School of Public Health

Patient delay and associated factors among patients diagnosed with TB in Kajiado County

Thu, 01 Jan 2026 00:00:00 GMT

Patient delay and associated factors among patients diagnosed with TB in Kajiado County Supeyo, Moses Melita Background: TB is among the leading causes of death from a single infectious agent worldwide. Globally, TB cases increased to 10.6 million in 2022, from 10.0 million in 2020. Africa had 2.5 million TB infections in 2016, making it the continent with the highest new cases globally. There was a 16.7 percent rise in DSTB cases in 2021. Kajiado was among nine counties that had reported high rise in case notification in 2022. Objective: Determine patient delay and associated factors among patients diagnosed with TB in Kajiado County. Methods: A cross-sectional research was carried out at five hospitals within Kajiado County from May to August 2021 on 354 TB patients who were 15 years of age or older. Data was collected using a pre-tested, semi-structured questionnaire that was entered into an Excel database. We cleaned the data in MS Excel and ran the analyses in Epi Info. Data were summarised for discrete variables using basic proportions and percentages, and for continuous variables using mean and standard deviations. We used the median time as our cut-off for patient delay calculations. A patient is considered to have delayed if they seek medical attention at a health facility 28 days (median time) or more after the onset of tuberculosis symptoms. Patients' delay was determined using logistic regression. Adjusted odds ratios were calculated with a 95% confidence interval, and we considered factors statistically significant in multivariate when p-values were less than or equal to 0.05. Results: A total of 354 (100%) patients with Tuberculosis participated in the study. The median time of the patient delay was 28 (+20) days. 46.3% of the study participants delayed to seek diagnosis. Lack of knowledge and lack of accessibility were the factors significantly associated with patient delay. Conclusion: The findings suggest that delay in seeking Tuberculosis diagnosis remains a challenge as a significant proportion of patients delayed in seeking diagnosis. Lack of knowledge and lack of accessibility to diagnostic sites were significantly associated with Tuberculosis patient delay. These factors for delay can be the subject of future interventions to reduce delay in diagnosis among patients with tuberculosis. Recommendations: The findings highlight the importance of relevant stakeholders to emphasize health education through community sensitization to ensure everyone is reached. The County Department of Health should strengthen referral and linkages between the community and health facilities. Enhance access through mobile outreach services. Further interventions that will improve knowledge and accessibility to TB care.

Prevalence and factors associated with iron deficiency and inadequate dietary zinc intake among children aged 6 – 59 months at Moi Teaching and Referral Hospital, Eldoret- Kenya Edwin Gudu

Wed, 01 Jan 2025 00:00:00 GMT

Prevalence and factors associated with iron deficiency and inadequate dietary zinc intake among children aged 6 – 59 months at Moi Teaching and Referral Hospital, Eldoret- Kenya Edwin Gudu Gudu, Edwin Background: Micronutrients are chemical elements required in small quantities that are vital for normal growth and development. Micronutrient deficiency affects at least 2 billion people globally. In Kenya, Zinc (83%) and Iron deficiencies (35%) are most prevalent. Pregnant, lactating women and children less than 5 years of age are most affected. Objectives: This study aims to estimate prevalence and determine factors associated with zinc deficiency, inadequate dietary zinc intake, iron deficiency, and iron deficiency anaemia among children 6 – 59 months treated at Moi Teaching and Referral Hospital (MTRH). It also describes the infant and young child feeding practices associated with these deficiencies. Methods: This was a cross sectional study with a sample size of 354 participants recruited using systematic random sampling. Sociodemographic, clinical, laboratory and anthropometric data was collected. The laboratory tests included: serum iron, ferritin, total iron binding capacity and complete blood counts. We used 24-hour dietary recall to assess for adequacy of dietary zinc intake. Dietary diversity scores were assessed using the WHO food groups. Levels of stunting were used as a population indicator for zinc deficiency. Odds ratios were calculated at 95% confidence interval and p values < 0.05 were considered statistically significant. Univariate, bivariate and multivariate analyses were carried out on the categorical variables. Results: The median age of the study participants was 31 months (IQR 15, 46) with a male majority (61%). The prevalence of inadequate zinc intake was 60% with a median age of 20 months (IQR 11, 48). Fifty percent (50%) of the study participants did not meet the minimum dietary diversity (MDD) score of at least four WHO food groups. Inadequate MDD was associated with inadequate dietary zinc intake (OR 3.1; CI 2.0 – 4.8; p<0.001). Twenty-six percent (26%) of the participants were stunted. Factors associated with increased odds of stunting included: Inadequate zinc intake (OR 1.5; CI 0.9 -2.6; p=0.09), Pre-term children (OR 3.1; CI 1.1 – 8.5; p=0.02), no prior deworming (OR 3.7; CI 2.2 – 6.1; p<0.001). There prevalence of iron deficiency was 77% (based on transferrin saturation levels) and 63% (based on serum ferritin levels). The factors associated with decreased the odds of iron deficiency (ID) included: Adequate MDD (OR 0.9; CI 0.6 – 1.9; p = 0.83) and deworming (OR 0.2; CI 0.1 – 0.5; p<0.001), exclusive breastfeeding for 6 months (OR 0.6; CI 0.1 – 2.7; p= 0.47). Factors associated with increased odds of iron deficiency included: pre-term birth (OR 3.7; CI 0.5 – 28.7; p=0.18), hypochromia (OR 3.8; CI 2.1 – 6.8; p<0.001), microcytosis (OR 1.4; CI 0.8 – 2.3; p = 0.23). The median age for iron deficiency anaemia (IDA) was 23 months (IQR 11, 43). Microcytosis (OR 2.5; CI 1.6 – 4.0; p<0.001) and hypochromia (OR 2.8; CI 1.5 – 5.5; p = 0.001) were associated with IDA. Conclusions: Inadequate dietary zinc intake is still common. Iron deficiency and iron deficiency anaemia are still highly prevalent diseases of public health importance. Concurrent iron and zinc deficiency are common. Adequate minimum dietary diversity is necessary for prevention of iron and zinc deficiency.

Patient delay and associated factors among patients diagnosed with TB in Kajiado County

Thu, 01 Jan 2026 00:00:00 GMT

Prevalence and factors associated with iron deficiency and inadequate dietary zinc intake among children aged 6 – 59 months at Moi Teaching and Referral Hospital, Eldoret- Kenya

Thu, 01 Jan 2026 00:00:00 GMT

Prevalence and factors associated with iron deficiency and inadequate dietary zinc intake among children aged 6 – 59 months at Moi Teaching and Referral Hospital, Eldoret- Kenya Gudu, Edwin Background: Micronutrients are chemical elements required in small quantities that are vital for normal growth and development. Micronutrient deficiency affects at least 2 billion people globally. In Kenya, Zinc (83%) and Iron deficiencies (35%) are most prevalent. Pregnant, lactating women and children less than 5 years of age are most affected. Objectives: This study aims to estimate prevalence and determine factors associated with zinc deficiency, inadequate dietary zinc intake, iron deficiency, and iron deficiency anaemia among children 6 – 59 months treated at Moi Teaching and Referral Hospital (MTRH). It also describes the infant and young child feeding practices associated with these deficiencies. Methods: This was a cross sectional study with a sample size of 354 participants recruited using systematic random sampling. Sociodemographic, clinical, laboratory and anthropometric data was collected. The laboratory tests included: serum iron, ferritin, total iron binding capacity and complete blood counts. We used 24-hour dietary recall to assess for adequacy of dietary zinc intake. Dietary diversity scores were assessed using the WHO food groups. Levels of stunting were used as a population indicator for zinc deficiency. Odds ratios were calculated at 95% confidence interval and p values < 0.05 were considered statistically significant. Univariate, bivariate and multivariate analyses were carried out on the categorical variables. Results: The median age of the study participants was 31 months (IQR 15, 46) with a male majority (61%). The prevalence of inadequate zinc intake was 60% with a median age of 20 months (IQR 11, 48). Fifty percent (50%) of the study participants did not meet the minimum dietary diversity (MDD) score of at least four WHO food groups. Inadequate MDD was associated with inadequate dietary zinc intake (OR 3.1; CI 2.0 – 4.8; p<0.001). Twenty-six percent (26%) of the participants were stunted. Factors associated with increased odds of stunting included: Inadequate zinc intake (OR 1.5; CI 0.9 -2.6; p=0.09), Pre-term children (OR 3.1; CI 1.1 – 8.5; p=0.02), no prior deworming (OR 3.7; CI 2.2 – 6.1; p<0.001). There prevalence of iron deficiency was 77% (based on transferrin saturation levels) and 63% (based on serum ferritin levels). The factors associated with decreased the odds of iron deficiency (ID) included: Adequate MDD (OR 0.9; CI 0.6 – 1.9; p = 0.83) and deworming (OR 0.2; CI 0.1 – 0.5; p<0.001), exclusive breastfeeding for 6 months (OR 0.6; CI 0.1 – 2.7; p= 0.47). Factors associated with increased odds of iron deficiency included: pre-term birth (OR 3.7; CI 0.5 – 28.7; p=0.18), hypochromia (OR 3.8; CI 2.1 – 6.8; p<0.001), microcytosis (OR 1.4; CI 0.8 – 2.3; p = 0.23). The median age for iron deficiency anaemia (IDA) was 23 months (IQR 11, 43). Microcytosis (OR 2.5; CI 1.6 – 4.0; p<0.001) and hypochromia (OR 2.8; CI 1.5 – 5.5; p = 0.001) were associated with IDA. Conclusions: Inadequate dietary zinc intake is still common. Iron deficiency and iron deficiency anaemia are still highly prevalent diseases of public health importance. Concurrent iron and zinc deficiency are common. Adequate minimum dietary diversity is necessary for prevention of iron and zinc deficiency