College of Heaith Sciences JKUAT (COHES)

The Prevalence and Associated Factors of Atopic Dermatitis in Children aged between Six Months and Twelve Years Attending the Pediatrics Dermatology Clinic at Kenyatta National Hospital, Kenya

Thu, 14 May 2026 00:00:00 GMT

The Prevalence and Associated Factors of Atopic Dermatitis in Children aged between Six Months and Twelve Years Attending the Pediatrics Dermatology Clinic at Kenyatta National Hospital, Kenya Hassan, Zahara Haji Background: Atopic dermatitis (AD), is chronic inflammatory skin disease characterized by acute flare-ups of intense pruritus and dry scaly lesions. The onset of AD is usually between 2 and 6 months of age, although it can begin at any age. AD affects up to 20% of children and 3% of adults; latest global data shows increases in its prevalence. In Africa, the prevalence of AD ranges from 4.7% to 23%. In Kenya, the prevalence and the associated factors among pediatrics is poorly defined as there is paucity of evidence around it. As such, the clinicians attending to these clients often rely on the theoretical and literature evidence sourced from other parts of the world. The study main objective is to determine the prevalence and associated factors of atopic dermatitis among pediatric patients aged between six months and twelve years seen at the dermatology clinic at Kenyatta National Hospital, Kenya.This was a cross sectional study conducted at the Dermatology Pediatrics Clinic in the period between August and November 2024. The sample for the study was recruited consecutively until the sample size of 148children was achieved. A structured questionnaire was used to collect data. The data collected include demographic, family and personal history of associated atopic conditions, atopic dermatitis diagnosis and severity of atopic dermatitis using POEM score. Ethical Approval was acquired from KNH-UON ERC. Data was analyzed using SPSS v.25 and the prevalence of atopic dermatitis was calculated as a proportion of the total sample size and expressed as percentage. Binary logistic regression was performed to investigate factors associated with AD. Significance was assessed at< 0.05. The results showed that majority of the patients, N=90(60.8%) were female, N=59 (39.9%) were aged more than 10 years, most patients had 1-5 siblings N= 62(41.9%) and N=112(75.7% had their mothers unemployed. The prevalence of atopic dermatitis was N=38(25.7%) with a CI of between 18.9% to 33.5%. After adjusting for cofounders, the adjusted odds ratio showed that factors associated with Atopic Dermatitis included age of 5 years and below (aOR = 12.11, 95% CI: 3.11, 56.37, p < 0.001), males (aOR = 2.83, 95% CI: 1.32, 6.03, p = 0.015), family history of allergic asthma (aOR = 8.33, 95% CI: 3.67 33.11, p < 0.001), family history of allergic rhinitis (aOR = 18.13, 95% CI: 7.67–70.11, p < 0.001), family history of allergic conjunctivitis (aOR = 6.11, 95% CI: 2.64–20.78, p = 0.007), family history of atopic dermatitis (aOR = 7.11, 95% CI: 1.36–23.63, p = 0.019), allergic asthma(aOR 11.18 95% CI3.14,25.11 P=<0.001), allergic rhinitis (aOR 12.88,95%CI 2.65,51.02 P=<0.001) and allergic conjunctivitis (aOR 15.53,95% CI 1.71,52.75 P=<0.001) . The severity of eczema among patients N=38 was assessed using the POEM score. The findings showed that 44.7% had minimal eczema, 34.2% had mild eczema, 13.1% had moderate eczema, and 7.4% had severe eczema. The study concluded that one in four children attending dermatology clinic were found to have atopic dermatitis. Younger children, males, and those with unemployed mothers had higher odds of developing AD. A family history of allergies and personal factors like allergic asthma, rhinitis, and conjunctivitis also increased the risk of AD. Thus, healthcare providers prioritize early screening for AD in children, especially those with a family history of allergies. Keywords: Atopic dermatitis, Eczema, pruritus, prevalence, associated factors Master of Medicine in Dermatology

Effectiveness of Reminders and Social Support Framework on Birth and Health Outcomes among HIV Exposed Infants in Nyahururu County Referral Hospital, Kenya

Fri, 15 May 2026 00:00:00 GMT

Effectiveness of Reminders and Social Support Framework on Birth and Health Outcomes among HIV Exposed Infants in Nyahururu County Referral Hospital, Kenya Lodeke, Silas The reminder systems and social support mechanisms not only reduce antiretroviral therapy (ART) default rates but also ensure continuity of care, which is essential for improving both maternal and infant health outcomes. The role of short message service (SMS) reminders has significantly enhanced antenatal care (ANC) attendance, adherence to antiretroviral drugs (ARVs), viral suppression, and prevention of mother to-child transmission (PMTCT) of HIV. In Kenya, mother-to-child transmission remains a concern, with Laikipia County showing a higher infection rate among infants. These trends highlight the urgent need for targeted interventions in Laikipia County to improve infant health outcomes. The objective of the study was to assess the effectiveness of reminders and the social support framework on birth and health outcomes among HIV exposed infants (HEIs) at Nyahururu County Referral Hospital in Laikipia County. A quasi-experimental design was used in this study. In addition, 220 HIV positive pregnant mothers attending the comprehensive care Centre were recruited. Systematic random sampling was used to select the respondents. Both primary and secondary data were collected using structured questionnaires. The collected data were analyzed using Statistical Package for Social Sciences (SPSS) software, version 28. Descriptive statistics, including frequencies and percentages, were used to summarize and organize the data. Correlation, regression and Chi- square statistic was used to test for association/relationship between variables and level of significance. All statistical tests of significance were conducted at a coefficient level of alpha less than 0.05 with the help of SPSS 2.5 for windows. Results showed that 63.1% of mothers in the reminder group adhered to three to four ANC visits, compared to 57.7% in the routine group. In addition, the study found that most mothers in both groups had spontaneous vaginal deliveries (96.4% in the reminders group), with fewer requiring medical interventions. Moreover, the findings showed that 77.7% of mothers in the reminder group practiced exclusive breastfeeding for six months, compared to 65.0% in the routine follow-up group, indicating. Moreover, the study found a significantly higher proportion of infants in the reminder group tested HIV negative (98.2%) compared to 95.0% in the routine group. Survivorship was also higher, with 95.5% of infants in the reminder group surviving past one year, compared to 86.0% in the routine follow-up group. The correlation coefficient of 0.78 signified a strong positive relationship between the use of on reminders and improved health outcomes for HIV exposed infants, including higher survival rates (p-value=0.000). The Chi Square value of 20.8 reflected a significant association between the use of reminders and improved health outcomes for infants, underscoring the substantial impact of on reminders on enhancing infant health and survival rates (p-value=0.000). The study concludes that the use of reminders significantly enhances and infant health outcomes. The study recommends integrating structured reminder systems and social support into maternal and child health programs to improve adherence to ANC and ART, enhance birth outcomes, promote exclusive breastfeeding, and boost infant health and survival among HIV exposed populations. PhD in Public Health

Clinical Etiology and Histopathologic Correlation of Exfoliative Erythroderma at the Kenyatta National Hospital

Fri, 15 May 2026 00:00:00 GMT

Clinical Etiology and Histopathologic Correlation of Exfoliative Erythroderma at the Kenyatta National Hospital Wainaina, Karen Waithera Exfoliative erythroderma is a dermatologic emergency characterized by diffuse skin redness and scaling involving at least 70% of the body surface area. It is a clinical presentation that usually indicates an underlying primary process. Once a clinical diagnosis of EE was made, prompt supportive measures were instituted while efforts were undertaken to identify the underlying cause of the presentation. These causes were determined clinically and/or through histopathological evaluation following a skin biopsy. Identifying the underlying cause was important for reducing recurrences, complications associated with skin failure, and mortality risk. The correlation between clinical and histopathological diagnoses had not been determined for the Kenyan population. The purpose of the study was to assess the frequency of causes of EE and their histopathologic correlation at Kenyatta National Hospital. This was an ambispective study that included both prospective and retrospective components conducted in the wards and clinics of Kenyatta National Hospital. All adult patients with EE who met the study criteria were included. This study assessed 94 cases of EE at KNH to determine the frequency of skin biopsies and clinicopathologic correlation. Descriptive analysis was used to summarize clinical and pathological findings. Correlation analysis was conducted using Kappa statistics, and sensitivity analysis was also performed to determine the accuracy of clinical findings. A p-value of <0.05 was considered statistically significant at a 95% confidence interval. Data analysis was performed using SPSS version 27. While clinical assessments frequently identified psoriasis and malignancies, the leading histopathologic causes were malignancies (kappa=0.73) and immunobullous diseases (kappa=0.89). To prevent clinical misdiagnosis of the underlying cause of EE, a biopsy-first protocol was recommended for all new EE presentations to ensure diagnostic accuracy and guide next management steps. Master of Medicine in Dermatology

Factors Influencing Burden of Schistosoma Haematobium Infection and the Influencing Factors among Pregnant Women in Kwale County, Kenya

Fri, 15 May 2026 00:00:00 GMT

Factors Influencing Burden of Schistosoma Haematobium Infection and the Influencing Factors among Pregnant Women in Kwale County, Kenya Mwachuo, Rehema Omar Schistosomiasis is a disease of global public health importance among populations residing in Schistosoma-infection prone areas. Global interventions have not succeeded yet in control, elimination nor eradication of the burden with 40 million women of reproductive age still affected. About 250 million people in 78 Countries in Africa are at risk. The Kenyan Coast is endemic to Schistosoma haematobium infections. Preventive measures and mass treatment of infected populations can reduce or possibly eliminate schistosomiasis. In Kenya, pregnancy is a contraindication to praziquantel (PZQ) treatment while World Health Organisation (WHO) recommends its’ use in pregnancy; effects of bilharzia in pregnancy and unborn child are known to be disastrous. Pregnant women in Kwale County remain at high risk together with the unborn child. This study aimed at investigating factors that influence Schistosoma haematobium (S.haematobium) infection among pregnant women in Kwale County. This was analytical cross-sectional study; quantitative and qualitative methods were used. The study was done in Kwale County in March through August 2016 within four Sub Counties; Matuga, Kinango, Msambweni and Lunga Lunga. Sample size was 368 pregnant women. Quantitative analysis used Stata version 12.0, qualitative data used N- Vivo version 8. Thematic analysis used six steps and themes were generated and clarified. Fisher’s exact tests were used for parity vs schistosomiasis comparisons with p value of 0.05 for significance. Odds ratios were used with 0.05 p value and 95% confidence interval to analyse Knowledge, Practice and Attitude factors significance as an association to Schistosomiasis infection. Structured questionnaires were used for quantitative data; in-depth interview guide was used on Key Informants for qualitative data. Clinical investigations were done to detect Schistosoma infection. Quantification of Schistosoma eggs using Kato-Katz technique was done. Pregnancy test was done to confirm pregnancy. Obstetric history was taken to assess previous deliveries and rule out abnormalities. The prevalence of S.haematobium infection among pregnant women in kwale County was 12.2%. Kinango Sub County reported highest prevalence 14.1%. Rice farming was a significant predisposing factor. Among the participants 36.7% utilize river waters and 14% use water pans. Among the participants 29% did not use toilets. Regarding knowledge of bilharziasis; 96.7% knew what bilharzia was and 84.8% were aware of the causal agent as parasite. Intensity of S.haematobium among pregnant mothers in Kwale County is low. Majority of the participants had no formal education which is known to increase the risk. Practices and attitude of the mothers had little significance to the infection. Rice farming was a risk factor, but the areas with highest prevalence are none rice growers. Bathing in rivers and use of untreated water increased the risk of infection. The county government together with ministry of health should integrate routine screening and treatment for S. haematobium disease into antenatal care services in affected areas like Kwale County. Mass drug administration campaigns to focus more on all women of reproductive age to lower community reservoir and cut the chain of reinfection which could reduce possible infections before they conceive thus alleviating gestational burden of schistosomiasis. water, sanitation and Hygiene Initiatives (WASH) to be expanded with more focus on bilharzia high prevalent areas to increase access to clean safe water sources to the community. The County government with ministry of health should increase sensitization health talks with emphasis on behaviour change to the population on xvii water hygiene practices, safe farming practices with emphasising on proper use of protective personal equipment to limit exposure to new infections and reinfections. MSc in Epidemiology