http://ir.mu.ac.ke:8080/jspui/handle/123456789/5 2026-10-04T17:12:15Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10515 Prevalence and determinants of undiagnosed diabetes mellitus among patients presenting for elective surgery at Moi Teaching and Referral Hospital, Eldoret Kenya Kimetto, Joan Background: Diabetes mellitus (DM) is a group of metabolic disorders characterized by chronic hyperglycemia due to defects in insulin secretion, action, or both. The International Diabetes Federation estimates that over 10.5% of adults aged 20–79 years globally have diabetes, with half undiagnosed. In Kenya, the true prevalence is unclear, and the reported 3% likely underestimates the burden. Routine diabetes screening is uncommon, particularly among elective surgical patients. Known risk factors include age, overweight/obesity, physical inactivity, poor diet, family history, and comorbidities such as hypertension and dyslipidaemia. However, local evidence on these determinants remains limited, underscoring the need to assess undiagnosed diabetes among elective surgical patients. Objective: To determine the prevalence of undiagnosed DM and describe the social, demographic, economic, lifestyle and clinical factors associated with undiagnosed DM among patients presenting for elective surgery at Moi Teaching and Referral Hospital (MTRH). Methods: This was a descriptive cross-sectional study conducted in four surgical wards of MTRH (Kilimanjaro, Longonot, Rehema, and Sergoit). A total of 540 adult patients (≥18 years) admitted for elective surgery with unknown diabetes status were recruited through consecutive sampling. Data was collected using a structured questionnaire and clinical measurements, including fasting plasma glucose. Undiagnosed diabetes mellitus was defined as fasting plasma glucose ≥7.0 mmol/L with no prior history of diabetes. Ethical approval was obtained from the Institutional Research and Ethics Committee (IREC) of Moi University/MTRH, and permission to undertake the study was granted by hospital management. Written informed consent was obtained from all participants. Data were analyzed using SPSS version 20. Descriptive statistics were used to summarize variables as frequencies and percentages (n, %). Associations were assessed using binary logistic regression, with results presented as odds ratios (OR) and 95% confidence intervals (CI). Statistical significance was set at p<0.05. Results: The prevalence of undiagnosed DM among patients presenting for elective surgery in MTRH was 3.5%. The highest prevalence was found in the age group 36-55 years, with a rate of 6.3%. Single individuals exhibited a significantly higher likelihood of undiagnosed DM (p-value of 0.029). Additionally, business persons and those employed portrayed a higher likelihood of undiagnosed DM with statistically significant associations (p-values of 0.04, 0.01 and 0.02 respectively). Although clinical, lifestyle and dietary factors were found to be associated with the undiagnosed DM, these relationships were not statistically significant. Conclusion: There is a higher proportion of persons with undiagnosed diabetes among those presenting for elective surgery at MTRH compared to the general population. Among those presenting for elective surgery, the middle-aged, and employed are at a higher risk of undiagnosed diabetes. Recommendations: Routine screening is recommended in all adults undergoing elective surgery at the Moi Teaching and Referral Hospital and similar healthcare facilities to enable early detection and appropriate management of undiagnosed diabetes. The Ministry of Health Kenya should incorporate opportunistic diabetes screening into national guidelines and strengthen implementation across hospital settings 2026-01-01T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10454 Factors associated with the uptake of assisted partner notification services among newly diagnosed HIV-positive adults on care in Ndhiwa Sub-County; Homa Bay County, Kenya Masila, Hellen Mulalya Background: With over 38 million people living with HIV worldwide, the virus continues to be a serious public health challenge. Kenya and other countries continue to carry the greatest burden of HIV, with almost 67% of incidences. Homa Bay County has an HIV prevalence of 19.6% and recorded 5,643 new HIV infections in 2022. Ndhiwa sub-County reported 892 new cases, the highest among all sub-counties in the county. Objectives: To determine what percentage of newly diagnosed HIV-positive people receiving treatment informed their sexual partners through assisted partner notification services (aPNS), determine the preferred method of referral and describe the factors that influence the uptake of aPNS. Methods: A cross-sectional study was conducted among newly diagnosed HIV clients enrolled in HIV care and treatment services in Ndhiwa Sub-County. Using systematic sampling, a total of 254 participants were selected from the sampled health facilities. Data was collected through semi-structured questionnaires. The analysis of continuous variables was done using measures of central tendency and dispersion, whereas categorical variables were presented using frequencies and percentages. Associations between independent variables and the uptake of aPNS were assessed using crude odds ratios (cOR) with 95% confidence intervals (CI). Variables with a p- value <0.05 were considered statistically significant Results: Of the 254 participants in the study, 63.4% were female. The proportion of index clients who disclosed their HIV status to their sexual partners was 78.7%. The provider referral method was preferred by the majority of the study participants, accounting for 43.7%. Uptake of aPNS was independently associated with the testing location of the index client (aOR=3.8; 95% CI: 1.46-9.83, p-value=0.006), knowledge of the HIV status of their sexual partner(s) (aOR =5.2; 95% CI: 2.09–11.43; p-value= 0.002) and absence of intimate partner violence (aOR=15.0; 95% CI: 4.92-45.80, p- value <0.001). Conclusion: There was a high uptake of aPNS among newly diagnosed HIV-positive clients. The provider referral was the most preferred method. Testing location, knowledge of partner’s HIV status, and absence of intimate partner violence increased the uptake od aPNS. Recommendation: Provider referral should be promoted as the preferred option among index clients. The HIV care settings should incorporate routine IPV screening, counseling, and support services to ensure client safety and facilitate safe disclosure. Longitudinal studies should be recommended to monitor trends in aPNS uptake and associated factors over time. 2025-01-01T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10431 Contextual challenges of implementing adolescent and youth-friendly health services in Uasin Gishu county Kenya: a qualitative analysis Embleton, Lonnie; Ashimosi, Celestine; Kirwa, Sheila; Boal, Ava; Chory, Ashley; Kodituwakku, Thiyasha; Johanek, Camila; A. Ott, Mary; C. Vreeman, Rachel; Marete, Irene Objectives: Substantial gaps in the implementation of adolescent and youth-friendly health services (AYFHS) have been identified in Uasin Gishu (UG) county, Kenya, across all eight domains of the WHO global standards, particularly with respect to adolescent health literacy, community sup- port, provider competencies, and equity and non-discrimi- nation. To respond, we undertook a qualitative analysis to explore contextual challenges of implementing AYFHS from the perspectives of adolescents and young adults (AYA) aged 10-24 years, policymakers, caregivers of AYA, healthcare providers, peer mentors, and community leaders. Methods: We used a hybrid inductive/deductive thematic analysis to explore contextual and systems-level de- terminants of implementing AYFHS in UG county, Kenya. Results: Our analysis generated four major themes: 1) pri- orities of political leadership and health systems manage- ment; 2) financial challenges; 3) human resources andfacility infrastructure; and 4) social-cultural barriers. Par- ticipants perceived political will, leadership, and health systems management to be obstacles to implementing AYFHS. Further, participants stated that financial challenges were a leading barrier to the implementation of AYFHS in the county, and that dispersion of funds from the county government to facilities was inadequate. Intersecting with the political-economic context, participants discussed limited human resources, poor facility infrastructure, and supply issues as determinants of implementation. Lastly, social-cultural norms in association with sexual and repro- ductive health discussed as a substantial issue. Conclusions: Addressing implementation determinants of AYFHS, including political, economic, and social-cultural barriers, can enable adoption and facilitate implementation and scale of AYFHS that are a fundamental component of living healthy and productive lives for AYA in Kenya. 2026-07-08T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10415 Determinants of ultrasonography training outcomes among radiography diploma students in selected Kenya Medical Training Colleges, in Kenya public hospitals Chebet, Nancy Chepkwony Background: Ultrasound technology has become an effective clinical diagnostic tool in low and middle income countries (LMICs) to meet the objectives of improved primary health care (PHC). However, availability of ultrasound machines and skill training needed continue to limit expanded use of ultrasound in LMICs. In Kenya, concerns have been raised over the quality of work output of sonographers and clinicians practicing ultrasound (Kagima et al., 2021). All these increase the risks of poor diagnosis and patient management and could result in increased morbidity and preventable deaths. This can be attributed to the quality of training and student related factors. Objectives: To determine how students ‘perception of curriculum space limitations affect ultrasonography training outcomes, to analyze how availability of ultrasound machines for training affects ultrasonography training outcomes and to examine how students attitudes on training moderates the relationship between institutional factors and ultrasonography training outcomes. Methods: Study was carried out using a mixed research approach employing both qualitative and quantitative methods. It targeted five Kenya Medical Training College (KMTC) campuses offering the radiography course that are based in four county (Level 6) and one level 5 teaching hospitals in the country, that is, Nakuru, Uasin Gishu, Nairobi Kisumu and Kericho respectively. The target population were final year KMTC students undertaking their radiography and imaging course, the faculty members and the hospital-based instructors. Systematic random sampling was used to select 98 students, of who 45 are females and 53 males, while the census method was used to select 26 faculty members and 10 hospital-based instructors. Questionnaires for students, interview schedules for lecturers, hospital-based instructors and Focus Group discussions for students were used for data collection. Quantitative data from the questionnaire were analyzed using both descriptive and inferential data analysis. Results: Students’ perception of curriculum space limitations did not significantly affect ultrasonography training outcomes. Availability of ultrasound machines for training significantly affects ultrasonography training outcomes and Students attitudes had a significant moderating effect on the relationship between institutional factors and ultrasonography training outcomes among diploma Radiography students. Conclusions: Students’ perception of curriculum space limitations did not have a statistically significant effect on ultrasonography training outcomes. Availability of ultrasound machines for training had a statistically significant effect on ultrasonography training outcomes. Recommendations: College management should establish clear guidelines and prerequisites for ultrasound training, ensuring that only students from relevant medical imaging or ultrasonography programs are prioritized. To address students’ lack of confidence in using the simulators for training, a blended training approach is recommended, where simulators are used to build foundational skills before transitioning to human models. Further, greater emphasis should be placed on mentorship, career guidance, and the long-term relevance of radiography and sonography careers to boost student motivation. 2026-01-01T00:00:00Z