School of Medicine

Ethics in Biobanking: A collaborative article regarding The ethics of research involving biobanking specimens from Kenyan adolescents (published in 2026) discusses human-centered design for consent in pediatric genomics.

2026-05-22T06:17:42Z

Ethics in Biobanking: A collaborative article regarding The ethics of research involving biobanking specimens from Kenyan adolescents (published in 2026) discusses human-centered design for consent in pediatric genomics. Teresa Lotodo, Tyler, Severance; Serem, Enock; Njuguna, Festus; Melly, Beatrice; Orido, Millicent; Tonui, Ronald; Olbara, Gilbert; Koima, Raphael; Kigen, Nicholas; Kussick, Steven; Ratliff, Vicki; Holl, Eda; Monahan, Patrick O; Boova, Tony; Vik, Terry Introduction Each year, an estimated 1700 children should be diagnosed with cancer in western Kenya, with leukaemia making up nearly one-third of cases. However, far fewer are actually diagnosed, highlighting significant delays or errors in diagnosis. Flow cytometry, which the WHO considers essential for leukaemia diagnosis, remains underused across sub-Saharan Africa due to high costs, outdated equipment and a lack of trained personnel. In Kenya, decades-old cytometers have been adapted for leukaemia detection, but these systems are now outdated. Newer platforms, such as simplified single-tube multiparametric assays, provide a scalable and sustainable alternative. This study presents a protocol to evaluate the accuracy of diagnosis and the potential for implementing a streamlined flow cytometry assay using peripheral blood, supported by a regional educational initiative. Methods and analysis This prospective, mixed-methods implementation study has three aims: (1) to assess the concordance between the Beckman Coulter ClearLLab 10C gold standard 4-tube assay and the streamlined ClearLLab LS 1-tube assay using paired bone marrow and peripheral blood samples; (2) to evaluate the feasibility of peripheral facility referrals and transport logistics with couriered peripheral blood samples from referring sites across western Kenya; and (3) to measure training effectiveness and knowledge gain through a multimodal educational programme using the Project ECHO (Extension for Community Healthcare Outcomes) model. Up to 300 patients at Moi Teaching and Referral Hospital in Eldoret, Kenya, will be enrolled in Aim 1. A separate sample of 100 patients from peripheral facilities will be included in Aim 2. Surveys, knowledge assessments and structured interviews will be used to evaluate training impact under Aim 3. Diagnostic concordance, sensitivity, specificity and knowledge gain will be measured through appropriate quantitative and qualitative methods. Ethics and dissemination The protocol has received approval from institutional ethics committees at Moi University, MTRH and Indiana University. De-identified data will be analysed and shared through peer-reviewed publications, stakeholder presentations and educational platforms.

Ulienda wapi: Long-term follow-up of past participants of North American and European rotations from Moi University School of Medicine, Kenya

2026-05-21T08:48:58Z

Ulienda wapi: Long-term follow-up of past participants of North American and European rotations from Moi University School of Medicine, Kenya Huskins , J. Owiti P ,Wambui C , Stone G ,Umoren R. , Helphinstine J., Litzelman D. K , Mining S , Ayuo P , Gardner ;

A pilot randomized controlled trial to explore the feasibility of a peer-delivered single-session brief intervention for youth with moderate risk substance use

2026-03-30T07:13:11Z

A pilot randomized controlled trial to explore the feasibility of a peer-delivered single-session brief intervention for youth with moderate risk substance use Jaguga, Florence; Turissini, Matthew; Kamaru Kwobah, Edith; Apondi, Edith; A. Enane, Leslie; Barasa, Julius; Kosgei, Gilliane; Olando, Yvonne; A. Ott, Mary; Kimaina, Allan; C. Aalsma, Matthew Background Youth in sub-Saharan Africa are at high risk of substance use yet lack access to appropriate interventions. The goal of this project was to evaluate the feasibility of a definitive trial to explore efficacy of a peer-delivered single-session brief intervention (SSBI) for youth with substance use in Kenya. Methods Seventy youth aged 15−24 years with moderate risk substance use were randomized to SSBI or to psychoeducation. Data was collected at baseline and month three. Pri- mary outcomes: Feasibility criteria, e.g., study participation rate, proportion of partici- pants willing to be randomized, and study completion rate. Strategies for recruitment in a future trial were collected using focus group discussions with the youth at month three. Secondary outcomes: (i) Change in substance use (Alcohol, Smoking & Sub- stance Use Involvement Screening Test for Youth [ASSIST-Y] questionnaire), depres- sion (Patient Health Questionnaire [PHQ-9]), anxiety (Generalized Anxiety Disorder [GAD-7 scale]), and quality of life (World Health Organization-Quality of Life BriefVersion [WHO-QOL BREF]) scores between baseline and month 3; (ii) Fidelity to the intervention assessed using fidelity checklists. Results This pilot met most of the predefined minimum requirements for feasibility. For instance, 96.9% of those meeting eligibility criteria consented to participate (bench- mark was 80%), and 100% of those who consented were willing to be randomized to either study arm. Youth reported that young people who use substances can be most effectively recruited from community settings. The SSBI showed a small effect on reducing total ASSIST-Y (Standardized Mean Difference [SMD] −0.33 95% Con- fidence Interval [CI] −0.83,0.16) scores in the intervention group compared to the control. There was a moderate improvement in the quality of life for the intervention group compared to the control (SMD −0.41 CI −0.91,0.09). The intervention had no effect on depression (SMD 0.23 CI −0.27,0.72) and anxiety symptoms (SMD 0.70 CI 0.19,1.2) at month 3. Conclusion It is feasible to conduct a randomized controlled trial of a peer-delivered SSBI for youth with moderate risk substance use in Kenya.

Pregnancy outcomes among women with and without HIV infections who underwent excisional treatment for high-grade cervical intraepithelial neoplasia: a retrospective cohort study in low-resource settings

2026-03-30T06:49:57Z

Pregnancy outcomes among women with and without HIV infections who underwent excisional treatment for high-grade cervical intraepithelial neoplasia: a retrospective cohort study in low-resource settings Amubuomombe, Poli Philippe; Itsura, Peter; K Tonui, Philiph; Omenge Orang’o, Elkanah; Elly Odongo, Benjamin; Joseph Loehrer, Patrick; Cu-Uvin, Susan Objective The standard treatment for high-grade squamous intraepithelial lesions is excisional involving the uterine cervix, while surveillance is an acceptable approach for low-grade squamous intraepithelial lesions. There is controversy about excisional treatment on pregnancy outcomes. The objective of this study was to determine pregnancy outcomes in women living with and without HIV who underwent excisional treatment for high- grade cervical intraepithelial lesions. Design This retrospective cohort study compared the pregnancy outcomes of women with and without HIV who were or were not treated for cervical intraepithelial lesions. A cohort of 488 women with and without HIV infection who did or did not receive excisional treatment for cervical intraepithelial lesions between 2009 and 2022 was enrolled. Adverse pregnancy outcomes (preterm delivery and pregnancy loss) in women with and without HIV, untreated or treated for cervical dysplasia, were recorded and analysed. The significance of the obtained results was judged at the 5% level. Study settings The study was conducted at all Academic Model Providing Access to Healthcare-Kenya satellite sites, which offer cervical cancer screening and treatment for cervical dysplasia in western Kenya. The Moi Teaching and Referral Hospital was also included. Participants A cohort of 488 women aged between 20 years and 49 years, with and without HIV, diagnosed and treated for high-grade cervical intraepithelial neoplasia, and those followed up for low-grade cervical intraepithelial neoplasia between 2009 and 2022, were included. Outcomes measured The study was interested in adverse pregnancy outcomes, particularly pregnancy loss and preterm delivery following cervical excision treatment for high-grade cervical intraepithelial lesions. Results After adjustment for confounding factors, excisional treatment involving the uterine cervix— particularly cold knife conisation—was associated with higher odds of adverse pregnancy outcomes (OR 13.1; 95% CI 1.1 to 137.1; p=0.032). A prior history of adverse pregnancy outcomes was also strongly associated with subsequent adverse outcomes after treatment (OR 37.7; 95% CI 13.8 to 102.7; p<0.001). In contrast, maternal HIV infection was not independently associated with adverse pregnancy outcomes after adjustment (p=0.125). Conclusion Adverse pregnancy outcomes after excisional treatment of the uterine cervix for high-grade squamous intraepithelial lesions are multifactorial and were associated with cold knife conisation and prior adverse pregnancy outcomes, while maternal HIV infection was not independently associated with adverse outcomes.