Publications by authors named "Asiki Gershim"

: Front-of-package labeling (FOPL) is shown to support healthier consumer choices. Many countries have adopted different FOPL systems. Objective: This study explored perceptions and understanding of three FOPLs and identified features that could enhance their effectiveness in Kenya.

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: Front-of-pack-labels (FOPLs) on packaged foods provide essential information to help consumers make informed dietary choices. However, evidence on their effectiveness, particularly in low- and middle-income countries like Kenya, is limited. : This study assessed the effectiveness of three FOPLs in helping consumers identify nutrients of concern in packaged food products and influencing their purchase intention in Kenya.

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Background: The double burden of malnutrition (DBM) during adolescence is associated with growth and developmental impairment and risk of non-communicable diseases. There is limited evidence on adolescent's dietary patterns (DPs), and how they contribute to DBM in urban low income contexts in sub Saharan Africa. This study assessed DPs of adolescents, their drivers and association with DBM in Kenya's urban slums.

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The availability of quality and timely data for routine monitoring of mental, neurological and substance use (MNS) disorders is a challenge, particularly in Africa. We assessed the feasibility of using an open-source data science technology (R Shiny) to improve health data reporting in Nairobi City County, Kenya. Based on a previously used manual tool, in June 2022, we developed a digital online data capture and reporting tool using the open-source Kobo toolbox.

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Background: Ensuring healthcare services are equipped to offer; emergency obstetric and newborn care (EmONC) is crucial for improving the quality of maternal and newborn care in low- and middle-income countries. We assessed the temporal trends of the availability and readiness of the healthcare system to provide EmONC in Burkina Faso.

Methods: We analyzed the data from three national health facilities surveys, conducted in 2014, 2016 and 2018, using the WHO Service Availability and Readiness Assessment tool.

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Objective: To assess the availability and marketing of ultra-processed foods (UPF) in modern retail food outlets (supermarkets and minimarts) in Kenya and associated factors.

Design: This cross-sectional study was conducted in Kenya from August 2021 to October 2021. Variables included the geographic location and the socio-economic status (SES) levels, the food items displayed for sale and advertised in the stores, and locations in the stores such as the entrance.

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Article Synopsis
  • Childhood mortality remains a serious issue in low and middle-income countries, especially in urban informal settlements, with limited data on risk factors affecting these populations.
  • A study in Nairobi's Viwandani and Korogocho settlements used data from the Nairobi Urban Health and Demographic Surveillance System to analyze under-five mortality from 2002 to 2018, finding a significant improvement in survival rates over the years.
  • Key factors that reduced mortality included BCG vaccination, children born to married mothers or non-working mothers, singleton pregnancies, and specific ethnic backgrounds, highlighting the need for targeted public health interventions to further decrease mortality rates.
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Background: The burden of chronic non-communicable diseases (NCDs) is a growing public health concern. The availability of cost-of-illness data, particularly public healthcare costs for NCDs, is limited in Sub-Saharan Africa (SSA), yet such data evidence is needed for policy action.

Objective: The objective of this study was to estimate the economic burden of type 2 diabetes (T2D) on Kenya's public healthcare system in 2021 and project costs for 2045.

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Background: In Africa, where the burden of diseases is disproportionately high, significant challenges arise from a shortage of skilled researchers, lack of research funding, and limited mentorship opportunities. The continent faces a substantial gap in research output largely attributed to the dearth of mentorship opportunities for early career researchers.

Objective: To explore existing mentorship approaches, identify challenges, gaps, successes, and benefits, and provide insights for strengthening mentorship programs in African health research institutions.

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Introduction: A transformation of food systems is urgently needed, given their contribution to three ongoing and interlinked global health pandemics: (1) undernutrition and food insecurity, (2) obesity and non-communicable diseases (NCDs), and (3) climate change and biodiversity loss. As policymakers make decisions that shape food systems, this study aimed to identify and prioritise policies with double- or triple-duty potential to achieve healthier and more environmentally sustainable food systems.

Methods: This study undertook a 4-step methodological approach, including (i) a compilation of international policy recommendations, (ii) an online survey, (iii) four regional workshops with international experts and (iv) a ranking for prioritisation.

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  • The study aimed to estimate the prevalence and distribution of epilepsy in two urban informal settlements in Nairobi, Kenya, recognizing a lack of data in urban areas compared to rural studies in Africa.
  • Researchers conducted a two-stage screening process with over 56,000 residents, where a validated questionnaire identified potential epilepsy cases which were then clinically assessed by neurologists.
  • The findings revealed an adjusted prevalence of 11.9 cases per 1000 people for all types of epilepsy, with 528 confirmed cases in the study population, highlighting a significant public health issue in these urban settings.
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  • This study is the largest genome-wide association study (GWAS) focusing on urinary albumin-to-creatinine ratio (UACR) in Sub-Saharan African (SSA) populations, involving nearly 18,000 participants.
  • Researchers identified two significant genetic loci associated with UACR, one in residents of SSA and another in non-resident individuals of African ancestry.
  • The findings highlight the limited transferability of polygenic scores across different populations, underscoring the importance of diverse genetic studies to understand kidney disease susceptibility in underrepresented groups.
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  • The COVID-19 pandemic significantly disrupted healthcare delivery for patients with type 2 diabetes in Kenya and Tanzania, affecting access to essential services.
  • A study involving 1,000 diabetes patients revealed that a notable percentage experienced changes in testing frequency and healthcare facility visits, with Kenya showing more severe disruptions compared to Tanzania.
  • Factors such as insurance status and economic conditions played a key role in the level of care disruption, highlighting the need for better health system preparedness for future emergencies.
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Background: Breastfeeding is important for early childhood nutrition and health. The positive effects on educational outcomes may be attributed to socioeconomic factors. Socioeconomic status is not a strong predictor of breastfeeding in sub-Saharan African countries.

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Background: The COVID-19 pandemic caused disruptions in care that adversely affected the management of non-communicable diseases (NCDs) globally. Countries have responded in various ways to support people with NCDs during the pandemic. This study aimed to identify policy gaps, if any, in the management of NCDs, particularly diabetes, during COVID-19 in Kenya and Tanzania to inform recommendations for priority actions for NCD management during any future similar crises.

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Introduction: Stunting is common among children in many low and middle income countries, particularly in rural and urban slum settings. Few studies have described child stunting transitions and the associated factors in urban slum settlements. We describe transitions between stunting states and associated factors among children living in Nairobi slum settlements.

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Article Synopsis
  • * Researchers identified two significant genetic loci associated with urinary albumin-to-creatinine ratio (UACR) — one on chromosome 6 and another on chromosome 11 — while confirming links to previously known regions associated with UACR.
  • * The findings highlight the genetic diversity in SSA populations and the limitations of polygenic scores from European ancestry studies, underscoring the need for more genetic research in diverse groups to better understand chronic kidney disease risk factors.
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Background: People with type 2 diabetes (T2D) are at increased risk of poor outcomes from COVID-19. Vaccination can improve outcomes, but vaccine hesitancy remains a major challenge. We examined factors influencing COVID-19 vaccine uptake among people with T2D in two sub-Saharan Africa countries that adopted different national approaches to combat COVID-19, Kenya and Tanzania.

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Objectives: Multimorbidity (MM) is a growing concern linked to poor outcomes and higher healthcare costs. While most MM research targets European ancestry populations, the prevalence and patterns in African ancestry groups remain underexplored. This study aimed to identify and summarise the available literature on MM in populations with African ancestry, on the continent, and in the diaspora.

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  • Fishing communities, like those on the shoreline of Lake Victoria in Uganda, are ideal for HIV prevention trials due to their high HIV rates, but their mobility presents challenges for tracking participants.
  • A study conducted from 2015 to 2017 used fingerprinting and GPS to track movements among fisherfolks, with over 99% accepting fingerprinting and showing high retention rates in follow-up surveys.
  • Findings indicated that while 85% of participants remained in the same village after 6 months, those who viewed their residence as temporary were less likely to migrate, showcasing the feasibility of using fingerprinting to monitor this population for health research.
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Background: Epstein-Barr virus (EBV) infection is ubiquitous and in sub-Saharan Africa, occurs early in life. In a population-based rural African cohort, we leveraged historical samples from the General Population Cohort (GPC) in Uganda to examine the epidemiology of infection with EBV over time, in the era of HIV.

Methods: We used 9024 serum samples collected from the GPC in 1992, 2000, 2008, from 7576 participants across the age range (0-99 years of age) and tested for anti-EBV immunoglobulin G (IgG) antibodies to EAd, VCA, and EBNA-1 using a multiplex bead-based assay.

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Understanding the patterns of multimorbidity, defined as the co-occurrence of more than one chronic condition, is important for planning health system capacity and response. This study assessed the association of different cardiometabolic multimorbidity combinations with healthcare utilization and quality of life (QoL). Data were from the World Health Organization (WHO) study on global AGEing and adult health Wave 2 (2015) conducted in Ghana.

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Objective: Understanding the facilitators and barriers to managing hypertension and type 2 diabetes (T2D) will inform the design of a contextually appropriate integrated chronic care model in Kenya. We explored the perceived facilitators and barriers to the integrated management of hypertension and T2D in Kenya using the Rainbow Model of Integrated Care.

Design: This was a qualitative study using data from a larger mixed-methods study on the health system response to chronic disease management in Kenya, conducted between July 2019 and February 2020.

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Background: This study aims to examine the association between mobility limitations and emotional dysfunction among older Ghanaians and evaluate the buffering effect of physical activity (PA) and social ties in this association.

Methods: The analysis included 1201 adults aged ≥50 from the 2016-17 Aging, Health, Psychological Well-being, and Health-seeking Behavior study. The Medical Outcomes Study Short Form-36 (MOS SF-36) assessed mobility limitations and emotional dysfunction.

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Digital transformation in health care has a lot of opportunities to improve access and quality of care. However, in reality not all individuals and communities are benefiting equally from these innovations. People in vulnerable conditions, already in need of more care and support, are often not participating in digital health programs.

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