Publications by authors named "Martha Kombe"

Article Synopsis
  • * This study analyzed data from two Kenyan studies, identifying risk factors linked to NDDs; significant findings include complications during pregnancy and birth, with specific odds ratios indicating which factors pose the greatest risk.
  • * Recognizing these risk factors, such as labour and birth complications, can help guide preventative measures and interventions for reducing the incidence of NDDs in affected populations.
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Article Synopsis
  • Children can be diagnosed with autism as early as 3 years old, but there is a significant delay in diagnosis in Africa, often occurring between ages 8-10.
  • A study in rural Kenya aimed to validate the Social Communication Questionnaire (SCQ) as an effective screening tool for autism, involving 172 children with neurodevelopmental disorders and 112 controls.
  • The study found that the SCQ had good internal consistency and an adequate factor structure, with a recommended cut-off score of 15 showing 72% sensitivity and 100% specificity for detecting autism compared to typically developing children.
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Introduction: The precise epidemiological burden of autism is unknown because of the limited capacity to identify and diagnose the disorder in resource-constrained settings, related in part to a lack of appropriate standardised assessment tools and health care experts. We assessed the reliability, validity, and diagnostic accuracy of the Developmental Diagnostic Dimensional Interview (3Di) in a rural setting on the Kenyan coast.

Methods: Using a large community survey of neurodevelopmental disorders (NDDs), we administered the 3Di to 2,110 children aged between 6 years and 9 years who screened positive or negative for any NDD and selected 242 who had specific symptoms suggestive of autism based on parental report and the screening tools for review by a child and adolescent psychiatrist.

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Objective: Focal epilepsy is common in low- and middle-income countries. The frequency and nature of possible underlying structural brain abnormalities have, however, not been fully assessed.

Methods: We evaluated the possible structural causes of epilepsy in 331 people with epilepsy (240 from Kenya and 91 from South Africa) identified from community surveys of active convulsive epilepsy.

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Genetic association studies have made significant contributions to our understanding of the etiology of neurodevelopmental disorders (NDDs). However, these studies rarely focused on the African continent. The NeuroDev Project aims to address this diversity gap through detailed phenotypic and genetic characterization of children with NDDs from Kenya and South Africa.

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Article Synopsis
  • The study aimed to determine the prevalence of different types of epilepsy (convulsive and non-convulsive) in a rural area of Kenya and to assess the associated mortality rates in individuals with epilepsy compared to those without.
  • Researchers surveyed 4,441 residents and found a prevalence of 31.7/1,000 for lifetime epilepsy and 21.6/1,000 for active epilepsy, with non-convulsive seizures accounting for 35% of cases.
  • The mortality rate for people with epilepsy was significantly higher at 6.3/1,000 compared to 2.8/1,000 for those without, indicating a higher risk of premature death associated with epilepsy, particularly in resource-limited settings.
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Objectives: Our aim was to compare the neurocognitive performance and mental health outcome of adults living with HIV on antiretroviral therapy with that of community controls, all of low literacy. Furthermore, we also wanted to explore the relationship of these outcomes with quality of life among adults living with HIV.

Study Design: This was a descriptive cross-sectional study.

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Background: Acute symptomatic seizures and febrile seizures are common in children admitted to hospitals in Africa and may be markers of brain dysfunction. They may be associated with behavioural and emotional problems, but there are no published community-based studies in Africa.

Methods: We screened 7047 children aged 1-6 years (randomly sampled from 50,000 in the community) for seizures (using seven questions) and invited those who screened positive and a proportion of negatives for a clinical assessment.

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Background: Three-quarters of the burden of mental health problems occurs in low-and-middle-income countries, but few epidemiological studies of these problems in preschool children from sub-Saharan Africa have been published. Behavioural and emotional problems often start in early childhood, and this might be particularly important in Africa, where the incidence of perinatal and early risk factors is high. We therefore aimed to estimate the prevalence and risk factors of behavioural and emotional problems in young children in a rural area on the Kenyan coast.

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Background: There are few studies on the epidemiology of epilepsy in large populations in Low and Middle Income Countries (LMIC). Most studies in these regions use two-stage population-based screening surveys, which are time-consuming and costly to implement in large populations required to generate accurate estimates. We examined the sensitivity and specificity of a three-stage cross-sectional screening methodology in detecting active convulsive epilepsy (ACE), which can be embedded within on-going census of demographic surveillance systems.

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