 83% of the respondent’s experienced moderate non-adherence, 12.2% low non-adherence while 4.8% had high incidences of non-adherence. Unique Contribution to Theory, Practice and Policy: Rational Emotive Theory may be used to anchor future studies relating to levels of non-adherence to TB treatment among TB patients. In this study, anxiety over the Tb diagnosis would be the activating agent, patient belief about treatment and treatment course and Non-adherence the consequence of the irrational belief. The study recommended that there is need for patients to be empowered with information on the importance of adherence to TB treatment to mitigate incidences of treatment failure and multidrug resistant tuberculosis through health education using health practitioners.  
    Type of Medium: Online Resource
    ISSN: 2957-6881
    Language: Unknown
    Publisher: IPR Journals and Books (International Peer Reviewed Journals and Books)
    Publication Date: 2023
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  • 3
    In: BMC Pulmonary Medicine, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2022-01-05)
    Abstract: Chronic obstructive pulmonary disease (COPD) is a leading cause of global mortality. In high-income settings, the presence of cardiovascular disease among people with COPD increases mortality and complicates longitudinal disease management. An estimated 26 million people are living with COPD in sub-Saharan Africa, where risk factors for co-occurring pulmonary and cardiovascular disease may differ from high-income settings but remain uncharacterized. As non-communicable diseases have become the leading cause of death in sub-Saharan Africa, defining multimorbidity in this setting is critical to inform the required scale-up of existing healthcare infrastructure. Methods We measured lung function and carotid intima media thickness (cIMT) among participants in the UGANDAC Study. Study participants were over 40 years old and equally divided into people living with HIV (PLWH) and an age- and sex-similar, HIV-uninfected control population. We fit multivariable linear regression models to characterize the relationship between lung function (forced expiratory volume in one second, FEV 1 ) and pre-clinical atherosclerosis (cIMT), and evaluated for effect modification by age, sex, smoking history, HIV, and socioeconomic status. Results Of 265 participants, median age was 52 years, 125 (47%) were women, and 140 (53%) were PLWH. Most participants who met criteria for COPD were PLWH (13/17, 76%). Median cIMT was 0.67 mm (IQR: 0.60 to 0.74), which did not differ by HIV serostatus. In models adjusted for age, sex, socioeconomic status, smoking, and HIV, lower FEV 1 was associated with increased cIMT (β = 0.006 per 200 mL FEV 1 decrease; 95% CI 0.002 to 0.011, p  = 0.01). There was no evidence that age, sex, HIV serostatus, smoking, or socioeconomic status modified the relationship between FEV 1 and cIMT. Conclusions Impaired lung function was associated with increased cIMT, a measure of pre-clinical atherosclerosis, among adults with and without HIV in rural Uganda. Future work should explore how co-occurring lung and cardiovascular disease might share risk factors and contribute to health outcomes in sub-Saharan Africa.
    Type of Medium: Online Resource
    ISSN: 1471-2466
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2059871-3
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  • 4
    In: BMC Cardiovascular Disorders, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2022-12)
    Abstract: Left ventricular diastolic dysfunction (LVDD) is a recognized complication of diabetes mellitus that precedes and is a risk factor for heart failure. We aimed to determine the prevalence of LVDD and its association with body mass index in ambulatory adults with diabetes mellitus in rural Uganda. Methods We conducted a cross-sectional study, over 5 months, to enroll 195 ambulatory Ugandan adults living with diabetes mellitus for at least five years at Mbarara Regional Referral Hospital. We collected demographic, and clinical data and measured body mass index (BMI). Echocardiography was performed to determine LVDD by assessing the mitral inflow ventricular filling velocities (E/A and E/è ratios), tricuspid regurgitant jet peak velocity, and left atrium maximum volume index. We used logistic regression to estimate the odds ratio for the association of LVDD with BMI and evaluated the variation of associations by age and hypertension status. Results Of the 195 participants, 141 (72.31%) were female, the mean age was 62 [standard deviation, 11.50] years, and the median duration of diabetes diagnosis was 10 [interquartile range, 7, 15] years. Eighty-six percent (n = 168) had LVDD with the majority (n = 127, 65.1%) of participants in the grade 1 category of LVDD. In the adjusted model, the odds of LVDD for each 1 kg/m 2 increase in BMI was 1.11 [95% confidence interval 1.00, 1.25, p = 0.04]. The adjusted odds of LVDD among individuals aged ≥ 50 years with BMI ≥ 25 kg/m 2 was 13.82 times the odds of LVDD in individuals aged  〈  50 years with BMI  〈  25 kg/m 2 . Conclusion LVDD is prevalent and positively associated with BMI among ambulatory Ugandan adults living with diabetes mellitus for at least five years. The association was higher for older overweight/obese than younger individuals with normal weight. Future studies should focus on the effect of weight loss on LVDD as a possible target for the prevention of heart failure.
    Type of Medium: Online Resource
    ISSN: 1471-2261
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2059859-2
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  • 5
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 147, No. Suppl_1 ( 2023-02-28)
    Abstract: Introduction: Over the past 30 years, obesity prevalence has markedly increased in the United States, including tripling among children. Although numerous obesity genetic loci have been identified by genome-wide association studies (GWAS) in adults, less is known about the genetic architecture of early childhood obesity. Moreover, most childhood obesity GWAS have been restricted to severe obesity and primarily European ancestry populations. Hypothesis: We hypothesized that meta-analysis of GWAS of early childhood standardized body mass index z-scores (BMIz) from the ancestrally diverse ZOE 2.0 cohort, the Santiago Longitudinal Study (SLS), and two primarily European ancestry studies (Early Growth Genetics [EGG] Consortium and the Norwegian Mother and Child Cohort [MoBa] ) would identify novel early childhood BMI genetic loci. Methods: To identify genetic loci associated with early childhood BMI, we performed GWAS of BMIz in the ZOE 2.0 cohort, a community-based sample of children enrolled in public preschools in North Carolina (total n = 6,054 children, mean age 4 years, 48% African American [n=2891], 20% Hispanic [n=1214] , 18% White [n=1066], 2% American Indian/Alaska Native [n=146] , 12% other or more than one race [n=737]), and the SLS, a longitudinal cohort of children recruited from community clinics in Santiago, Chile (n = 861 children, mean age 5.5 years), using SAIGE and SUGEN, respectively. Genetic data were imputed to the TOPMed Freeze 8 (ZOE 2.0) and 1000 Genomes Phase III admixed American (SLS) reference panels. GWAS models were adjusted for self-reported race/ethnicity and 8 ancestry principal components (PCs) (ZOE 2.0), and 5 PCs (SLS). We performed inverse variance weighted fixed-effect meta-analysis of these results with previously published summary statistics of BMIz of children in the EGG Consortium (ages 2-10 years , all European participants) and the MoBa cohort (age 3 years, all European participants), for a total N of 63,747 individuals. Variants were filtered for minor allele frequency (MAF) 〉 0.01 and effective N 〉 20. Results: We identified 3 genome-wide significant ( p 〈 5 x 10 -8 ) loci ( PTBP2, LOC374295, DTWD2 on chromosomes 1, 2, and 5) that have not been previously associated with childhood obesity traits, although PTBP2 has also been associated with adult BMI. We also identified 3 genome-wide significant loci previously associated with body size at younger ages: birth weight ( LCORL , HMGA2 , chromosomes 4 and 12) or BMI at less than 8 months ( SH3GL3, chromosome 15). LCORL and HMGA2 have also been associated with adult obesity traits. Conclusions: Our findings are consistent with previous literature reporting age-specific genetic effects across early childhood as well as some shared genetic architecture with adult BMI. We are currently pursuing replication of novel findings in diverse populations, and mechanistically validating our novel signals.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 1466401-X
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  • 6
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation Vol. 142, No. Suppl_3 ( 2020-11-17)
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 142, No. Suppl_3 ( 2020-11-17)
    Abstract: Introduction: The usefulness of serial measurement of BNP to reduce hospitalization or mortality in patients with HIV and heartfailure is unknown. Hypothesis: We sought to describe changes in B-type natriuretic peptide (BNP) and estimate the effect of HIV on BNP over a week of observation in an acute heart failure cohort of 40 HIV-infected adults (≥18 years) on antiretroviral therapy (ART) and 175 HIV-uninfected hospitalized patients in Uganda. Methods: We measured BNP using i-STAT BNP (Abbott point of care, Princeton, New Jersey) and compared changes by HIV serostatus, and evaluated BNP as a predictor of all-cause mortality at 30 days from hospitalization using multilevel mixed and competitive risk regression models respectively. Results: Overall HIV-infected participants had a higher mean BNP than HIV-uninfected counterparts. After initial declines in BNP in both groups between day 0 and day 3, BNP moderately increased among the HIV-infected on day 7 and continued to decline in the HIV-uninfected group. Each 1 pg/mL increase in baseline BNP from 400 pg/mL increased the risk of all-cause mortality within 30 days by 1% (adjusted standardized hazard ratio (aSHR) 1.01, 95%CI 1.01, 1.01). Other predictors of increased 30-day all-cause mortality included smoking (aSHR 1.99, 95%CI 1.04, 3.84), hypotension (aSHR 1.69, 95%CI 1.26, 2.26) and renal failure stage 3 (aSHR 2.06, 95%CI 1.34, 3.18), and renal failure stage 5 (aSHR 2.02, 95%CI 1.30, 3.13). We found a lower risk of 30-day all-cause mortality of 38% (95%CI 20%, 73%) for those receiving loop diuretics and 74% (95%CI 56%, 99%) for antiplatelet agents. Conclusions: Over a week of observation, HIV-infected people hospitalized with acute heart failure in Uganda have higher BNP levels than HIV-uninfected counterparts. Increases in BNP above the upper bound of the normal predicted heightened risk of all-cause mortality within 30 days of hospitalization.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1466401-X
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  • 7
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 145, No. Suppl_1 ( 2022-03)
    Abstract: Introduction: Blood pressure (BP) is known to rise during developmental stages from childhood to adulthood, and that those with higher BP trajectories are more likely to develop hypertension and CVD. Yet, there is a paucity of studies that have evaluated trajectories of BP change or the genetic factors involved in the BP changes from childhood to adulthood. Epidemiological and genetic epidemiological studies of longitudinal BP changes through the life-course may enable a better understanding of the pathogenesis of hypertension and may lead to the identification of loci associated with BP trajectories and CVD risk during this critical period. Methods: We leverage multiple self-identified Hispanic/Latino populations with longitudinal BP and genomic data across the lifecourse, in particular between adolescence and young adulthood. We present herein preliminary results from the Santiago longitudinal study (SLS) that enrolled infants of Hispanic ancestry and measured BP at late adolescence (average age of 16 years) and early adulthood (average age of 22 years) to identify genetic variants associated with trajectories of BP traits (systolic BP, diastolic BP, mean arterial pressure and pulse pressure). We conducted a complete case analysis excluding participants taking antihypertensive medications and those whose BP measures were statistical outliers. Linear mixed models were used to assess the trajectories of individual BP traits between late adolescence and early adulthood (n = 1236), adjusting for age, sex and BMI. We assessed the relationship between residuals and genetic variants adjusting for two ancestral principal components using SUGEN software. Results: Males constituted 51% of the total SLS cohort. Interestingly, with each year increase in age, we observed downward trajectories of both mean systolic BP (-0.3 mmHg, 95% CI (-0.4, -0.2)) and mean diastolic BP (-0.1 mmHg, 95% CI (-0.2, -0.04)) adjusted for BMI and sex. We identified evidence for five known BP loci and two suggestive new signals. Our most significant finding is rs10894989 [beta (SE) = 6.57 (1.26), p =1.86x10 -7 , minor allele frequency (EAF = 0.94)] near the ARHGAP42 gene, an established locus for hypertension. However, this variant is not in linkage disequilibrium with the commonly reported SNP rs604723 (r 2 = 0.04). Ancestry-specific allele frequencies differed with rs604723 more common in East Asians and Europeans and rs10894989 commonest in Africans. Conclusion: Our longitudinal analyses of BP from late adolescence to early adulthood replicated BP loci and identified novel suggestive loci associated with BP trajectories supporting a need for further GWAS of longitudinal BP. We are currently conducting a meta-analysis of longitudinal BP trajectories in 3,000 young adults self-identified as Hispanic Latino in the Population Architecture using Genomics and Epidemiology (PAGE) study.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1466401-X
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  • 8
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 49, No. 12 ( 2018-12), p. 3063-3066
    Abstract: Rates of intracerebral hemorrhage (ICH) are estimated to be highest globally in sub-Saharan Africa. However, outcomes of ICH are poorly described and standard prognostic markers for ICH have not been validated in the region. Methods— We enrolled consecutive patients with computed tomography-confirmed ICH at a referral hospital in southwestern Uganda. We recorded demographic, clinical, and radiographic features of ICH, and calculated ICH scores. We fit Poisson regression models with robust variance estimation to determine predictors of case fatality at 30 days. Results— We enrolled 73 individuals presenting with computed tomography-confirmed ICH (mean age 60 years, 45% [33/73] female, and 14% [10/73] HIV-positive). The median ICH score was 2 (interquartile range, 1–3; range, 0–5). Case fatality at 30 days was 44% (32/73; 95% CI, 33%–57%). The 30-day case fatality increased with increasing ICH score of 0, 1, and 5 from 17%, 23%, to 100%, respectively. In multivariable-adjusted models, ICH score was associated with case fatality (adjusted relative risk, 1.48; 95% CI, 1.23–1.78), as were HIV infection (adjusted relative risk, 1.92; 95% CI, 1.07–3.43) and female sex (adjusted relative risk, 2.17; 95% CI, 1.32–3.59). The ICH score moderately improved with the addition of a point each for female sex and HIV serostatus (0.81 versus 0.73). Conclusions— ICH score at admission is a strong prognostic indicator of 30-day case fatality in Uganda. Our results support its role in guiding the care of patients presenting with ICH in the region.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 1467823-8
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  • 9
    In: Lung, Springer Science and Business Media LLC, Vol. 196, No. 1 ( 2018-2), p. 49-57
    Type of Medium: Online Resource
    ISSN: 0341-2040 , 1432-1750
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2018
    detail.hit.zdb_id: 1459394-4
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  • 10
    Online Resource
    Online Resource
    International Journal for Innovation Education and Research ; 2016
    In:  International Journal for Innovation Education and Research Vol. 4, No. 12 ( 2016-12-31), p. 23-39
    In: International Journal for Innovation Education and Research, International Journal for Innovation Education and Research, Vol. 4, No. 12 ( 2016-12-31), p. 23-39
    Abstract: Information and Communication Technology (ICT) has brought about profound changes in this 21st century era.ICT has changed the way people communicate and do business. In education, the role of ICT and whether or not it positively influences the learners’ attitudes to work and particularly in language (Kiswahili) has been a matter of much debate. Globally, Kiswahili is taught as a language in universities such as Harvard, Yale, Germany, Osaka-Japan, China, South Korea, South Africa, Ghana and Nigeria just to mention a few. Further, the African Union meetings recognize Kiswahili as one of the languages of communication. The use of ICT creates an environment which moves away from the traditional teacher-centered approaches that have been devoid of learner enjoyment and explorativeness which are important characteristics of effective and meaningful learning. ICT allows learners to create, collect, store, use knowledge and information; and it enables learners to connect with people and resources all over the world (Alberta Learning, 2000). The emphasis of teaching Kiswahili language in Kenya is becoming commonplace. The professional development of teachers on the use of ICT enables them develop and update themselves on the ever changing trends and techniques of integrating Educational Technology (ICT-based ) in teaching. The Ministry of Education in Kenya as in many countries in the world realized and accepted the importance of ICT in teaching. It was with this regard that New Partnership for Africa Development (NEPAD) a pilot project was started with an aim of trying to find out the possibility of realizing the dream of integrating ICT in teaching in secondary schools. However, like any new project, there is a possibility of certain challenges such as students’ attitudes and how to impart knowledge and skills which may first need to be addressed in order to guarantee full implementation and success of the project in Kenyan secondary schools. The presenters of this paper did a study of selected secondary schools in Kisii County Kenya. The purpose of the study was to investigate the professional preparedness of the Kiswahili teachers in integrating educational technology into the teaching of the language and establish challenges teachers face while trying to integrate technology into Kiswahili instructional process. The findings have important implications for the future integration of educational technology in the teaching of Kiswahili in Kenya. Will this dream come true? The presenters will share their findings and experience.
    Type of Medium: Online Resource
    ISSN: 2411-2933 , 2411-3123
    Language: Unknown
    Publisher: International Journal for Innovation Education and Research
    Publication Date: 2016
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