Background: Pre-eclampsia has been linked to poor neonatal outcomes such as; stillbirth, low birt... more Background: Pre-eclampsia has been linked to poor neonatal outcomes such as; stillbirth, low birth weight (LBW), prematurity and neonatal morbidities. Objective: To determine the prevalence of LBW and immediate (within 24 hours) birth outcomes of LBW neonates born of pre-eclamptic women at Moi Teaching & Referral Hospital, Kenya. Methods: A descriptive cross-sectional study was conducted among 364 participants (346 singletons and 18 twins). A structured interviewer administered questionnaire was used to gather data on birth weight and neonatal outcomes. Data was cleaned, coded and entered into SPSS version 22 for analysis. Descriptive statistics were computed for the prevalence of LBW and immediate birth outcomes. Results: The prevalence of LBW was 180(49.45%). Notably, of the LBW neonates; 162(90%) were alive while 18(10%) were stillbirths. Immediate morbidities were; birth asphyxia 51(28.73%), neonatal jaundice 38(21%), hypothermia 18(7.90%) and neonatal sepsis 1(0.68%). Of the ne...
New-borns, especially preterm new-borns are at risk of developing bloodstream infections shortly ... more New-borns, especially preterm new-borns are at risk of developing bloodstream infections shortly after birth or later. This study aimed to evaluate the infection prevention & control measures through hand hygiene practices and determine the procedures associated with risk of infection to small and sick new-borns at the Newborn Unit of Moi Teaching and Referral Hospital. This was a hospital-based cross-sectional study carried out at the neonatal unit of the largest tertiary hospital of western Kenya. It included quantitative data collection using a standardized checklist for each of the procedures observed during day and night shifts for a period of 6 weeks, which represented a sample unit. Data were analysed using Statistical Package for the Social Sciences version 20.0. Categorical data were described using frequency and percentage. The values less than 0.05 was judged statistically significant. Out of the 553 observed contacts, the nurses did 52.4%. The intravenous cannula inserti...
Background: Pre-eclampsia has been linked to poor neonatal outcomes such as; stillbirth, low birt... more Background: Pre-eclampsia has been linked to poor neonatal outcomes such as; stillbirth, low birth weight (LBW), prematurity and neonatal morbidities. Objective: To determine the prevalence of LBW and immediate (within 24 hours) birth outcomes of LBW neonates born of pre-eclamptic women at Moi Teaching & Referral Hospital, Kenya. Methods: A descriptive cross-sectional study was conducted among 364 participants (346 singletons and 18 twins). A structured interviewer administered questionnaire was used to gather data on birth weight and neonatal outcomes. Data was cleaned, coded and entered into SPSS version 22 for analysis. Descriptive statistics were computed for the prevalence of LBW and immediate birth outcomes. Results: The prevalence of LBW was 180(49.45%). Notably, of the LBW neonates; 162(90%) were alive while 18(10%) were stillbirths. Immediate morbidities were; birth asphyxia 51(28.73%), neonatal jaundice 38(21%), hypothermia 18(7.90%) and neonatal sepsis 1(0.68%). Of the ne...
Background This paper examines the discordance between biological data of HIV and herpes simplex ... more Background This paper examines the discordance between biological data of HIV and herpes simplex virus type 2 (HSV-2) infections and self-reported questionnaire responses among orphan adolescents in Western Kenya. Methods In 2011, 837 orphan adolescents from 26 primary schools were enrolled in an HIV prevention trial. At baseline, blood samples were drawn for HIV and HSV-2 infection biomarker testing, and participants completed an audio computer-assisted self-interviewing survey. Results Comparing biological data with self-reported responses indicated that 70 % of HIV-positive (7 out of 10) and 64 % of HSV-2-positive (18 out of 28 positive) participants reported never having had sex. Among ever-
The Author(s) 2014. This article is published with open access at Springerlink.com Abstract Self-... more The Author(s) 2014. This article is published with open access at Springerlink.com Abstract Self-report of sexual behavior among adolescents is notoriously inconsistent, yet such measures are commonly used as outcomes for human immunodeficiency virus (HIV) prevention interven-tion trials. There has been a growing interest in the use of HIV and other sexually transmitted disease bio-markers as more valid measures of intervention impact in high HIV prevalence areas, particularly in sub-Saharan Africa. We examine the challenges, benefits, and feasibility of including HIV and herpes simplex virus type 2 (HSV-2) biomarker data, with details about different data collection and disclosure methods from two adolescent prevention trials in Kenya and
Introduction: Women have different perspectives of the meaning of quality care during childbirth ... more Introduction: Women have different perspectives of the meaning of quality care during childbirth in hospital. Women will tend to avoid hospital birth if the care provided does not meet these perspectives. The researcher sought to determine what women consider quality care during childbirth in the hospital. Methods: A qualitative method using exploratory descriptive design was applied. The study was carried out in the postnatal section of Riley mother-baby hospital of Moi Teaching and Referral Hospital, Eldoret Kenya. In-depth interviews were used in collecting data from 14 mothers who had hospital birth. The interviews were audio recorded and field notes taken. Audio recorded data was transcribed into Ms Word. Analytic triangulation was done using NVIVO 8 software and Tesch’s method of qualitative analysis. The interviews were read; emerging ideas were identified, and then grouped into subthemes, which were further categorized to generate themes. Findings: Presence of caregiver, les...
Introduction : Neonates especially the premature are affected by many factors. Neonatal circadian... more Introduction : Neonates especially the premature are affected by many factors. Neonatal circadian rhythm, growth and feeds retention is influenced by environmental characteristics that can be changed. Infant oral feeding is significantly improved by lower light levels. However, this has not been put in place in most Newborn care Units in Kenya. Methods : This was a change process done at Moi Teaching and Referral Hospital’s newborn unit. The administrator of pediatric department, head of the department (HOD) at New-Born Unit (NBU), the nurse manager, the ward in-charge, nurse in charge of supplies, biomedical officer at NBU and the clinical nurse educator were involved. The change project required some resources and processes. Findings: At the Newborn Unit at the Moi Teaching and Referral hospital, the available strategies on use of continuous lighting at the NBU were found to be  underutilized by the health care providers due to lack of conviction by the decision makers and the pro...
Purpose: Women have different perspectives of the meaning of quality care during childbirth in ho... more Purpose: Women have different perspectives of the meaning of quality care during childbirth in hospital. Women will tend to avoid hospital birth if the care provided does not meet these perspectives. The researcher sought to determine what women consider quality care during childbirth in the hospital. Methods: A qualitative method using exploratory descriptive design was applied. The study was carried out in the postnatal section of Riley mother-baby hospital of Moi Teaching and Referral Hospital, Eldoret Kenya. In-depth interviews were used in collecting data from 14 mothers who had hospital birth. The interviews were audio recorded and field notes taken. Audio recorded data was transcribed into Ms Word. Analytic triangulation was done using NVIVO 8 software and Tesch’s method of qualitative analysis. The interviews were read; emerging ideas were identified, and then grouped into subthemes, which were further categorized to generate themes. Findings: presence of caregiver, less fre...
Background. Birth asphyxia is the leading cause of neonatal mortality in Kenya. Quality care duri... more Background. Birth asphyxia is the leading cause of neonatal mortality in Kenya. Quality care during neonatal resuscitation (NR) can contribute to a reduction in neonatal mortality related to birth asphyxia by 30 percent. This study assessed the quality of care (QoC) during NR for newborns with birth asphyxia. Methods. Direct observations of 138 newborn resuscitations were done in labor ward and maternity theatre. Twenty-eight healthcare providers were observed 3–5 times using a structured checklist. Descriptive and inferential statistics were calculated and quality of care scores computed. Ordered logistic regression model identified HCPs characteristics associated with the QoC scores during NR. Results. Overall QoC scores were good for airway clearance (83%). Suctioning in meconium presence (40%) was poorly performed. Years of experience working in maternity were associated with good drying/stimulation (β = 1.86, P=0.003, CI = 0.626–3.093) and airway maintenance (β = 1.887, P=0.009...
Herpes simplex virus type 2 (HSV-2) biomarkers are often used in adolescent sub-Saharan HIV preve... more Herpes simplex virus type 2 (HSV-2) biomarkers are often used in adolescent sub-Saharan HIV prevention studies, but evaluations of test performance and disclosure outcomes are rare in the published literature. Therefore, we investigated the proportion of ELISA-positive and indeterminate samples confirmed by western blot (WB), the psychosocial response to disclosure and whether reports of sexual behaviour and HSV-2 symptoms are consistent with WB confirmatory results among adolescent orphans in Kenya. In 2011, 837 Kenyan orphan youth in grades 7 and 8 enrolled in an HIV prevention clinical trial with HSV-2 biomarker outcomes. We used a modified algorithm for the Kalon HSV-2 ELISA to improve specificity; positive and indeterminate results were WB tested. We developed culturally sensitive protocols for disclosing positive results, and documented psychosocial responses, reports of sexual contact and HSV-2 symptoms. 28 adolescents (3.3%) were identified as HSV-2 seropositive, six as inde...
Elderly populations are susceptible to many non-communicable diseases, including diabetes. Lack o... more Elderly populations are susceptible to many non-communicable diseases, including diabetes. Lack of awareness regarding disease status and risk factors increase complications and mortality. We conducted a cross-sectional community-based study of 1633 randomly selected participants aged 60 years and above in urban and rural areas in the Kathmandu Valley of Nepal. Study goals were: (i) to determine the prevalence of diabetes in elderly subjects as diagnosed prior to and during the study, and (ii) to identify and compare the determinants of diabetes as diagnosed prior to and during the study. A structured questionnaire was used to collect information regarding prevalence and potential determinants of diabetes diagnosed during and before the survey. Anthropometric measurements, blood pressure measurements and fasting blood sugar tests were also measured. Risk factor analysis was done using multinomial logistic regression; subjects with no diabetes constituted the reference group. We dete...
This paper examines the discordance between biological data of HIV and herpes simplex virus type ... more This paper examines the discordance between biological data of HIV and herpes simplex virus type 2 (HSV-2) infections and self-reported questionnaire responses among orphan adolescents in Western Kenya. In 2011, 837 orphan adolescents from 26 primary schools were enrolled in an HIV prevention trial. At baseline, blood samples were drawn for HIV and HSV-2 infection biomarker testing, and participants completed an audio computer-assisted self-interviewing survey. Comparing biological data with self-reported responses indicated that 70% of HIV-positive (7 out of 10) and 64% of HSV-2-positive (18 out of 28 positive) participants reported never having had sex. Among ever-married adolescents, 65% (57 out of 88) reported never having had sex. Overall, 10% of study participants appeared to have inconsistently reported their sexual behaviour. Logistic regression analyses indicated that lower educational level and exam scores were significant predictors of inconsistent reporting. Our study demonstrates the discordance between infections measured by biomarkers and self-reports of having had sex among orphan adolescents in Kenya. In order to detect programme effects accurately in prevention research, it is necessary to collect both baseline and endline biological data. Furthermore, it is recommended to triangulate multiple data sources about adolescent participants' self-reported information about marriage and pregnancies from school records and parent/guardians to verify the information. Researchers should recognise potential threats to validity in data and design surveys to consider cognitive factors and/or cultural context to obtain more accurate and reliable information from adolescents regarding HIV/sexually transmitted infection risk behaviours. NCT01501864.
Background: Pre-eclampsia has been linked to poor neonatal outcomes such as; stillbirth, low birt... more Background: Pre-eclampsia has been linked to poor neonatal outcomes such as; stillbirth, low birth weight (LBW), prematurity and neonatal morbidities. Objective: To determine the prevalence of LBW and immediate (within 24 hours) birth outcomes of LBW neonates born of pre-eclamptic women at Moi Teaching & Referral Hospital, Kenya. Methods: A descriptive cross-sectional study was conducted among 364 participants (346 singletons and 18 twins). A structured interviewer administered questionnaire was used to gather data on birth weight and neonatal outcomes. Data was cleaned, coded and entered into SPSS version 22 for analysis. Descriptive statistics were computed for the prevalence of LBW and immediate birth outcomes. Results: The prevalence of LBW was 180(49.45%). Notably, of the LBW neonates; 162(90%) were alive while 18(10%) were stillbirths. Immediate morbidities were; birth asphyxia 51(28.73%), neonatal jaundice 38(21%), hypothermia 18(7.90%) and neonatal sepsis 1(0.68%). Of the ne...
New-borns, especially preterm new-borns are at risk of developing bloodstream infections shortly ... more New-borns, especially preterm new-borns are at risk of developing bloodstream infections shortly after birth or later. This study aimed to evaluate the infection prevention & control measures through hand hygiene practices and determine the procedures associated with risk of infection to small and sick new-borns at the Newborn Unit of Moi Teaching and Referral Hospital. This was a hospital-based cross-sectional study carried out at the neonatal unit of the largest tertiary hospital of western Kenya. It included quantitative data collection using a standardized checklist for each of the procedures observed during day and night shifts for a period of 6 weeks, which represented a sample unit. Data were analysed using Statistical Package for the Social Sciences version 20.0. Categorical data were described using frequency and percentage. The values less than 0.05 was judged statistically significant. Out of the 553 observed contacts, the nurses did 52.4%. The intravenous cannula inserti...
Background: Pre-eclampsia has been linked to poor neonatal outcomes such as; stillbirth, low birt... more Background: Pre-eclampsia has been linked to poor neonatal outcomes such as; stillbirth, low birth weight (LBW), prematurity and neonatal morbidities. Objective: To determine the prevalence of LBW and immediate (within 24 hours) birth outcomes of LBW neonates born of pre-eclamptic women at Moi Teaching & Referral Hospital, Kenya. Methods: A descriptive cross-sectional study was conducted among 364 participants (346 singletons and 18 twins). A structured interviewer administered questionnaire was used to gather data on birth weight and neonatal outcomes. Data was cleaned, coded and entered into SPSS version 22 for analysis. Descriptive statistics were computed for the prevalence of LBW and immediate birth outcomes. Results: The prevalence of LBW was 180(49.45%). Notably, of the LBW neonates; 162(90%) were alive while 18(10%) were stillbirths. Immediate morbidities were; birth asphyxia 51(28.73%), neonatal jaundice 38(21%), hypothermia 18(7.90%) and neonatal sepsis 1(0.68%). Of the ne...
Background This paper examines the discordance between biological data of HIV and herpes simplex ... more Background This paper examines the discordance between biological data of HIV and herpes simplex virus type 2 (HSV-2) infections and self-reported questionnaire responses among orphan adolescents in Western Kenya. Methods In 2011, 837 orphan adolescents from 26 primary schools were enrolled in an HIV prevention trial. At baseline, blood samples were drawn for HIV and HSV-2 infection biomarker testing, and participants completed an audio computer-assisted self-interviewing survey. Results Comparing biological data with self-reported responses indicated that 70 % of HIV-positive (7 out of 10) and 64 % of HSV-2-positive (18 out of 28 positive) participants reported never having had sex. Among ever-
The Author(s) 2014. This article is published with open access at Springerlink.com Abstract Self-... more The Author(s) 2014. This article is published with open access at Springerlink.com Abstract Self-report of sexual behavior among adolescents is notoriously inconsistent, yet such measures are commonly used as outcomes for human immunodeficiency virus (HIV) prevention interven-tion trials. There has been a growing interest in the use of HIV and other sexually transmitted disease bio-markers as more valid measures of intervention impact in high HIV prevalence areas, particularly in sub-Saharan Africa. We examine the challenges, benefits, and feasibility of including HIV and herpes simplex virus type 2 (HSV-2) biomarker data, with details about different data collection and disclosure methods from two adolescent prevention trials in Kenya and
Introduction: Women have different perspectives of the meaning of quality care during childbirth ... more Introduction: Women have different perspectives of the meaning of quality care during childbirth in hospital. Women will tend to avoid hospital birth if the care provided does not meet these perspectives. The researcher sought to determine what women consider quality care during childbirth in the hospital. Methods: A qualitative method using exploratory descriptive design was applied. The study was carried out in the postnatal section of Riley mother-baby hospital of Moi Teaching and Referral Hospital, Eldoret Kenya. In-depth interviews were used in collecting data from 14 mothers who had hospital birth. The interviews were audio recorded and field notes taken. Audio recorded data was transcribed into Ms Word. Analytic triangulation was done using NVIVO 8 software and Tesch’s method of qualitative analysis. The interviews were read; emerging ideas were identified, and then grouped into subthemes, which were further categorized to generate themes. Findings: Presence of caregiver, les...
Introduction : Neonates especially the premature are affected by many factors. Neonatal circadian... more Introduction : Neonates especially the premature are affected by many factors. Neonatal circadian rhythm, growth and feeds retention is influenced by environmental characteristics that can be changed. Infant oral feeding is significantly improved by lower light levels. However, this has not been put in place in most Newborn care Units in Kenya. Methods : This was a change process done at Moi Teaching and Referral Hospital’s newborn unit. The administrator of pediatric department, head of the department (HOD) at New-Born Unit (NBU), the nurse manager, the ward in-charge, nurse in charge of supplies, biomedical officer at NBU and the clinical nurse educator were involved. The change project required some resources and processes. Findings: At the Newborn Unit at the Moi Teaching and Referral hospital, the available strategies on use of continuous lighting at the NBU were found to be  underutilized by the health care providers due to lack of conviction by the decision makers and the pro...
Purpose: Women have different perspectives of the meaning of quality care during childbirth in ho... more Purpose: Women have different perspectives of the meaning of quality care during childbirth in hospital. Women will tend to avoid hospital birth if the care provided does not meet these perspectives. The researcher sought to determine what women consider quality care during childbirth in the hospital. Methods: A qualitative method using exploratory descriptive design was applied. The study was carried out in the postnatal section of Riley mother-baby hospital of Moi Teaching and Referral Hospital, Eldoret Kenya. In-depth interviews were used in collecting data from 14 mothers who had hospital birth. The interviews were audio recorded and field notes taken. Audio recorded data was transcribed into Ms Word. Analytic triangulation was done using NVIVO 8 software and Tesch’s method of qualitative analysis. The interviews were read; emerging ideas were identified, and then grouped into subthemes, which were further categorized to generate themes. Findings: presence of caregiver, less fre...
Background. Birth asphyxia is the leading cause of neonatal mortality in Kenya. Quality care duri... more Background. Birth asphyxia is the leading cause of neonatal mortality in Kenya. Quality care during neonatal resuscitation (NR) can contribute to a reduction in neonatal mortality related to birth asphyxia by 30 percent. This study assessed the quality of care (QoC) during NR for newborns with birth asphyxia. Methods. Direct observations of 138 newborn resuscitations were done in labor ward and maternity theatre. Twenty-eight healthcare providers were observed 3–5 times using a structured checklist. Descriptive and inferential statistics were calculated and quality of care scores computed. Ordered logistic regression model identified HCPs characteristics associated with the QoC scores during NR. Results. Overall QoC scores were good for airway clearance (83%). Suctioning in meconium presence (40%) was poorly performed. Years of experience working in maternity were associated with good drying/stimulation (β = 1.86, P=0.003, CI = 0.626–3.093) and airway maintenance (β = 1.887, P=0.009...
Herpes simplex virus type 2 (HSV-2) biomarkers are often used in adolescent sub-Saharan HIV preve... more Herpes simplex virus type 2 (HSV-2) biomarkers are often used in adolescent sub-Saharan HIV prevention studies, but evaluations of test performance and disclosure outcomes are rare in the published literature. Therefore, we investigated the proportion of ELISA-positive and indeterminate samples confirmed by western blot (WB), the psychosocial response to disclosure and whether reports of sexual behaviour and HSV-2 symptoms are consistent with WB confirmatory results among adolescent orphans in Kenya. In 2011, 837 Kenyan orphan youth in grades 7 and 8 enrolled in an HIV prevention clinical trial with HSV-2 biomarker outcomes. We used a modified algorithm for the Kalon HSV-2 ELISA to improve specificity; positive and indeterminate results were WB tested. We developed culturally sensitive protocols for disclosing positive results, and documented psychosocial responses, reports of sexual contact and HSV-2 symptoms. 28 adolescents (3.3%) were identified as HSV-2 seropositive, six as inde...
Elderly populations are susceptible to many non-communicable diseases, including diabetes. Lack o... more Elderly populations are susceptible to many non-communicable diseases, including diabetes. Lack of awareness regarding disease status and risk factors increase complications and mortality. We conducted a cross-sectional community-based study of 1633 randomly selected participants aged 60 years and above in urban and rural areas in the Kathmandu Valley of Nepal. Study goals were: (i) to determine the prevalence of diabetes in elderly subjects as diagnosed prior to and during the study, and (ii) to identify and compare the determinants of diabetes as diagnosed prior to and during the study. A structured questionnaire was used to collect information regarding prevalence and potential determinants of diabetes diagnosed during and before the survey. Anthropometric measurements, blood pressure measurements and fasting blood sugar tests were also measured. Risk factor analysis was done using multinomial logistic regression; subjects with no diabetes constituted the reference group. We dete...
This paper examines the discordance between biological data of HIV and herpes simplex virus type ... more This paper examines the discordance between biological data of HIV and herpes simplex virus type 2 (HSV-2) infections and self-reported questionnaire responses among orphan adolescents in Western Kenya. In 2011, 837 orphan adolescents from 26 primary schools were enrolled in an HIV prevention trial. At baseline, blood samples were drawn for HIV and HSV-2 infection biomarker testing, and participants completed an audio computer-assisted self-interviewing survey. Comparing biological data with self-reported responses indicated that 70% of HIV-positive (7 out of 10) and 64% of HSV-2-positive (18 out of 28 positive) participants reported never having had sex. Among ever-married adolescents, 65% (57 out of 88) reported never having had sex. Overall, 10% of study participants appeared to have inconsistently reported their sexual behaviour. Logistic regression analyses indicated that lower educational level and exam scores were significant predictors of inconsistent reporting. Our study demonstrates the discordance between infections measured by biomarkers and self-reports of having had sex among orphan adolescents in Kenya. In order to detect programme effects accurately in prevention research, it is necessary to collect both baseline and endline biological data. Furthermore, it is recommended to triangulate multiple data sources about adolescent participants' self-reported information about marriage and pregnancies from school records and parent/guardians to verify the information. Researchers should recognise potential threats to validity in data and design surveys to consider cognitive factors and/or cultural context to obtain more accurate and reliable information from adolescents regarding HIV/sexually transmitted infection risk behaviours. NCT01501864.
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