Publications by authors named "Carophine Nasambu"

Background: Most children with developmental disabilities (DD) live in low- and middle-income countries, but access to services is limited, impacting their ability to thrive. Pilot study findings of the World Health Organization's Caregiver Skills Training (WHO CST) intervention, which equips caregivers with strategies to facilitate learning and adaptive behaviours in children with DD, are promising but evidence from an appropriately powered trial delivered by non-specialist facilitators is lacking. This study will investigate the effectiveness and the resource impacts and costs and consequences of the WHO CST intervention in four sites in rural and urban Kenya and Ethiopia.

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Background: Evidence is needed to understand factors that influence child development and caregiving experiences, especially in marginalized contexts, to inform the development and implementation of early childhood development (ECD) interventions. This study explores caregiving practices for young children in an urban informal settlement with Kenyans and embedded refugees, and identifies factors shaping these caregiving experiences, to inform the design and development of potentially appropriate ECD interventions.

Methods: A qualitative formative study, which included 14 focus group discussions (n = 125 participants), and 13 key informant interviews was conducted between August and October 2018.

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Background: Sexual behavior (SB) is a well-documented pathway to HIV acquisition in emerging adults and remains common amongst African emerging adults. Previous research in high-income countries indicates a correlation between disordered eating behavior (DEB) and engaging in sexual behaviors. We aimed to describe the relationship between DEB and SB amongst emerging adults attending a tertiary educational institution at the Kenyan Coast.

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Introduction: There are no published data on the long-term impact of invasive group B disease (iGBS) on economic costs or health-related quality of life (HRQoL) in low-income and middle-income countries. We assessed the impact of iGBS on healthcare utilisation, costs and HRQoL in Argentina, India, Kenya, Mozambique and South Africa.

Methods: Inpatient and outpatient visits, out-of-pocket (OOP) healthcare payments in the 12 months before study enrolment, and health-state utility of children and caregivers (using the EuroQol 5-Dimensions-3-Level) were collected from iGBS survivors and an unexposed cohort matched on site, age at recruitment and sex.

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a) To document the prevalence and correlates of frailty among older adults living with HIV (OALWH) and their uninfected peers, and b) Investigate HIV status as an independent predictor of frailty. This cross-sectional study was conducted between 2020 and 2021 at the Kenyan coast among 440 older adults aged ≥50 years (257 OALWH). Frailty was assessed using the Reported Edmonton Frail Scale.

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Article Synopsis
  • Tungiasis, a neglected tropical disease, significantly impacts children's neurocognitive and mental health, highlighting the need for more research in this area.
  • A study involving 454 school children in Kenya and Uganda assessed literacy, language, and memory among infected and uninfected participants, revealing that both mild and severe infections negatively affected cognitive skills.
  • Results indicated that children with tungiasis scored lower in various cognitive measures, suggesting a detrimental effect on learning and behavior, particularly with increasing severity of infection.
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  • * Using qualitative data from interviews with 26 key informants, the research identifies various SRTBs, such as unprotected sex and transactional relationships, and maps their interconnected influences through an ecological model and causal loop diagram.
  • * The findings indicate a strong prevalence of unprotected sex among emerging adults, suggesting that improved sexuality education and enhanced counseling support could help mitigate these risky behaviors in Kenyan universities.
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Introduction: Empirical research on the burden and determinants of common mental disorders (CMDs), especially depression and anxiety, among older adults living with HIV (OALWH) in sub-Saharan Africa is inadequate. To bridge the gap in Kenya we: (1) determined the prevalence of CMDs among OALWH on routine HIV care compared to HIV-negative peers; (2) investigated HIV status as an independent predictor of CMDs in older adults; and (3) investigated CMD determinants.

Methods: In a cross-sectional study conducted between 2020 and 2021, the prevalence of CMDs and associated determinants were investigated at the Kenyan coast among 440 adults aged ≥50 years (257 OALWH).

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Background: Problem Management Plus (PM+) is a psychological intervention that seeks to address common mental disorders among individuals exposed to adversity. Thus far, the potential for delivering PM+ by mobile phones has not been evaluated.

Aims: To adapt PM+ for telephone delivery (ten weekly sessions of about 45 min each) and preliminarily evaluate its acceptability and feasibility with young people living with HIV (YLWH) in coastal Kenya.

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Article Synopsis
  • The study examined the long-term effects of invasive group B Streptococcus (iGBS) disease in early infancy, particularly focusing on neurodevelopmental impairment (NDI) in children from low- and middle-income countries.
  • It included a cohort of children aged 1.5-18 years with a history of iGBS disease and compared them to age- and sex-matched children without this history across multiple countries.
  • Results indicated that 38.1% of iGBS survivors showed some level of NDI, which is notably higher than the 21.7% observed in non-iGBS children, with more severe impairments typically seen in those who had meningitis compared to sepsis.
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Background: Group B streptococcus (GBS) colonisation during pregnancy can lead to invasive GBS disease (iGBS) in infants, including meningitis or sepsis, with a high mortality risk. Other outcomes include stillbirths, maternal infections, and prematurity. There are data gaps, notably regarding neurodevelopmental impairment (NDI), especially after iGBS sepsis, which have limited previous global estimates.

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Background: Mothers and other primary caregivers play a crucial role in looking after perinatally HIV infected, and HIV exposed uninfected adolescents in sub-Saharan Africa. Day- to-day caregiving in the context of limited instrumental support and added biomedical risk (HIV seropositivity) may expose these caregivers to adverse states of health. Unfortunately, very few studies have examined their health-related quality of life (HRQoL).

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Article Synopsis
  • Young adults living with HIV in rural Kenya face diverse challenges that span individual, family, and community levels, including issues of acceptance, adherence to treatment, economic strain, and stigma.
  • The study, through in-depth interviews with 22 individuals aged 18-24, reveals that these challenges often intersect and complicate the lives of emerging adults.
  • Support systems, including social connections and spiritual reliance, play a crucial role in helping these young adults cope with their circumstances, highlighting the need for comprehensive, multi-level interventions tailored to their unique experiences.
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Background: There is a dearth of instruments that have been developed and validated for use with children living with HIV under the age of 17 years in the Kenyan context. We examined the psychometric properties and measurement invariance of a short version of the Berger HIV stigma scale administered to perinatally HIV-infected adolescents in a rural setting on the Kenyan coast.

Methods: A cross-sectional study was conducted among 201 perinatally HIV-infected adolescents aged 12-17 years between November 2017 and October 2018.

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Background: Survivors of invasive group B Streptococcus (iGBS) disease, notably meningitis, are at increased risk of neurodevelopmental impairment. However, the limited studies to date have a median follow-up to 18 months and have mainly focused on moderate or severe neurodevelopmental impairment, with no previous studies on emotional-behavioral problems among iGBS survivors.

Methods: In this multicountry, matched cohort study, we included children aged 18 months to 17 years with infant iGBS sepsis and meningitis from health demographic surveillance systems, or hospital records in Argentina, India, Kenya, Mozambique, and South Africa.

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The emergence of COVID-19 has profoundly affected mental health, especially among highly vulnerable populations. This study describes mental health issues among caregivers of young children and pregnant women in three urban informal settlements in Kenya during the first pandemic year, and factors associated with poor mental health. A cross-sectional telephone survey was administered to 845 participants.

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Article Synopsis
  • Sexual risk behavior (SRB) during adolescence is a significant public health issue, and this study examined the relationship between self-esteem, hopefulness, and SRB in Kenyan adolescents aged 12-17 from diverse settings in Kilifi and Nairobi.* -
  • The research involved a survey of 296 adolescents who reported experiences of SRB, primarily sexual violence and transactional sex, with 13% of participants having experienced at least one form of SRB.* -
  • While higher hopefulness was linked to not experiencing SRB, neither self-esteem nor hopefulness significantly influenced SRB outcomes in the adjusted analysis; however, depressive symptoms and feelings of unsafety in the neighborhood were strongly associated with an increased occurrence of SRB.*
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Article Synopsis
  • The study focuses on the prevalence and factors associated with common mental disorders (CMDs), specifically depression and anxiety, among young people living with HIV (YLWH) in sub-Saharan Africa (SSA).
  • Out of nearly 4,000 articles reviewed, 31 studies were selected, revealing CMD prevalence rates among YLWH that vary significantly, with major depression at 16.0% to 40.8% and anxiety symptoms from 2.2% to 25.0%.
  • Key findings highlight that YLWH have a higher occurrence of depressive disorders compared to HIV-negative peers, with factors like female gender, older age, and social support being important correlates of mental health issues.
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Background: The Millennium Developmental Goals ensured a significant reduction in childhood mortality. However, this reduction simultaneously raised concerns about the long-term outcomes of survivors of early childhood insults. This systematic review focuses on the long-term neurocognitive and mental health outcomes of neonatal insults (NNI) survivors who are six years or older.

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Objective: The purpose of this study was to evaluate the psychometric properties of the World Health Organization's five item well-being index (WHO-5) when administered to adults living with HIV or epilepsy in a rural setting at the coast of Kenya.

Methods: A case control study design was conducted among 230 adults aged 18-50 years, who comprised 147 cases (63 living with epilepsy and 84 living with HIV) and 83 healthy controls. The participants were administered to a face-to-face interview during which they completed the Swahili version of WHO-5 well-being index, the Major Depression Inventory (MDI) and responded to some items on their socio-demographic characteristics.

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