Kisumu County Research Articles

Women’s empowerment and uptake of sulfadoxine–pyrimethamine for intermittent preventive treatment of malaria during pregnancy: results from a cross-sectional baseline survey in the Lake endemic region, Kenya

BackgroundMalaria in pregnancy remains a major public health problem in endemic areas of the sub-Saharan African (SSA) region. However, there is limited understanding of the association between women’s empowerment and the uptake of sulfadoxine–pyrimethamine for intermittent preventive treatment of malaria during pregnancy (IPTp-SP) in Kenya. This study examines the association between women’s empowerment indicators (decision-making power, control of assets, education, and employment status) and the uptake of three or more doses of IPTp-SP in the Lake endemic region of Kenya.MethodsThe analysis utilized a dataset from a cross-sectional baseline survey of 3129 women aged 15–49 years in Kisumu and Migori Counties who had a live birth within the last 2 years preceding the study. Data were collected between June to August 2021. A descriptive analysis was conducted to show the distribution of respondents by key background characteristics, and bivariate and multivariate logistic regression to examine statistically significant associations between women’s empowerment measures and the uptake of 3+ doses of IPTp-SP.ResultsAmong the 3129 women surveyed, 1978 (65.7%) received 3+ doses of IPTp-SP during their most recent pregnancy. Controlling for individual characteristics and the number of ANC visits, the odds of taking 3+ doses of IPTp-SP increased among women who had high decision-making autonomy (AOR = 2.33; CI = 1.81–3.01; P < 0.001); and tertiary level of educational attainment (AOR = 1.51; CI = 1.10–2.06). However, the association between control of assets and uptake of IPTp-SP was positive but not statistically significant.ConclusionWomen’s decision-making autonomy and educational attainment were positively associated with the uptake of IPTp-SP. As a result, maternal health interventions should focus on less empowered women, specifically those with less decision-making autonomy and no/low formal education, as they are less likely to achieve optimal uptake of IPTp-SP during pregnancy.

Assessing awareness and use of HIV self-testing kits after the introduction of a community-based HIV self-testing programme among men who have sex with men in Kenya.

Men who have sex with men (MSM) bear a disproportionate burden of new HIV infections in Kenya, while experiencing discrimination, leading to suboptimal levels of HIV care. HIV self-testing (HIVST) is a tool to increase HIV screening and earlier diagnosis; however, questions remain regarding how best to scale-up HIVST to MSM in Kenya. The main objective of this study was to examine changes in knowledge and use of HIVST after implementation of a community-led HIVST project. Participants were MSM recruited from Kisumu, Mombasa, and Kiambu counties. Data were collected from two rounds (Round 1: 2019; Round 2: 2020) of serial cross-sectional integrated biological and behavioural assessments (IBBA), pre-, and post-project implementation. Two main outcomes were measured: 1) whether the respondent had ever heard of HIVST; and 2) whether they had ever used HIVST kits. Changes in outcomes between IBBA rounds were examined using modified multivariable Poisson regression models; adjusted prevalence ratios (aPR) and 95% confidence intervals (95% CI) are reported. A total of 2,328 respondents were included in main analyses. The proportion of respondents who had heard of HIVST increased from 75% in Round 1 to 94% in Round 2 (aPR: 1.2, 95% CI: 1.2-1.3), while those reporting using an HIVST kit increased from 20% to 53% (aPR: 2.3, 95% CI: 2.0-2.6). Higher levels of education and HIV programme awareness were associated with both outcomes. Awareness and use of HIVST kits increased after implementation of a community-led HIVST implementation project, demonstrating the importance of integration with existing community groups.

The Fidelity of a Pharmacy-Based Oral HIV Pre-Exposure Prophylaxis Delivery Model in Kenya.

HIV pre-exposure prophylaxis (PrEP) delivery at private pharmacies is a promising new differentiated service delivery model that may address barriers to PrEP delivery at public health care facilities. We measured the fidelity of this model (ie, delivery as intended) in a pilot study in Kenya. Five private, retail pharmacies in Kisumu and Thika Counties. Trained pharmacy providers delivered PrEP services, including identifying eligible clients, counseling on HIV risk, assessing PrEP safety, testing for HIV, and dispensing PrEP. Pharmacy clients completed surveys that assessed the fidelity of the services received after each visit. Standardized client actors (ie, mystery shoppers) were trained on 4 different case scripts, then made unannounced pharmacy visits, and then completed a 40-item checklist that assessed the fidelity and quality of service delivery components. From November 2020 to December 2021, 287 clients initiated and 159 (55%) refilled PrEP. At initiation, most clients were counseled on PrEP adherence (99%, 284 of 287) and potential side effects (97%, 279 of 287) and all received provider-assisted HIV self-testing before PrEP dispensing (findings consistent across refill visits). Nine standardized client actors completed 15 pharmacy visits. At each visit, most actors were asked about their behaviors associated with HIV risk (80%, 12/15) and all were counseled on PrEP safety and side effects. All actors reported that pharmacy providers treated them with respect. In this first pilot study of pharmacy-delivered PrEP services in Africa, the fidelity of service delivery was high, suggesting that trained providers at private pharmacies can deliver quality PrEP services.

Effect of Resource Availability on the Performance of Energy and Petroleum Sector State Corporations in Kisumu County, Kenya.

The purpose of this study was to establish the effect of resource availability on performance of energy and petroleum sector state corporations in Kenya. The study employed explanatory research design. The target population was 99 senior managers from 11 energy and petroleum sector state corporations in Kisumu County. Data was collected using structured questionnaire and secondary data schedule. SPSS was used for data analysis. Descriptive and inferential statistics were used for the analysis of quantitative data. Percentages, standard deviation and mean was used in descriptive while, correlation (r) and regression analysis were used for hypothesis testing at 95% confidence interval in in inferential statistics. Reliability was tested through Cronbach’s alpha coefficient. SD and mean were used to analyses the objective. Organization structure (p=0.12). Organization structure had statistically significant with organization performance and the null hypothesis rejected. It was evident that organization structure significantly influenced Kenyan energy and petroleum sector state corporations performance. The management of energy and petroleum sector state corporations in Kenya should therefore leverage all the aspects of resource availability to exponentially enhance the corporations’ performance

Capacity of Clinical Officers to Care for Patients with Hypertension and Type 2 Diabetes Mellitus in Rural Healthcare Facilities in Kisumu County, Kenya

This study aimed to investigate the ability of clinical staff in a rural Kenyan health facility to manage patients with hypertension and type 2 diabetes mellitus. The study involved 146 clinicians from 56 medical facilities who were interviewed using semi-structured questionnaires, simulations, and observational instruments. Descriptive analysis was performed using SPSS version 24. Results showed that lack of knowledge of risk factors for HTN&amp;amp; T2DMHTN &amp;amp; T2DM, inability to perform a complete physical examination, inability to identify first-line medications for either hypertension or type 2 diabetes mellitus, unavailability of assigned patient follow-up clinic day/staff/room, and lack of treatment guidelines for hypertension and diabetes were associated with an inability to manage such patients. However, concurrent prescription of anti-hypertension medication along with advice on lifestyle modification strategies was associated with an ability to do so (OR 0.079; 95% CI0.016-0.934; P=P = 0.002). The study recommends that clinical staff receive education on the risk factors, physical examination, and first-line medications for managing hypertension and type 2 diabetes mellitus. Additionally, the study highlights the importance of having scheduled clinic days, assigned staff, dedicated rooms, and protocols and guidelines to improve the management of these conditions

HPV vaccination in Kenya: a study protocol to assess stakeholders' perspectives on implementation drivers of HPV vaccination and the acceptability of the reduced dose strategy among providers.

Cervical cancer is the leading cause of cancer-related deaths among Kenyan women. Persistent infection with high-risk oncogenic Human papillomavirus (HPV) genotypes is a necessary cause of cervical cancer. HPV vaccines are safe, durable, and efficacious in preventing incident HPV infections. In Kenya, despite efforts to increase HPV vaccination, coverage remains low. We sought to assess: (1) barriers and facilitators of HPV vaccination from the perspective of adolescent girls and young women (AGYW), their guardians as well as stakeholders involved in HPV vaccine delivery, and (2) the acceptability of the single dose of the HPV vaccination among healthcare providers (HCPs). Our study is nested within the KENya Single-dose HPV-vaccine Efficacy study (KEN SHE) that sought to test the efficacy of single-dose bivalent (HPV 16/18) and single-dose nonavalent (HPV 16/18/31/33/45/52/58/6/11) vaccination. We are conducting this study in Kiambu, Nairobi, and Kisumu counties. In these counties, we are interviewing stakeholders (n = ∼25), selected based on their role in HPV vaccination at the county and national levels. Interviews are audio recorded and conducted in English or Swahili. The semi-structured interview guides were designed based on: (1) the Theoretical Domains Framework (TDF) for AGYW and guardians and (2) the Consolidated Framework for Implementation Research (CFIR) for other stakeholders. The Theoretical Framework of Acceptability (TFA) was leveraged to design the survey administered to HCPs (n = ∼309) involved in HPV vaccination. We will develop a codebook based on emerging codes from the transcripts and constructs from the TDF and CFIR. Emerging themes will be summarized highlighting similarities and differences between and within the different stakeholder groups and counties. Descriptive statistics and a χ2 test will be used to assess the distribution of responses between the different sites and regression analysis will be used to assess factors associated with high acceptability of the single-dose strategy while controlling for confounding variables. Our study will describe key barriers and facilitators that affect HPV vaccination from the perspective of multiple stakeholders as well as insights on the perspective of HCPs towards the single-dose strategy to inform the designing of strategies to increase HPV vaccination uptake in Kenya and comparable settings.

Developing a suicide prevention action plan in Kisumu County, Kenya

AbstractSuicide prevention is a complex and context‐dependent challenge. About 75% of deaths by suicide occur in low‐ and middle‐income countries; yet, most current suicide prevention strategies build upon data from high‐income countries (HIC). The Kisumu County Government (KCG) in Kenya recognized the need for a suicide prevention action plan. In the absence of a Kenyan national suicide strategy, it also did not solely depend on recommendations from HIC. The KCG therefore convened a multidisciplinary workgroup with stakeholders from various sectors that led the development of the Kisumu County Suicide Prevention Action Plan (KCSPAP). The team utilized a mixed‐method approach (literature review, a desk review of mental health indicators and death certificates, focus group discussions, and key informant interviews) identifying the following: (a) magnitude and variations of suicide cases (higher number of suicide completions compared to attempts; the leading method was organophosphate poisoning though the suicide method often was not specified); (b) protective and risk factors (male gender, being between 19 and 45 years of age, and being married); (c) community perceptions of suicide (taboo topic; associated with negative spirits; community members were divided on suicide decriminalization); (d) potential solutions (need for data collection, awareness creation; scale‐up of traditional and nontraditional mental health approaches). Given the importance of a public health perspective on suicide prevention, the data in the KCSPAP are organized in a public health prevention framework that builds on a data collection framework. The KCSPAP was handed over to the KCG in mid‐2020; different recommendations have been implemented since. The KCSPAP is an example of policymaking based on local knowledge. This homegrown policymaking approach has multiple benefits and can be used by stakeholders locally and in other countries.

Influence of health system factors on Fetomaternal outcomes among pregnant women presenting with antepartum hemorrhage at Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu-Kenya

Background: Globally, maternal mortality is decreasing, but in developing countries, especially Sub-Saharan Africa, maternal death has remained high. Antepartum haemorrhage (APH), which is the per-vaginal bleeding after 28 weeks of gestation and before delivery complicates 2-5% of pregnancies. Although timely access to quality obstetric services, availability of trained health service providers, availability of transfusion products, theatre waiting time are major determinants of both maternal and new-born outcomes after antepartum haemorrhage, the impact of the health system and health provider related factors associated with APH on the neonatal and maternal outcomes remains to be investigated. As such, this study evaluated the influence of health system factors on maternal and neonatal outcomes among women presenting with Antepartum haemorrhage at the Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH), Kisumu County, Kenya. Methods: The study was a prospective case-control study that recruited mothers (n=63) presenting at the maternity department with antepartum haemorrhage. The control group comprised of mothers (n=63) presenting without antepartum haemorrhage at the same maternity. The study took a period of one year. Data was coded and analysed by SPSS program version 23.0 and STATA version 14.0. Results: Abruptio placentae and placenta Previa were the major causes of APH recorded in 17 (27%) and 39 (61.9%) of APH patients, respectively. A large proportion of patients presenting with antepartum haemorrhage (APH) were younger, aged between 20-29 years (n=37, 58.7%), with an overall mean age of 26.22. Cases with APH had a lower mean parity (1.17), while controls had a higher mean parity (2.97 Caesarean section rate was high among pregnant women who had APH (n=42, 66.7%). (p=0.001). Out of these, 32 (52.4%) were done as emergency. Majority of the emergency caesarean sections were done within 30 minutes from the time the decision to deliver had been made (n=17, 54.8%). Most patients who presented with APH were referred from another facility (n=42 (66.7%) in our study. Risks of perinatal and maternal mortality were higher for patients who came from outside of JOOTRH compared to patients from JOOTRH (OR=3.16, 95%CI=1.34-5.57, P&lt; 0.0001). High risks of perinatal mortality (19.9%) and maternal mortality (3.2%) were observed among APH patients in our study hospital compared to mothers who did not experience APH (8% and 0% respectively). Majority of new-borns of patients who had APH were admitted to NBU (n=42, 66.7%) (p=0.017) and the major reason for admission to NBU was prematurity and low Apgar score. Conclusion of the study is that APH is a major cause of maternal and perinatal morbidity and mortality. This could be prevented by regular and focused antenatal care, early detection of risk factors and prompt referrals. Many facilities for caesarean sections, availability of blood banks and blood transfusion products, facilities with ICU and proper new-born units with adequate staffing can improve maternal and perinatal outcome of patients with APH

Effect of Organizational Leadership on Performance of Energy and Petroleum Sector State Corporations in Kisumu County, Kenya

The purpose of this study was to establish the effect of organizational leadership on performance of energy and petroleum sector state corporations in Kenya. The study employed explanatory research design. The target population was 99 senior managers from 11 energy and petroleum sector state corporations in Kisumu County. Data were collected using structured questionnaire and secondary data schedule. SPSS was used for data analysis. Descriptive and inferential statistics were used for the analysis of quantitative data. Percentages, standard deviation and mean was used in descriptive while, correlation (r) and regression analysis were used for hypothesis testing at 95% confidence interval in inferential statistics. Reliability was tested through Cronbach’s alpha coefficient. SD and mean were used to analyse the objective. Organization leadership (p=0.12). Organization structure had statistically significant with organization performance and the null hypothesis rejected. It was evident that organization structure significantly influenced Kenyan energy and petroleum sector state corporations performance. The management of energy and petroleum sector state corporations in Kenya should therefore leverage all the aspects of organization leadership to exponentially enhance the corporations’ performance.

Early sexual debut is associated with drug use and decreased educational attainment among males and females in Kisumu County, Kenya

Differing global sociocultural contexts of sexual relationships influence age at first sexual intercourse with potentially long-lasting region-specific effects such as increased risk of contracting HIV and other sexually transmitted infections (STIs). In these cross-sectional analyses of data from the screening and enrollment visits for an HIV incidence study in Kisumu County, Kenya, we evaluated factors associated with having experienced an early sexual debut (ESD) among males and females aged 18–35 years. Clinical evaluation was performed and sexual behaviors were assessed via questionnaire. ESD was defined as self-reported age 15 years or younger at first sexual intercourse. Robust Poisson regression was used to estimate prevalence ratios (PRs) and 95% confidence intervals (95% CIs) for factors associated with ESD. Of 1057 participants, 542 (51.3%) were female. Participants' median age at study screening was 25 years (interquartile range [IQR]: 22–29), and at sexual debut was 16 years (IQR: 14–17). Five hundred and four participants (47.7%) reported ESD. ESD was less common among females (PR 0.78, CI 0.67–0.90) and participants with more than primary education (PR 0.56, CI 0.47–0.66). ESD was more common in participants with a history of drug use (PR 1.28, CI 1.10–1.49). Drug use removed the protective effect of education (some secondary education or less, no drug use: PR 0.72, CI 0.61–0.85; some secondary education or less, drug use: PR 0.94, CI 0.74–1.18). ESD was common in our study and associated with lower educational attainment and increased likelihood of drug use. Interventions are needed early in life, well before 15 years of age, to encourage engagement in schooling and prevent drug use. Comprehensive sexual education and interventions to prevent drug use may be beneficial before the age of 15 years.

The Influence of School Based Menstrual Hygiene Management Programs on School Attendance among Girls in Public Primary Schools in Kisumu West Sub-County, Kisumu County, Kenya

Most governments have prioritized Menstrual Hygiene Management (MHM) practices for safe schools. However, girls and women in Low and Middle-Income Countries (LMIC) still face significant challenges in managing their menstruation. This study examined the influence of school based MHM Programs on school attendance among girls in public Primary schools in Kisumu west sub-county, Kisumu County, Kenya. The study was anchored on the Sanitary Hardware theory. The study employed descriptive survey research design where both qualitative and quantitative methods were used. Questionnaires were administered to a selected sample of 356 respondents drawn from a target population of 3233. The sample size was arrived at using the Yamane (1967) formula. The respondents consisted of class 6-8 girls, teachers, Head-Teachers, and MoE officials who were key informants for the study. The collected data was filtered, organized, coded and later analyzed using Statistical Package for Social Sciences (SPSS) version 22 software. Analysis was done in form of descriptive and inferential statistics. From the findings, the F ratio is 111.855, which means that improvement due to fitting the model is much greater than the model inaccuracies (F (1, 336) = 111.855, p=0.001). This implies that Menstrual Hygiene Management school-based programs are useful predictor of school attendance. The researcher therefore recommends that schools should be able to ensure consistent availability of water for use by girls during menstruation. They should be empowered to involve themselves in making reusable pads to assist those who cannot afford disposable pads use locally available materials in menstrual management.

Influence of Menstrual Hygiene Management Knowledge, Attitudes and Practices and School Attendance among Girls in Public Primary Schools in Kisumu West Sub-County, Kisumu County, Kenya

School based comprehensive sexuality education that addresses Menstrual Hygiene Management (MHM) knowledge practices – including hygiene practices and management of menstrual pain may be an avenue for addressing both poor MHM practices and absenteeism, if they are locally adapted and practiced. Inadequate knowledge, lack of access to quality sanitary materials, cultural beliefs and taboos around menstruation and MHM, are common challenges that can negatively affect Education, Employment, Health and psychosocial outcomes. The study aimed at examining Menstrual Hygiene Management Knowledge, Attitudes and Practices in public primary schools in public Primary schools in Kisumu west sub-county. The respondents consisted of class 6-8 girls, teachers, Head teachers, and MoE officials who were key informants for the study. Data was collected using structured questionnaires and interview schedules. The data analyzed using Statistical Package for Social Sciences (SPSS) version 22 software. Both quantitative and qualitative findings were presented in the study. The study revealed that there is high prevalence of poor MHM among adolescent girls, and there exist a strong association between poor MHM and low knowledge. The study concluded that menstrual hygiene management in public primary schools is greatly influenced by knowledge, attitudes and practices of school management and girls’ perceptions. The study recommends the need for comprehensive education interventions in school settings, delivered during early adolescence to reach pre-menarche girls, particularly in rural settings for improve menstrual hygiene practices. The government should have a clear monitoring tool to ensure pupils receive accurate and timely information on menstruation and menstrual hygiene management.

The use of clinical laboratory and radiologic data in the assessment of pediatric extrapulmonary tuberculosis cases in Kisumu County Kenya

Extrapulmonary tuberculosis is detected more frequently in children than adults since the risk of lymphohematogen spread is high in young children. Tuberculosis may attack any organ in the body, including the lymph nodes and the central nervous system. In children, it is difficult to detect tuberculosis since most signs and symptoms are not easily detected in young children. However, it has been documented to be the most crucial cause of mortality in the childhood age group. It has also been found to be non-specific, with low sensitivity to diagnostic tests amongst pediatric patients. This is partly because of its ability to mimic many other disease manifestations. This study evaluated the clinical, laboratory, and radiologic observations and treatment outcomes in pediatric patients followed up in the TB clinic.

The use of clinical, laboratory, and radiologic data in the assessment of pediatric extra pulmonary tuberculosis cases in Kisumu County, Kenya

Extrapulmonary tuberculosis is detected more frequently in children than adults since the risk of lymphohematogen spread is high in young children. Tuberculosis may attack any organ in the body, including the lymph nodes and the central nervous system

Enhancing Performance of HIV/AIDS Projects through Digital Health Interventions for Client Appointments in Kisumu County, Kenya

This study examined the perceptions of health service providers on the relationship between utilization of digital health intervention (DHI) for clients’ adherence to appointments and performance of HIV/AIDS projects in Kisumu County using an ex-post facto cross-sectional descriptive survey design. A census approach was used to recruit 191 participants who were at work during the data collection period across eight health facilities where the DHI was being used. Quantitative data was collected electronically using a questionnaire built a 5-point Likert scale and analyzed using SPSS version 26. Descriptive analysis involved generating the means and standard deviations while inferential analysis involved determining correlations and linear regression modelling. Results for both descriptive and inferential statistics are presented using tables. Qualitative data was collected using a key informant interview guide and analyzed thematically. Data were collected in January 2022. Results show a high level of utilization of DHI for clients’ appointments adherence (composite mean =4.28; SD=0.77; CI=95%). Performance of HIV/AIDS projects was scored highly with a composite mean of 4.47 (SD=0.057; CI=95%). A Pearson correlation coefficient of 0.349; p value&lt;0.001, showed a statistically significant positive relationship between the two variables. Utilization of DHI for clients’ appointments adherence could potentially influence performance of HIV/AIDS projects by up to 28% (R2=0.28, p value&lt;0.001). The study concluded that the DHI for clients’ appointments adherence was critical in improving adherence to treatment plans and management of appointments as an electronic diary at the health facilities hence improving performance of HIV/AIDS projects.

Antiretroviral Drug Management Tool and Performance of HIV/AIDS projects in Kisumu County, Kenya: A Digital Heath Solution Approach

The aim of this study was to assess the influence of utilization of the digital health intervention for antiretroviral drug management on performance of HIV/AIDS projects in Kisumu County. An ex-post facto cross-sectional descriptive study was conducted to gain understanding on the influence of the use of the digital health intervention for antiretroviral drug management on the performance of the HIV/AIDS projects. The study was conducted in eight (2 level V and 6 level IV) health facilities providing HIV/AIDS care and treatment in Kisumu. Using a census approach the study recruited 191 participants who were health service providers across the study sites. The study used a 5-point Likert scale to measure the perspectives of the participants on aspects of utilization of the digital health intervention for antiretroviral drug management and performance of HIV/AIDS projects. A key informant interview guide was used to collect qualitative data. There was a positive significant relationship between utilization of digital health interventions for antiretroviral drug management and performance of HIV/AIDS projects with a Pearson Coefficient value=0.507, p value&lt;0.001. A linear regression model gave an R square value of = 0.332, indicating that utilization of the digital health intervention for ARV drug management could positively influence up to 33.2% of improvement in performance of HIV/AIDS projects. This study concluded that using technology to manage drugs has potential to significantly improve overall performance of a health project. Increased investment towards scaling implementation of the Web antiretroviral dispensing tool as the commonly used intervention.

Catalytic Pyrolysis of Plastic Waste to Liquid Fuel Using Local Clay Catalyst

Plastics are nonbiodegradable, and safe disposal of this waste poses an environmental challenge all over the world. Catalytic pyrolysis is superior to thermal pyrolysis as it uses lower temperatures and hence less energy. The main objective of this study was to produce liquid fuel from plastic waste using indigenous clay as a catalyst through catalytic pyrolysis. The clay from Kisumu County was characterized through an X-ray fluorescence spectrometer (XRFS) and an X-ray diffractometer (XRD). The reaction setup consisted of a round-bottom flask reactor through which plastic feed and catalyst were heated in a temperature-controlled furnace. Vapor product was condensed using a Liebig type water condenser to give pyrolysis liquid product. Solid char was recovered from the flask at the end of the reaction. Optimization studies using central composite design (CCD) and response surface methodology (RSM) were performed in design expert software to predict optimal conditions of the operating variables for maximum yield of the liquid fuel. Results show that clay has a composition of silica and alumina at 64.5 wt% and 16.3 wt%, respectively, indicating high acidity of the clay, being a requirement for a good pyrolysis catalyst. For high-density polyethylene and polypropylene, the highest liquid yield of 87.23 wt% and 60.36 wt%, respectively, was at 300°C and a catalyst concentration of 10 wt%. Indigenous clay was established to be a suitable catalyst for catalytic pyrolysis of plastic waste, with the potential to replace imported catalysts since high yields of liquid fuel were obtained at lower reaction temperatures of 300-450°C, as compared to the 600°C required for thermal pyrolysis. In conclusion, waste plastics can be used to generate alternative fuel for industrial use. The liquid fuel can be used in diesel engines as a transport fuel, in turbines for electricity generation, and as a heating source in boilers and furnaces. Further studies on the modification of the surface and structure of clay are suggested to enhance its catalytic performance in the pyrolysis process for a better fuel yield.

Capacity of laboratories as surveillance sites for Neisseria gonorrhoeae culture and antimicrobial resistance or susceptibility testing in public hospitals within Kisumu County, Kenya

Capacity of laboratories as surveillance sites for Neisseria gonorrhoeae culture and antimicrobial resistance or susceptibility testing in public hospitals within Kisumu County, Kenya

Point-of-Care approach to assess the predisposing factors associated with Chlamydia trachomatis infection among sexually active women attending the outpatient clinics at Kisumu County Referral Hospital, Kenya

Point-of-Care approach to assess the predisposing factors associated with Chlamydia trachomatis infection among sexually active women attending the outpatient clinics at Kisumu County Referral Hospital, Kenya

Relationship between Demographic, Socioeconomic Factors, and Psychological Responses of Health Care Providers during COVID–19 Pandemic, Kenya

Context: Corona Virus Disease of 2019 (COVID-19), an infectious disease caused by Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2), spread across the globe, causing distress among various populations, including healthcare providers. This disease has had an unparalleled effect on the world's economic situation, livelihood, and mental and physical well-being across the globe.&#x0D; Aim: To assess the healthcare providers' psychological responses and related demographic and socioeconomic factors during the COVID-19 pandemic at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH).&#x0D; Methods: This was a hospital-based descriptive cross-sectional study at Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu County, Kenya. A stratified sampling method was used in the selection of 202 healthcare providers. The questionnaire used consisted of four components: demographic and socioeconomic factors. Standardized questionnaires measured the symptoms of depression and anxiety, the 9–item Patient Health Questionnaire (PHQ - 9) and the 7–item Generalized Anxiety Disorder Scale (GAD - 7), respectively.&#x0D; Results: Among 202 healthcare providers, the overall prevalence of depressive and anxiety symptoms was 57.4% and 59.9%, respectively. After using Pearson Chi-square for the relationship of GAD with demographic characteristics, it was revealed that age (OR 0.1, p = &lt;0.001), gender (OR 0.4, p = 0.002), and marital status (OR 4.2, p = &lt;0.001) were significantly associated. Also, the relationship of GAD with socioeconomic factors revealed that the level of education (OR 0.5, p = 0.019), income level (OR 4.6, p = &lt;0.001), living alone (OR 0.4, p = 0.004), living with partner and children (OR 2.4, p = 0.002), living with parent (OR 2.7, p = 0.001) and employment terms (OR 3.3, p = &lt;0.001), were related with symptoms of anxiety. Concerning depressive symptoms and demographic characteristics, age (OR 0.5, p = 0.006) and marital status (OR 3.2, p = &lt;0.001) were significantly associated. Also, the relationship of depression with socioeconomic factors revealed that living alone (OR 0.4, p = 0.002), living with a partner (OR 4, p = 0.007), living with a partner and children (OR 1.7, p = 0.045), living with parent (OR 2.5, p = 0.001) and having a chronic medical condition (OR 0.5, p = 0.048) were related with depressive symptoms.&#x0D; Conclusion: There was a relatively high prevalence of anxiety and depression among JOOTRH healthcare providers during the pandemic. Those with a partner and children, those living without parents, high-income level, level of education undergraduate and above, were married, above 30 years, female, and being on permanent employment were significantly related to anxiety. Those living with someone else, without a chronic medical condition, being over 30 years and married were more likely to have depression than their counterparts. The study recommends providing psychological support to healthcare providers to enhance their psychological resilience during pandemics.