Theses and Dissertations

Chemical Health Risks Exposure among Laboratory Staff in Kenya Marine and Fisheries Research Institute in Mombasa County, Kenya

Tue, 29 Sep 2026 00:00:00 GMT

Chemical Health Risks Exposure among Laboratory Staff in Kenya Marine and Fisheries Research Institute in Mombasa County, Kenya Magara, Eric Okenagwa To ensure a safe and healthy work environment for employees, the occupational Safety and Health Act 2007 was enacted in Kenya, and employers are required to comply with the Act. Owing to the global increase in the production and use of chemicals and other related reagents, chemical health risks have significantly risen. While necessary measures are in place to ensure safety in the labs, laboratory personnel are still vulnerable to exposure due to nature of work. Chemical hazards contribute to health risks resulting in significant fatalities and injuries to laboratory personnel, hence the need to protect them against such. This study evaluated chemical health risks exposure to laboratory staff in Kenya Marine and Fisheries Research Institute (KMFRI) in Mombasa County, Kenya. The objectives of the study were to assess Occupational Safety and Health Awareness, Effective PPE usage and exposure to radiations from unstable radioactive chemicals on laboratory staff, and how they contribute to chemical health risks. The study employed descriptive cross-sectional research design. Structured questionnaires, observation checklists and radiation measurements were used for data collection from a sample of 110 personnel from each of the KMFRI laboratories. The staff were selected based on specific inclusion, exclusion criteria. Only technical personnel who had worked in the laboratories for more than 5 years and who consistently worked for at-least five hours per day were considered eligible for participation in the study. Exposure to radiation was assessed using a calibrated radiation detector (dosimeter badges) meter to determine the extent of radiation exposure in the affected laboratory section. Data was analyzed using Statistical package for Social Sciences (SPSS) version 26.0. The study found a positive correlation between Occupational safety and Health awareness (r=.945 N=97 p<.01), PPE Usage (r=.883 N=97 p<.01), Exposure to radiation (r=.955 N=97 p<.01) and exposure to chemical health risks. The Analysis of Variance revealed a strong positive relationship between OSH awareness, PPE usage, exposure to radiation, and chemical health risks. The variables were found to be statistically significant and found to influence exposure to chemical health risks; OSH awareness, PPE usage and exposure to radiation largely contributed to exposure to chemical health risks among the laboratory staff. This study also revealed non-compliance to the set standards, leading staff to being exposed to potential chemical risks. The study findings further indicated that OSH awareness creation was not effectively done; hence a majority of the laboratory personnel were not privy to what was expected of them in terms of ensuring their occupational safety. Levels of exposure to radiation ranged between 0.018mSv/Month - 0.642mSv with a mean of 0.289mSv. The exposure to radiation was found to be within acceptable limits set by the Kenya nuclear regulatory authority in conjunction with the International Commission on Radiological Protection. The study recommends; mandatory OSH awareness creation and training for all laboratory staff; adequate provisions be made for quality PPE in compliance with standards for effective use; stringent measures be put in place to ensure controlled or eliminated exposure to radiation. The findings from this study will help laboratory management, policy makers, and occupational health practitioners to develop and implement effective safety measures, improve work place health standards, and enhance compliance with occupational safety regulations. Master of Science in Occupational Safety and Health

Effect of an Educational Intervention on Patients’ Rights Awareness among pregnant women attending Antenatal Care Clinics in Kirinyaga County, Kenya

Tue, 29 Sep 2026 00:00:00 GMT

Effect of an Educational Intervention on Patients’ Rights Awareness among pregnant women attending Antenatal Care Clinics in Kirinyaga County, Kenya Chepkorir, Egla Patients' rights are a fundamental human right and is a global health concern in health services delivery. The majority of maternal health intervention programmes across sub-Saharan Africa have focused on improving coverage of skilled birth attendance and emergency obstetric and newborn care however there has been a lack of focus on interventions and programmes that seek to provide comprehensive and individualized care for women and their babies before and after childbirth. Pregnant women frequently experience abuse, which may significantly contribute to maternal morbidity and mortality. In 2020, 95% of maternal deaths in the world occurred in low and lower-middle-income countries, Kenya’s maternal mortality rate stands at 355 per 100,000 births which is significantly higher than the WHO's SDG target goal 3.1 of less than 70 per 100,000 by 2030. Awareness of the patients’ rights increases maternal health literacy. The study’s main objective was to determine the effect of an educational intervention on patients’ rights awareness among pregnant women attending antenatal clinics. Educational intervention involved the use of health talks and bookmarks where a mixed method with a quasi-experimental quantitative arm study design that utilized convergent parallel was employed with two health centers purposively sampled. The study targeted 168 respondents where convenience sampling was used to sample pregnant women attending ANC clinics and purposive sampling for health care providers. An interviewer administered semi structured questionnaire, a key informant interview and focus group discussion guide were used to collect qualitative and quantitative data at pre-intervention and post-intervention phases. Quantitative data were analyzed using SPSS version 26.0, with chi-square used to assess associations and variables that were included into the multivariable model to show the effect of the intervention. Qualitative findings were transcribed and analyzed thematically using NVIVO version 12. Ethical approvals were sought from SERU. Majority of the participants 66(68%) were between the ages of 18-30years, married 74(77%), and had attained secondary education 54(56%). The level of awareness of patient rights was 19(19.8%) Of those who had knowledge of patient rights, 60(68.4%) of them reported that healthcare providers were their source of information. The quantitative analysis demonstrated pregnant women in the intervention group reported higher proportions of good awareness 40(41.7%) compared to the control group 15(20.8%, χ² = 8.11, df = 2, p = 0.017). Similarly, tertiary education and three or more ANC visits were strongly associated with good awareness (χ² = 18.566, p = 0.017 and χ² = 19.035, p = 0.015, respectively). There was a significant improvement in awareness of patient rights from 19(19.8%) to 61(67.8%) at post-intervention. The multiple linear regression model demonstrates that the intervention significantly enhances perceived quality of care and patient rights awareness, with a 6.314-unit increase for the intervention group and an additional 6.806-unit increase over time (DiD effect). Significant variables include education level (β = 1.643, p = 0.001), ANC visits (β = 1.770, p = 0.002), and service quality (β = 0.845, p < 0.001. From the qualitative findings, pregnant women acknowledged the role of HCP in sensitizing ANC clients, the need to translate the PRC into local languages and frequent monitoring of implementation for efficiency. In conclusion, healthcare provider-led health education proved effective in improving the knowledge of patient rights and awareness. With these findings, the study underscores the importance of integrated continuous sensitizations using translated educational materials which are sustainable. The Ministry of Health should scale up interventions, implement regular training and develop educational materials to sustain these initiatives. Doctor of Philosophy in International Health

Two Levels of Negative Pressure in Open Tracheal Suctioning and their Effect on Cardiorespiratory Indices and Care Outcomes among Adult Patients in Critical Care Unit at Machakos Level Five Hospital

Tue, 29 Sep 2026 00:00:00 GMT

Two Levels of Negative Pressure in Open Tracheal Suctioning and their Effect on Cardiorespiratory Indices and Care Outcomes among Adult Patients in Critical Care Unit at Machakos Level Five Hospital Ngui, Mark Lewa Tracheal Tube Suctioning is performed on intubated patients to clear secretions by sucking them out by means of negative pressure via a suction catheter. Disparities exist among practitioners on amount of suction pressure. Negative suction pressures ranging from 80-300mmHg have been tested. The Nursing Council of Kenya prescribes a suction pressure of 80-120mmHg. Suction levels beyond 200mmHg pose risks. ICU mortality in Kenya is 38.6% compared to world-wide level of 19.9%. This study was formulated to establish effect of open tracheal tube suctioning at 180mmHg and 100mmHg on cardiorespiratory indices and care outcomes among mechanically ventilated adult patients at Machakos level five county hospital. Ethical approval was granted by Jomo Kenyatta University Ethics Review Committee (JKU/ISERC/02316/0914) and permit issued by NACOSTI (P/23/28497). All ethical principles were upheld. A Randomized Controlled Trial, involving 76 mechanically ventilated adult patients was conducted with random allocation to 180mmHg and 100mmHg suction groups in 2024. Data was collected pertaining to cardiorespiratory indices at four suction-time points during open tracheal tube suctioning, on critical care outcome metrics, safety and effectiveness measures and suction catheter passes that cleared tracheal secretions. Independent t-test and Mann–Whitney U test were used for statistical comparison of quantitative indices; Chi-square test was used to determine homogeneity between the groups; and Repeated Measures Analysis of Variance and Friedman test were used to assess differences in the means within each group at Alpha level of 0.05. Results showed that the higher pressure was more effective in tracheal secretion clearance (p < .001) and both suction levels cause significant changes in cardiorespiratory indices (p < .05). There were significant differences (p < .05) between the two groups on diastolic and mean arterial blood pressure with the 100mmHg suction pressure causing bigger increment. There were no significant differences in metric patient care outcomes, Ventilator Associated Events and on incidences of bloody tracheal secretions (p > .05). The 180mmHg suction pressure did not therefore show additional harm compared 100mmHg suction level. Further research is recommended to establish the relationship between such suctioning and tracheal mucosal damage, intracranial pressure, pneumonia and for validation in a multi-center study. PhD in Nursing (Critical Care Nursing)

Efficacy of Endophytic Fungi in the Management of Spoladea recurvalis (Lepidoptera: Crambidae) on Amaranth (Amaranthus dubius)

Tue, 29 Sep 2026 00:00:00 GMT

Efficacy of Endophytic Fungi in the Management of Spoladea recurvalis (Lepidoptera: Crambidae) on Amaranth (Amaranthus dubius) Nyamamba, Druscilla Obonyo Amaranth is a Traditional African Vegetable (TAV) that in recent years has gained global popularity due to its exceptional nutritional, medicinal and economic attributes. However, its production is significantly limited by insect pest infestations, mainly lepidopteran defoliators. Spoladea recurvalis, commonly known as Hawaiian beet webworm has been reported as the major pest that feeds voraciously on the leaves leading to substantial yield losses of up to 100% under severe pest infestation. Chemical control remains a widely used method for the management of S. recurvalis. The use of fungal endophytes has emerged as a promising, sustainable and eco-friendly alternative to chemical pesticides in the management of insect pests. Therefore, this study evaluated the efficacy of selected 15 fungal isolates to endophytically colonize Amaranthus dubius host plant. Only two fungal isolates Hypocrea lixii F3ST1 and Trichoderma asperellum M2RT4 were found to be endophytic to A. dubius with varied colonization rates among them. The results revealed that both endophytes successfully colonized over 90% of all the examined plant tissues (root, stem and leaves). The two fungal isolates were further evaluated for their endophytic persistence, effect on host plant growth promotion and insecticidal activity against S. recurvalis life cycle and F1 progeny. Also, the behavioral and chemical mechanism through which the presence of the most potent endophytes H. lixii F3ST1 and T. asperellum M2RT4 within amaranth plants influence S. recurvalis host selection and herbivory were investigated. Both endophytes persisted in the host plant throughout the four-week assessment period exhibiting varying colonization rates influenced by significant interaction between time, fungal isolates and plant parts. Although T. asperellum M2RT4 outperformed H. lixii F3ST1 in the weekly assessment on plant growth promotion, the two endophytes significantly improved plant height, the number of leaves, leaf length and leaf width. Trichoderma asperellum M2RT4 significantly enhanced dry shoot biomass when compared with H. lixii F3ST1 and the control. Further, both endophytes significantly reduced number of egg masses laid, egg hatchability, increased larval mortality, reduce pupae formation, adult emergence and reduced survival/longevity of F1 progeny. Amaranthus dubius plants endophytically colonized by H. lixii F3ST1 significantly recorded the lowest number of egg masses (3.75 ± 1.11) resulting in 5% and 49.8% reductions, followed by T. asperellum M2RT4 (36.75 ± 3.77) compared to (73.25 ± 5.14) in the control. Upon egg hatching, H. lixii F3ST1 endophytically colonized plants significantly recorded the lowest number of larvae (13.75 ± 1.75) followed by T. asperellum M2RT4 (94.5 ± 11.66) compared to 196.5 ± 22.14 in the control. There was no significant difference in larval mortality by H. lixii F3ST1 endophytically colonized (40 ± 0.82%) and T. asperellum M2RT4 plants (42 ± 0.74%) compared to (2.91 ± 0.29%) in the control. Fewer pupae were obtained in H. lixii F3ST1 (3.75 ± 1.75) followed T. asperellum M2RT4 (44.5 ± 1.94) compared to 76.25 ± 1.43 in the control. Besides, adult emergence of S. recurvalis varied significantly between the fungal isolates with the lowest number of moths emerging from H. lixii F3ST1 endophytically colonized plants (3.25 ± 0.25) followed by T. asperellum M2RT4 (38.5 ± 1.19) compared to the control (66.5 ± 2.25). Furthermore, the two endophytes H. lixii F3ST1 and T. asperellum M2RT4 significantly reduced the survival of S. recurvalis F1 progenies. The behavioral bioassay using the Y-tube olfactometer revealed that S. recurvalis showed a preference for non-colonized amaranth plants over those colonized by both endophytes. Nevertheless, the findings showed that S. recurvalis moths were not attracted to either infested non-colonized or infested endophyte-colonized amaranth plants. Gas chromatography-mass spectrometry (GC-MS) analysis of volatiles emitted from non-inoculated, inoculated, non-inoculated infested, and inoculated infested amaranth plants colonized by H. lixii F3ST1 and T. asperellum M2RT4 revealed the presence of 80 and 74 volatile organic compounds (VOCs), respectively. Similarity percentage analysis highlighted the major compounds contributing to the differences observed among treatments. In H. lixii F3ST1-colonized plants, key discriminating VOCs included (Z)-3-Hexenyl acetate, pentadecane, α-Cedrene, o-Xylene, and (E)-β-Ocimene while for T. asperellum M2RT4-colonized plants, predominant differentiating compounds were Germacrene D, (Z)-3-hexenol, 1,3-Dimethylbenzene, Tetradecane, and 2,4,4-Trimethyl-1-pentene. The distinct VOC profiles linked to their colonization and treatment status suggest that these endophytes may influence plant defense signaling pathways, further contributing to their biocontrol efficacy for the management of S. recurvalis. Hence, providing insights for their integration into environmentally friendly pest management strategies in amaranth cropping systems. However, further studies are warranted to assess the effects of the key identified synthetic compounds on the pest and validate the results under field conditions. Master of Science in Plant Health Science and Managemen