Patient and provider perspectives on pain management during manual vacuum aspiration.

Manual vacuum aspiration (MVA) is a painful procedure often conducted without analgesia. The World Health Organization (WHO) recommends a paracervical block (PCB) as the mode of pain relief during MVA. Few studies have assessed patient perspectives on pain control during MVA.

Development of Primal World Beliefs.

Primal world beliefs ("primals") capture individuals' basic understanding of what sort of world this is. How do children develop beliefs about the nature of the world? Is the world a good place? Safe or dangerous? Enticing or dull? Primals were initially introduced in social and personality psychology to understand beliefs about the world as a whole that may influence well-being and personality. This article introduces the concept of primals to developmental scientists and reviews preliminary research examining how primals relate to sociodemographic and well-being indicators.

An evaluation of the effectiveness of an updated pre-service midwifery curriculum integrated with emergency obstetric and newborn care in Kenya: a cluster randomised controlled trial.

Introduction: Quality midwifery education is central to improving midwifery service delivery and maternal and newborn health outcomes. In many settings, midwifery educators insufficiently prepared for their teaching role and deficient curriculum compared to international standards affect the quality of healthcare provided by the midwifery graduates. This study assessed the effectiveness of an EmONC enhanced midwifery curriculum delivered by trained and mentored midwifery educators on the quality of education and student performance in Kenya.

Safety and adherence to self-administered intravaginal 5-fluorouracil cream following cervical intraepithelial neoplasia (CIN) 2/3 treatment among HIV-positive women in Kenya: A phase 1 clinical trial.

Objective: To determine the safety, tolerance, and adherence to self-administered intravaginal 5% fluorouracil (5FU) cream as adjuvant therapy following cervical intraepithelial neoplasia grade 2 or 3 (CIN2/3) treatment among women living with HIV (WLWH) in Kenya.

Methods: A phase I pilot trial was performed among 12 WLWH in Kenya, aged 18-49 years between March 2023 and February 2024 (ClinicalTrial.gov NCT05362955).

Factors Associated With Feeling Ashamed of Disclosure of HIV-Positive Status Among Women Who Self-Reported to Health Facilities for HIV Testing in Kenya: Analysis of 2022 Kenya Demographic and Health Survey.

Background: This study aimed to determine the factors associated with feeling ashamed of disclosing HIV-positive status among females who self-reported to health facilities for HIV testing in Kenya.

Method: This study used the Kenya Demographic Health Survey data set for 2022. A total of 18,506 women aged 15-49 years were selected from the sample clusters; 13,815 had ever tested for HIV and 332 had positive results for HIV.

Haemoglobin types and variant interference with HbA1c and its association with uncontrolled HbA1c in type 2 diabetes mellitus.

Diabetes mellitus is among the leading global health concerns, causing over 1.5 million deaths alongside other significant comorbidities and complications. Conventional diagnosis involves estimating fasting, random blood glucose levels and glucose tolerance test.

The Fish Feed Sector in Kenya, Uganda, Tanzania, and Rwanda: Current Status, Challenges, and Strategies for Improvement-A Comprehensive Review.

This review paper provides an in-depth analysis of the current status, challenges, and strategies for improvement within the fish feed industry in East Africa, focusing on Kenya, Uganda, Tanzania, and Rwanda. Aquaculture production in these countries is experiencing steady growth, driven by increasing demand for fish and fish products for both nutritional and economic purposes. Despite the market facilitating the transition from extensive to semi-intensive and moderately intensive farming systems across the four countries, the sector's progress is hampered by a lack of sustainable, locally produced, high-quality, and cost-effective fish feeds tailored to different developmental stages of fish.

Discovery of α-amylase and α-glucosidase dual inhibitors from NPASS database for management of Type 2 Diabetes Mellitus: A chemoinformatic approach.

Postprandial hyperglycemia, typical manifestation of Type 2 Diabetes Mellitus (T2DM), is associated with notable global morbidity and mortality. Preventing the advancement of this condition by delaying the rate of glucose absorption through inhibition of α-amylase and α-glucosidase enzymatic activities is of utmost importance. Finding a safe antidiabetic drug is essential since those that are currently on the market have drawbacks like unpleasant side effects.

Postpartum modern family planning among women living with HIV attending care at health facilities in Busia County, Kenya.

Background: For women living with the human immunodeficiency virus (WLHIV), preventing untimed pregnancies during the postpartum period reduces vertical transmission and improves other maternal and child health outcomes. In Kenya, Busia County's HIV prevalence and mother-to-child transmission rate are higher than the national average yet uptake of postpartum family planning (PPFP) is generally low. This study examined health system factors influencing the consistent use of PP modern FP methods among WLHIV in Busia County.

Women's Perspectives on the Unique Benefits and Challenges of Self-Injectable Contraception: A Four-Country In-Depth Interview Study in Sub-Saharan Africa.

Implementing self-injection (SI) of subcutaneous depot-medroxyprogesterone acetate (DMPA-SC) is a key self-care strategy for sexual and reproductive health, but SI uptake remains low, and assertions about the potential of SI to increase women's control over contraceptive use lack evidence. We sought to qualitatively explore how women with diverse contraceptive experiences-including those with and without experience using SI-view the benefits and challenges of SI as compared to other methods. We conducted 241 in-depth interviews with women across four sub-Saharan African countries and found alignment between the perceived and experienced benefits of SI across our diverse sample.

Parenting Risk and Protective Factors in the Development of Conduct Problems in Seven Countries.

This study advances the understanding of risk and protective factors in trajectories of conduct problems in adolescence in seven countries that differ widely on a number of sociodemographic factors as well as norms related to adolescent behavior. Youth- and parent-report data from 988 adolescents in seven countries (Colombia, Italy, Kenya, Philippines, Sweden, Thailand, and the USA) who were followed longitudinally from ages 10 to 18 (yielding 6872 total data points) were subject to latent class growth analysis. A 4-class model provided the best fit to the data: Late Starters, Alcohol Experimenters, Mid-Adolescent Starters, and Pervasive Risk Takers.

Proximal and distal minority stressors and mental health among young gay and bisexual men and other men who have sex with men (GBMSM) in Kisumu, Kenya.

Young gay and bisexual men and other men who have sex with men (GBMSM) in Kenya experience pervasive intersectional stigma and discrimination, contributing to elevated levels of negative mental health symptoms. Grounded in the Minority Stress Model, this paper explores associations of proximal and distal minority stressors with three types of negative mental health outcomes among young HIV-negative GBMSM (n = 63) between the ages of 19-34 who participated in a pilot trial of a sexual health intervention. Using the PHQ-9, GAD-7, and PC-PTSD-5 screening measures, levels of clinically significant symptoms were reported as follows: 15.

Alkaloids Isolated from Vepris glandulosa with Antidiabetic Properties: An In Vitro and In Silico Analysis.

Diabetes is a major global health issue and as current treatments fail, the search for new antidiabetic drugs is crucial. This investigation, focusing on identifying potential antidiabetic compounds from the endangered plant species Vepris glandulosa, led to the isolation of two known alkaloids, choisyine acetate (1) and choisyine (2). The study established the in vitro inhibitory activities and in silico molecular interaction of the two alkaloids with α-amylase based on IC values, Linewaever-Burk/Dixon plot kinetic analyses and Molecular docking, respectively.

The role of co-infections on cervical intraepithelial neoplasia prevalence in western Kenya.

Background: Screening for co-infections with HIV, HSV-2 and among high-risk human papilloma virus (hr-HPV) positive women remains essential in alleviating high morbidity of cervical cancer (CC). The aim of this study was to determine the prevalence of cervical intraepithelial neoplasia (CIN) among women referred for CC screening at a referral hospital in Kisumu County, Kenya; and to establish the role of co-infection on CIN.

Method: In a cross-sectional study, we collected HPV, HIV, HSV-2 and CT data, cervical cytology results, and demographic information from 517 referrals.

Transcriptomic and Proteomic Insights into Host Immune Responses in Pediatric Severe Malarial Anemia: Dysregulation in HSP60-70-TLR2/4 Signaling and Altered Glutamine Metabolism.

Severe malarial anemia (SMA, Hb < 6.0 g/dL) is a leading cause of childhood morbidity and mortality in holoendemic transmission zones. This study explored the entire expressed human transcriptome in whole blood from 66 Kenyan children with non-SMA (Hb ≥ 6.

Validation of a novel medical device (Chloe SED®) for the administration of analgesia during manual vacuum aspiration: a randomized controlled non-inferiority pilot study.

Introduction: Millions of women worldwide annually undergo manual vacuum aspiration (MVA) with no pain medication, which is a violation of their basic human dignity. We designed a novel device (Chloe SED®) to administer paracervical block (PCB) during MVA in countries where pain medication is not typically given due to the high cost of the necessary tools.

Methods: We conducted a single-blinded, randomized controlled non-inferiority trial including 61 patients at two hospitals in Kisumu, Kenya, to validate Chloe SED® for administration of PCB during MVA.

Training in the symptothermal method to ameliorate unmet need for family planning: knowledge, attitudes and satisfaction.

Background: Addressing the unmet need for family planning to prevent unintended pregnancies is a high priority for women's health, and training as an element of the symptothermal method (STM) is deemed to be an effective strategy. This study assessed training on knowledge, attitudes and satisfaction with STM to ameliorate the unmet need for family planning.

Methods: The study adopted a pre-post study design.

Can "the expanded free maternity services" enable Kenya to achieve universal health coverage by 2030: qualitative study on experiences of mothers and healthcare providers.

Introduction: Universal health coverage is a global agenda within the sustainable development goals. While nations are attempting to pursue this agenda, the pathways to its realization vary across countries in relation to service, quality, financial accessibility, and equity. Kenya is no exception and has embarked on an initiative, including universal coverage of maternal health services to mitigate maternal morbidity and mortality rates.

Attachment security, environmental adversity, and fast life history behavioral profiles in human adolescents.

One species-general life history (LH) principle posits that challenging childhood environments are coupled with a fast or faster LH strategy and associated behaviors, while secure and stable childhood environments foster behaviors conducive to a slow or slower LH strategy. This coupling between environments and LH strategies is based on the assumption that individuals' internal traits and states are independent of their external surroundings. In reality, individuals respond to external environmental conditions in alignment with their intrinsic vitality, encompassing both physical and mental states.