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  • 1
    In: Molecular Medicine, Springer Science and Business Media LLC, Vol. 14, No. 3-4 ( 2008-3), p. 89-97
    Type of Medium: Online Resource
    ISSN: 1076-1551 , 1528-3658
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2008
    detail.hit.zdb_id: 1475577-4
    detail.hit.zdb_id: 1283676-X
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  • 2
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2020-12)
    Abstract: Hypertension is the leading risk factor for mortality globally. African countries, including Kenya, have a high and rising prevalence of hypertension. Prehypertension is associated with an increased risk of progression to overt hypertension and a higher risk of cardiovascular disease and mortality. Despite this, little is documented on the prevalence and distribution of prehypertension in sub-Saharan Africa. This study sought to estimate the overall burden of prehypertension in Kenyan adults enrolled in a large hypertension control programme, Healthy Heart Africa. The distribution and determinants of prehypertension in the sample were explored as secondary objectives. Methods This was a post hoc analysis of cross-sectional data obtained from population-level blood pressure (BP) screening of adults aged ≥18 years in the community and ambulatory care facilities in 17/47 sub-national administrative units in Kenya. All participants with a complete record for systolic and diastolic BP were included. Descriptive analyses were performed for sociodemographic characteristics. Pearson’s chi-square test was used to assess differences in categorical variables. Multivariate logistic regression analysis was performed to identify factors independently associated with prehypertension. Results Of 5,985,185 participant records that were included in the analysis, 34% were men (mean age: 45 [SD 2.9] years). The majority (63%) lived in rural Kenya. The prevalence of prehypertension was 54.5% and that of hypertension was 20.8%. Characteristics that were independently associated with prehypertension (adjusted odds ratio [95% CI] ) included male sex (1.23 [±0.0023], p   〈   0.001 for all age groups 〉  25 years) and rural residence (1.60 [±0.023], p   〈   0.001). Conclusions Approximately one in every two Kenyan adults has prehypertension. This calls for urgent development and roll-out of a national BP screening and control programme. It also provides a strong basis for the formulation of multisectoral national policies that will ensure implementation of evidence-based, low-cost public health interventions geared towards primary prevention of hypertension, especially in population groups that are traditionally considered at low risk, such as young adults and rural residents.
    Type of Medium: Online Resource
    ISSN: 1471-2458
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2041338-5
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  • 3
    Online Resource
    Online Resource
    International Scientific Invention Journals ; 2021
    In:  International Journal of Innovative Research in Medical Science Vol. 6, No. 01 ( 2021-01-01), p. 1-12
    In: International Journal of Innovative Research in Medical Science, International Scientific Invention Journals, Vol. 6, No. 01 ( 2021-01-01), p. 1-12
    Abstract: Background: Differentiated service delivery, a model fashioned to address the specific requirements of the continuum of HIV prevention, care and treatment for a sub-type of clients, was rolled out in Kenya in 2016. Objective: The aim of the study was to determine patient knowledge, experience and preference towards differentiated service delivery for the category of patients who had completed a year of HIV treatment and were considered to be doing well and enrolled in differentiated services in facilities implementing the model in Kiambu County. Method: The study used mixed method descriptive cross-sectional survey to identify the determinants of satisfaction among stable HIV positive patients enrolled in differentiated service delivery. In the qualitative arm, a structured questionnaire was administered to 404 participants across six health care facilities who were HIV positive male or female patients above 20 years had been enrolled in differentiated service delivery. Analysis for quantitative data was two pronged; exploratory analysis to get preliminary patterns followed by inferential statistics to analyse relationship between variables of interest. Qualitative data was collected concurrently through Focused Group Discussions (FGDs) randomly selected from the same pool of patients involved in quantitative arm. On completion, triangulation was done to identify prevailing themes in qualitative and significant values in quantitative data. Results: High levels of patient satisfaction were reported. 99% of participants reported being either satisfied (45%) or being Very satisfied (54%) n=404. Knowledge in HIV condition and treatment, Knowledge of differentiated services, waiting time, savings in time and cost as well as health care worker respect had the strongest associations to satisfaction with differentiated services. Conclusion: Patients enrolled in differentiated service are satisfied with the services offered under the model.
    Type of Medium: Online Resource
    ISSN: 2455-8737
    Language: Unknown
    Publisher: International Scientific Invention Journals
    Publication Date: 2021
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  • 4
    Online Resource
    Online Resource
    AOSIS ; 2016
    In:  African Journal of Laboratory Medicine Vol. 5, No. 2 ( 2016-10-12)
    In: African Journal of Laboratory Medicine, AOSIS, Vol. 5, No. 2 ( 2016-10-12)
    Abstract: No abtract available.
    Type of Medium: Online Resource
    ISSN: 2225-2010 , 2225-2002
    Language: Unknown
    Publisher: AOSIS
    Publication Date: 2016
    detail.hit.zdb_id: 2708535-1
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  • 5
    In: Tropical Medicine & International Health, Wiley, Vol. 28, No. 2 ( 2023-02), p. 126-135
    Abstract: Achievement of ISO15189 accreditation demonstrates competency of a laboratory to conduct testing. Three programmes were developed to facilitate achievement of accreditation in low‐ and middle‐income countries: Strengthening Laboratory Management Towards Accreditation (SLMTA), Stepwise Laboratory Improvement Process Towards Accreditation (SLIPTA) and Laboratory Quality Stepwise Implementation (LQSI). Objective To determine the level of accreditation and associated barriers and facilitators among medical laboratories in the WHO‐AFRO region by 2020. Methods A desk review of SLIPTA and SLMTA databases was conducted to identify ISO15189‐accredited medical laboratories between January 2013 and December 2020. Data on access to the LQSI tool were extracted from the WHO database. Facility and country characteristics were collected for analysis as possible enablers of accreditation. The chi‐square test was used to analyse differences with level of significance set at 〈 0.05. Results A total of 668 laboratories achieved accreditation by 2020 representing a 75% increase from the number in 2013. Accredited laboratories were mainly in South Africa ( n  = 396; 55%) and Kenya ( n  = 106; 16%), two countries with national accreditation bodies. About 16.9% ( n  = 113) of the accredited laboratories were registered for the SLIPTA programme and 26.6% ( n  = 178) for SLMTA. Approximately 58,217 LQSI users were registered by December 2020. Countries with a higher UHC index for access to HIV care and treatment, higher WHO JEE scores for laboratory networks, a larger number of registered LQSI users, with national laboratory policy/strategic plans and PEPFAR‐priority countries were more likely to have an accredited laboratory. Of the 475 laboratories engaged in the SLIPTA programme, 154 attained ≥4 SLIPTA stars (ready to apply for accreditation) and 113 achieved ISO 15189 accreditation, with 96 enrolled into the SLMTA programme. Lower‐tier laboratories were less likely to achieve accreditation than higher‐tier laboratories (7.7% vs. 30%) ( p   〈  0.001). The probability of achieving ISO 15189 accreditation (19%) was highest during the first 24 months after enrolment into the SLIPTA programme. Conclusion To sustainably anchor quality improvement initiatives at facility level, national approaches including access to a national accreditation authority, adoption of national quality standards and regulatory frameworks are required.
    Type of Medium: Online Resource
    ISSN: 1360-2276 , 1365-3156
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2018112-7
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  • 6
    In: Malaria Journal, Springer Science and Business Media LLC, Vol. 9, No. S2 ( 2010-12)
    Type of Medium: Online Resource
    ISSN: 1475-2875
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2010
    detail.hit.zdb_id: 2091229-8
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  • 7
    Online Resource
    Online Resource
    The Royal Society ; 2023
    In:  Royal Society Open Science Vol. 10, No. 8 ( 2023-08)
    In: Royal Society Open Science, The Royal Society, Vol. 10, No. 8 ( 2023-08)
    Abstract: In this paper, performance of hurdle models in rare events data is improved by modifying their binary component. The rare-event weighted logistic regression model is adopted in place of logistic regression to deal with class imbalance due to rare events. Poisson Hurdle Rare Event Weighted Logistic Regression (REWLR) and Negative Binomial Hurdle (NBH) REWLR are developed as two-part models which use the REWLR model to estimate the probability of a positive count and a Poisson or NB zero-truncated count model to estimate non-zero counts. This research aimed to develop and assess the performance of the Poisson and Negative Binomial (NB) Hurdle Rare Event Weighted Logistic Regression (REWLR) models, applied to simulated data with various degrees of zero inflation and to Nairobi county’s maternal mortality data. The study data on maternal mortality were pulled from JPHES. The data contain the number of maternal deaths, which is the outcome variable, and other obstetric and demographic factors recorded in MNCH facilities in Nairobi between October 2021 and January 2022. The models were also fit and evaluated based on simulated data with varying degrees of zero inflation. The obtained results are numerically validated and then discussed from both the mathematical and the maternal mortality perspective. Numerical simulations are also presented to give a more complete representation of the model dynamics. Results obtained suggest that NB Hurdle REWLR is the best performing model for zero inflated count data due to rare events.
    Type of Medium: Online Resource
    ISSN: 2054-5703
    Language: English
    Publisher: The Royal Society
    Publication Date: 2023
    detail.hit.zdb_id: 2787755-3
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  • 8
    Online Resource
    Online Resource
    Lifescience Global ; 2022
    In:  International Journal of Statistics in Medical Research Vol. 11 ( 2022-10-14), p. 97-104
    In: International Journal of Statistics in Medical Research, Lifescience Global, Vol. 11 ( 2022-10-14), p. 97-104
    Abstract: In the recent past, both non-parametric and parametric approaches have consistently been used to model cost effectiveness in a variety of health applications. This study applies the semi-Markov model while presenting the sojourn time with well-defined probability distributions. We employed the Weibull distribution to model the hazard function for each of the defined transition paths. We defined three distinct states of the semi-Markov process using the quantity of HIV virus in the blood of an HIV-infected person i.e., viral load (VL) copies in a milliliter (copies/mL). The three states were defined; VL 〈 200 copies/mL, 200 copies/mL 〈 VL 〈 1,000 copies/mL, VL 〉 1,000 copies/mL and an absorbing state which is naturally death. We also developed a cumulative cost function, purposely to determine the average estimated cost per patient in each of the defined states. Incremental Cost Effectiveness Ratio (ICER) was utilized in the analysis of cost-effectiveness while comparing two program strategies i.e., Patients under the differentiated care model (DCM) and those who are not considered to be in any model of differentiated care during their respective ongoing clinical follow up. Results show the mean cost of the patients for each state 1, 2, and 3 was $765, $ 829, and $ 1,395 respectively. More so, the computed ICER ratio was $ 484/life-year-saved. In conclusion, the cost of keeping patients in state 1 (on DCM) was relatively cheaper and more efficient compared to the other states.
    Type of Medium: Online Resource
    ISSN: 1929-6029
    Language: Unknown
    Publisher: Lifescience Global
    Publication Date: 2022
    detail.hit.zdb_id: 2810580-1
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  • 9
    Online Resource
    Online Resource
    Scientific Research Publishing, Inc. ; 2020
    In:  Open Journal of Statistics Vol. 10, No. 02 ( 2020), p. 274-302
    In: Open Journal of Statistics, Scientific Research Publishing, Inc., Vol. 10, No. 02 ( 2020), p. 274-302
    Type of Medium: Online Resource
    ISSN: 2161-718X , 2161-7198
    Language: Unknown
    Publisher: Scientific Research Publishing, Inc.
    Publication Date: 2020
    detail.hit.zdb_id: 2680845-6
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  • 10
    In: African Journal of Laboratory Medicine, AOSIS, Vol. 10, No. 1 ( 2021-06-17)
    Type of Medium: Online Resource
    ISSN: 2225-2010 , 2225-2002
    Language: English
    Publisher: AOSIS
    Publication Date: 2021
    detail.hit.zdb_id: 2708535-1
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