http://ir.mu.ac.ke:8080/jspui/handle/123456789/4496 2026-07-14T03:33:20Z 2026-07-14T03:33:20Z Hagembe, Mildred N Barasa, FA Njiru EW1, EW http://ir.mu.ac.ke:8080/jspui/handle/123456789/10231 2026-06-19T10:05:41Z 2018-09-01T00:00:00Z

Title: Burden of Cardiac Disease among Patients Undergoing Chronic Haemodialysis at Moi Teaching and Referral Hospital, Eldoret, Kenya Authors: Hagembe, Mildred N; Barasa, FA; Njiru EW1, EW Abstract: Cardiovascular Disease (CVD) is the leading cause of mortality in patients with End Stage Renal Disease (ESRD) globally. Renal replacement therapy improves the quality of life of these patients but CVD remains a threat to their survival. Whereas atherosclerotic coronary artery disease is the leading culprit in high income countries, this has not been characterized in Kenya. Objective: To determine the prevalence and spectrum of cardiac disease in patients with ESRD undergoing haemodialysis at Moi Teaching and Referral Hospital (MTRH), a tertiary medical centre in Western Kenya. Methods: This was a cross sectional study conducted at MTRH renal unit. Consenting consecutive adults with ESRD undergoing chronic heamodialysis were enrolled into the study after obtaining ethical approval from the institution’s review board. Data on socio demographics, medical and drug history was collected using a structured questionnaire followed by a focused cardiovascular examination. A standard trans-thoracic echocardiogram was done by a study dedicated sonographer and interpreted by a cardiologist using American Society of Echocardiography guidelines. A standard 12 lead resting ECG was also done and read by the same cardiologist. Outcomes of interest included Left Ventricular Hypertrophy (LVH), Left Ventricular Ejection Fraction (LVEF), pathological valve disease, pathological Q waves and arrhythmias. The prevalence estimates were reported with the corresponding 95% confidence intervals. Results: Seventy two participants were included in the final analysis. Their median age was 41 (29.8, 60) years and 51.3% were male. Majority (93%) were on two sessions of dialysis per week, with 97.2% being known hypertensives. Almost three quarters of them (72.2%) had some form of cardiac disease as follows; left ventricular hypertrophy 58%, left ventricular systolic dysfunction 49%, pathological valvular disease 15.3%, arrhythmias 9.7% and pathological Q waves 6.9%. Conclusion: There is a high burden of cardiac disease in patients with ESRD on heamodialysis at MTRH with the predominant lesions being LVH and left ventricular systolic dysfunction.

2018-09-01T00:00:00Z KIRUIa, Nicholas KAMANO, Jemimah SAVAI, Simon MISOI, Lawrence RONO, Steven WERE, Martin C. http://ir.mu.ac.ke:8080/jspui/handle/123456789/10230 2026-06-19T09:33:46Z 2024-01-01T00:00:00Z

Title: Patient-Specific Mobile Phone-Generated Reminders and Quality of Hypertension Care in Western Kenya Authors: KIRUIa, Nicholas; KAMANO, Jemimah; SAVAI, Simon; MISOI, Lawrence; RONO, Steven; WERE, Martin C. Abstract: To evaluate the impact of clinician-targeted mHealth-generated care suggestions on compliance with hypertension care guidelines in a resource-limited setting. This study was conducted in 10 rural health clinics in Western Kenya that offered hypertension care through nurses and clinical officers. Sites were grouped into intervention and control groups. Intervention group clinicians had patientspecific care suggestions triggered and displayed on a mobile application, mUzima, for their action. Care suggestions were also triggered in the mHealth application for control arm clinicians but were not displayed. Differences in compliance with hypertension care guidelines were evaluated. The study involved 378 patients with hypertension who had care suggestions generated during visits (217 in intervention group and 161 in control group). There was a higher proportion of adherence to hypertension care guidelines in the intervention group compared to the control group (91.1% vs. 85.7%, p=0.014). The random effects model showed significant variability in compliance rates among study clinicians (variance of 0.44, 95% CI: 0.12 -1.62). When displayed care suggestions were rejected by intervention providers, the most common reason given was ‘Previously ordered’ (58.8%). Clinicians felt that care suggestions improved awareness of hypertension care guidelines. The successful scaled implementation of mUzima with patient specific care suggestions led to higher adherence to hypertension care guidelines and improved quality of hypertension care. Tailormade m-Health applications in resource constrained settings for hypertension care and other chronic noncommunicable diseases has the potential to lead to better adherence to care guidelines and quality of care.

2024-01-01T00:00:00Z