Dr. Marko Sabina Nyanchera Publications | ||||
1 | 2013 | Health-care Providers'perceptions Of Intravaginal Rings For Hiv Prevention In Nairobi, Kenya Click to View Abstract Background: Health-care providers form the backbone of health information and service delivery in many African communities. This study investigated health-care providers' (HCPs) attitudes towards a novel method of HIV prevention for women-a microbicide-embedded intravaginal ring (IVR). Methods: Qualitative interviews were conducted, covering initial attitudes towards IVRs, potential use among female sex workers, herbal practices for sexually transmitted infection (STI) management and the ways in which populations can access the rings should they become available. Twenty HCPs were interviewed in Mukuru and Kibera, which are informal settlements in Nairobi, Kenya, with high HIV prevalence, unemployment and commercial sex work. Results: The majority of HCPs had positive attitudes towards IVRs as a method of HIV prevention in this environment. HCPs liked that IVRs are female controlled and can be used covertly. Overall, HCPs reported a willingness to participate in the distribution of IVRs, and favoured distribution through health facilities at no cost. Conclusion: Findings from this study demonstrate that HCPs are willing to serve as the primary source of IVR information in target communities. However, they require adequate knowledge regarding microbicides and IVRs before these products reach the market | ||
2 | 2013 | A Pilot Quasi-experimental Study To Determine The Feasibility Of Implementing A Partograph E-learning Tool For Student Midwife Training In Nairobi Click to View Abstract the partograph is a tool used globally to record labour progress. Although it has the potential to improve maternal and neonatal outcomes, some midwives struggle with using it in practice. Training in partograph use is limited, and the theory is often divorced from practice. Innovative ways of improving training are urgently required. We therefore aimed to determine whether the use of an e-learning tool is beneficial for learning partograph skills. an uncontrolled before-and-after study was conducted, informed by Kirkpatrick's four-stage model of evaluation; we report on the first two stages. We included a cohort of third and fourth year midwifery students who were studying at one university in Nairobi. The same hypothetical case scenario was used, pre- and post-implementation of the World Health Organization partograph e-learning tool, to assess students' partograph completion ability. Views on the tool were also sought, using semi-structured questionnaires. Data were analysed using standard statistical techniques and framework analysis. 92 (88%) students participated. Students expressed positive views about the e-learning tool. However, the mean post-intervention score (27.21) was less than half of the maximum obtainable score. There was some improvement in test scores; year three mean score pre-intervention was 21.39 (SD 5.72), which increased to 25.10 (5.41) post-intervention (paired-t=3.47, p=0.001); year four mean score pre-intervention was 24.39 (5.98) which increased to 29.30 (6.77) post-intervention (paired t=3.85, df=91, p<0.001). In the post-test, year four students scored higher than year three students (unpaired t=3.28, df=90, p=0.001). Students were unable to plot cervical dilatation correctly, once established labour had been confirmed. e-Learning training is acceptable to student midwives and has the potential to be an effective means of teaching the practical application of the partograph. However, in this study, their inability to correctly plot transference from the latent to active phase of labour suggests that the partograph itself may be too complicated. Modifications and further evaluation of the e-learning tool would be required before any widespread implementation. Furthermore, students need the clinical support to operationalise their learning; educating qualified midwives and obstetricians to be positive role models when completing the partograph would be one potential solution. Further research is required, taking on board the recommendations from our pilot study, to investigate the impact of partograph e-learning on practice and clinical outcomes. | ||
3 | 2011 | Students' Experiences Of Using The Partograph In Kenyan Labour Wards Click to View Abstract Previous research has demonstrated the likely benefits of partograph use in low-resourced settings. However, the challenges of completing a partograph are also reported. The objective of this study was to examine students' views and experiences of partograph use to gain understanding of the realities of using this tool in the labour ward. Methods: In a qualitative study, 51 student nurses, undertaking their maternity placement at a university in Nairobi, Kenya, participated in five focus group discussions. Data were audio recorded, transcribed verbatim and analysed thematically. Results: Four main themes emerged from the analyses: challenges to 'doing the right thing'; theory-practice disconnectedness; negative role models; and retrospective recording. Conclusions: The results provide insight into the challenges faced by students when practising in the labour ward environment. A more effective approach to partograph training and implementation should be adopted to support students. However, student midwife training is unlikely to be implemented into practice unless the qualified team supports their learning. Given that the partograph had little status in the labour ward, change may only happen when senior health professionals (midwives and obstetricians) lead by example. Further research is required to explore the views of obstetricians and qualified midwives on partograph use. Appropriate implementation strategies also warrant further investigation | ||
4 | 2011 | Reasons For Ineligibility In Phase 1 And 2A HIV Vaccine Initiative (KAVI), Kenya Click to View Abstract With the persistent challenges towards controlling the HIV epidemic, there is an ongoing need for research into HIV vaccines and drugs. Sub-Saharan African countries - worst affected by the HIV pandemic - have participated in the conduct of clinical trials for HIV vaccines. In Kenya, the Kenya AIDS Vaccine Initiative (KAVI) at the University of Nairobi has conducted HIV vaccine clinical trials since 2001 | ||
5 | 2010 | Reasons For Ineligibility In Phase 1 And 2A HIV Vaccine Clinical Trials At Kenya Aids Vaccine Initiative (KAVI), Kenya Click to View Abstract Background: | ||
6 | 2010 | INTERPRETATION OF SAFE MOTHERHOOD POLICIES BY MIDWIVES PRACTITIONERS IN KENYA Click to View Abstract Background: In Africa Health Care Providers form the primary source of information and service provision. Majority of the health work force are nurses/midwives with diverse training and experiences. This study focused on knowledge and Safe motherhood policy implementation. | ||
7 | 2009 | Pregnancy Rates Among Female Participants In Phase I And Phase IIA AIDS Vaccine Clinical Trials In Kenya Click to View Abstract Female participants in AIDS candidate vaccine clinical trials must agree to use effective contraception to be enrolled into the studies, and for a specified period after vaccination, since the candidate vaccines’ effects on the embryo or foetus are unknown.country settings. Effective female-controlled contraceptives, administered at the clinical trial site, may empower female participants to better control their fertility, leading to more complete clinical trial data. | ||
8 | 2008 | 179 Challenges Recruiting Women Into Trials Click to View Abstract
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9 | 2008 | Safety And Immunogenicity Of Recombinant Low-dosage HIV-1 A Vaccine Candidates Vectored By Plasmid PTHr DNA Or Modified Vaccinia Virus Ankara (MVA) In Humans In East Africa Click to View Abstract The safety and immunogenicity of plasmid pTHr DNA, modified vaccinia virus Ankara (MVA) human immunodeficiency virus type 1 (HIV-1) vaccine candidates were evaluated in four Phase I clinical trials in Kenya and Uganda. Both vaccines, expressing HIV-1 subtype A gag p24/p17 and a string of CD8 T-cell epitopes (HIVA), were generally safe and well-tolerated. At the dosage levels and intervals tested, the percentage of vaccine recipients with HIV-1-specific cell-mediated immune responses, assessed by a validated ex vivo interferon gamma (IFN- ) ELISPOT assay and Cytokine Flow Cytometry (CFC), did not significantly differ from placebo recipients. These trials demonstrated the feasibility of conducting high-quality Phase 1 trials in Africa. | ||
10 | 2006 | Kenya Begins Enrollment For Phase I Vaccine Trial Click to View Abstract
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11 | 2004 | Kenya AIDS Vaccine Initiative HIV Vaccine Peer Leaders Training Manual Click to View Abstract MRC Human Immunology Unit, University of Oxford, Oxford, UK. The IFN-y enzyme-linked immunospot (ELI-Spot) assay is often used to map HIV-specific CD8 T-cell responses. We compared overlapping 15-mer pools with optimized CD8 epitopes to screen ELISpot responses in HIV-infected individuals. The 15-mer pools detected responses to previously undefined epitopes, but often missed low-level responses to predefined epitopes, particularly when the epitope was central in the 15-mer, rather than at the N-terminus or C-terminus. These factors should be considered in the monitoring of HIV vaccine trials. |
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