COHES Students Publications

INSTITUTIONAL FACTORS ASSOCIATED WITH SURGICAL SITE INFECTIONS AMONG POST CAESAREAN SECTION IN THIKA LEVEL 5 HOSPITAL

2026-03-31T00:00:00Z

INSTITUTIONAL FACTORS ASSOCIATED WITH SURGICAL SITE INFECTIONS AMONG POST CAESAREAN SECTION IN THIKA LEVEL 5 HOSPITAL Ndege, Jane Wanjiku Objective: The study aimed at determining the institutional factors that contribute to surgical site infections among post caesarean section in Thika Level 5 Hospital. Materials and Methods: The study employed a mixed unmatched case-control study design which targeted all mothers who had undergone caesarean section in maternity unit at Thika Level 5 Hospital and who had or did not have Surgical Site Infection from delivery up to thirty days post-delivery and nurse in-charges of maternity unit. Result: The sample size of the study was made up of 128 women comprising 32 cases and 96 controls. Qualitative results revealed that poor aseptic technique in theatre during C/S operations led to an increase in Surgical Site Infections (SSIs). Respondents highlighted the significance of maintaining a sterile and clean environment in the theatre to prevent contamination of surgical sites by microorganisms. The study found that mothers who stayed in hospital for more than 24 hours before Caesarian Section (CS) were more likely to get Surgical Site Infection (SSI) as compared those that had stayed in the hospital for less 24 hours before CS (OR=13.05 [95%CI=4.10-41.53]; p<0.001). Mothers who shared beds with other patients were more likely to get SSI as compared to those that did not share beds (OR=3.01 [95%CI=1.28-4.19]; p<0.001). Moreover, mothers who spent more than a week in the hospital were more likely to get SSI than those who stayed in the hospital for less than that period (OR=3.41 [95%CI=1.06-11.38]; p<0.001). Conclusion: The study concludes that there is a potential relationship between the duration of hospital stay prior to CS and the risk of SSI. Also, the institutional factors associated with SSIs are the response of healthcare workers to the needs of the patients, the level of care given at the hospital and facility accessibility. MSc Research Publication

Correlation between Escherichia coli resistant gene isolated from stool samples of children under five years and that from consumed water

2026-03-26T00:00:00Z

Correlation between Escherichia coli resistant gene isolated from stool samples of children under five years and that from consumed water Kibet, Suge Titus children. Kenya reports around 2.6 million cases and 7,000 deaths annually due to diarrhea. Antibiotic-resistant DEC strains are a significant public health concern, complicating treatment. The objective of this research was to correlate children’s water consumption and antimicrobial- resistant DEC development. The study sampled 1124 children under five with diarrhea in Nakuru, Kenya, using a case-control design. Among 384 eligible children, 192 cases showed Amoxicillin-resistant DEC. Water samples from households were collected and analyzed for DEC presence. The samples were filtered, plated onto MacConkey agar, and subcultured onto Eosin Methylene Blue agar for further analysis. The DEC pathotypes were identified based on morphological and biochemical characteristics, and antibiotic resistance was assessed using the Kirby-Bauer disk diffusion method. The study revealed a strong correlation of 11.613 (95 % Confidence Interval [CI]: 6.495–20.765, p-value: 0.000) between microbial burden in vended water (water sold by vendors) used by different households consumption and antimicrobial resistance in DEC. Water sources showed a high prevalence of DEC, primarily Enteroaggregative, enteropathogenic, enterotoxigenic, and enteroinvasive E. coli. DEC isolates also exhibited varying antibiotic resistance, and genes like bla CTX-M, bla TEM, and bla SHV were identified using PCR. The Spearman correlation coefficient was one, showing that resistance genes in water and stool were perfectly correlated. The study emphasizes the significance of improving water quality, hygiene, and antibiotic-resistant bacteria control to prevent and manage DEC and infectious diseases in Kenya. To combat outbreaks, effective surveillance and rapid reaction procedures are essential. The findings help to shape public health policies and initiatives. PhD research Publcation

In vitro assessment and comparison of quality of alcohol-based hand rubs, pre- and peri-COVID-19 pandemic outbreak in Kenya

2025-12-04T00:00:00Z

In vitro assessment and comparison of quality of alcohol-based hand rubs, pre- and peri-COVID-19 pandemic outbreak in Kenya Wafula, Samuel Omari In the wake of the coronavirus disease 2019 (COVID-19) pandemic, the World Health Organization recommended the use of alcohol-based hand rubs (ABHRs) to curb transmission, leading to increased production and use. This has posed a danger of production and use of poor-quality ABHRs. Methods This study assessed and compared the quality of ABHRs in the Kenyan market that were produced before and after the outbreak of the COVID-19 pandemic in March 2020. Quality testing was carried out against European EN 1500:2013 and Kenyan EAS 789:2013 Standards and 20 samples analyzed for alcohol content by GC-FID. Results The study found that 27.8% of the peri-COVID-19 pandemic sanitizers had less than 90% bactericidal reduction activity as compared to 12.5% manufactured pre-COVID-19 pandemic. Only 25% peri-COVID 19 pandemic ABHRs met the EAS 789:2013 acceptable limit of over version 3 (revision) 09 May 2024 version 2 (revision) 30 Apr 2024 version 1 01 Dec 2023 view view view view 1. 2. 3. Fred Tusabe , Infectious diseases Institute, Kampala, Uganda Sandry Kesuma , Health Polytechnic Ministry of Health Malang, Malang, Indonesia Kennedy Abuga , University of Nairobi, Nairobi, Kenya Any reports and responses or comments on the article can be found at the end of the article. Page 1 of 18 F1000Research 2024, 12:1546 Last updated: 13 NOV 2024 60% alcohol content. Product adulteration with methanol was found in 20 % of the samples with only 5% complying with FDA approval limit of <0.063% v/v methanol. Study found no correlation between the total alcohol content and the efficacy of ABHRs. Conclusions The study found that more substandard products were produced during the pandemic. This raises a concern about possible emergence of alcohol resistant strains of microorganisms. The study therefore recommends an adequate quality monitoring system to curb against substandard products. Keywords Coronavirus, COVID-19, Pandemic, Alcohol-based hand sanitizers, hand hygiene, Infection preventio MSc Research Publication

In vitro assessment and comparison of quality of alcohol-based hand rubs, pre- and peri-COVID-19 pandemic outbreak in Kenya

2025-12-03T00:00:00Z