http://localhost/xmlui/handle/123456789/1279 Medical Laboratory; Agriculture & environmental Biotecthology; Biochemistry; Molecular Medicine, Applied Epidemiology; Medicinal PhytochemistryPublic Health; 2026-08-17T10:13:04Z http://localhost/xmlui/handle/123456789/7104 Storage Related Hematological and Biochemical Changes in Sickle Cell Trait Donor Blood at Kisumu Regional Blood Transfusion Centre, Kenya Bwakali, Meshack Shiundu Sickle cell trait (HbAS) donor blood is widely used for transfusion in malaria-endemic regions, yet evidence comparing its storage-related deterioration with normal hemoglobin (HbAA) blood remains limited. This study evaluated hematological and biochemical changes occurring during storage of HbAS and HbAA donor blood at the Kisumu Regional Blood Transfusion Centre, Kenya. A prospective laboratory-based experimental design was conducted using 60 donor blood units comprising 30 HbAS and 30 HbAA units selected from 336 voluntary blood donors screened for sickle cell trait. Hematological and biochemical parameters were measured at baseline and weekly for 28 days using standardized laboratory methods, while data were analyzed using one-way ANOVA, R statistical software, and SPSS version 27 at a significance level of p<0.05. Both donor groups demonstrated progressive storage lesions, although changes were consistently more pronounced in HbAS blood. Hemoglobin and hematocrit increased, whereas platelet and total white blood cell counts declined markedly. Percentage hemolysis reached 0.78% in HbAS compared with 0.54% in HbAA by day 28. Lactate dehydrogenase increased steadily from 210.87 to 635.80 U/L in HbAS and from 196.09 to 530.69 U/L in HbAA, indicating greater cellular degradation in HbAS blood. Plasma potassium increased substantially from 4.98 to 19.28 mmol/L in HbAS versus 4.53 to 14.92 mmol/L in HbAA, while sodium declined progressively in both groups. Plasma bilirubin also increased throughout storage, reaching 19.98 ng/dL in HbAS and 13.48 ng/dL in HbAA, reflecting enhanced erythrocyte breakdown. The findings demonstrate that HbAS donor blood undergoes greater storage-related hematological and biochemical deterioration than HbAA blood, potentially compromising transfusion quality and safety. Routine screening for sickle cell trait among blood donors, differential storage protocols with shorter storage durations for HbAS units, and regular monitoring of biomarkers including lactate dehydrogenase, potassium, bilirubin, and hemolysis are recommended to improve transfusion safety and optimize blood quality in endemic settings. Master of Medical Laboratory Science (Hematology and Blood Transfusion) 2026-08-11T00:00:00Z http://localhost/xmlui/handle/123456789/7101 Effect of Traditional Birth Attendants-Led Health Education Intervention on Selected Maternal and Child Health Promotion Strategies in West Pokot County, Kenya Kaprom, Benadette Chepkomor Despite global progress in maternal and child health, disparities persist in resource-limited settings. Between 2000 and 2017, the global maternal mortality ratio declined by 38%, yet sub-Saharan Africa continues to bear a disproportionate burden. In West Pokot County, Kenya, a region characterized by poor infrastructure, challenging terrain, and high fertility rates, over half of all deliveries are managed by traditional birth attendants (TBAs). Skilled birth care (SBC), exclusive breastfeeding (EBF), postpartum family planning (PPFP), and infant vaccination coverage (IVC), which are maternal, newborn and child health (MNCH) strategies remain critically low, contributing to maternal and child morbidity and mortality. This study evaluated the effect of a TBA-led health education intervention on promoting SBC, EBF, PPFP and IVC in West Pokot County, Kenya. A quasi-experimental design was employed with an intervention group (Pokot South Sub-County) and a control group (North Pokot Sub-County). Baseline and end-line surveys were conducted among 408 expectant mothers, who were followed until their infants reached above nine months of age. In the intervention site, 24 TBAs were recruited, trained using an adapted Ministry of Health (MOH) curriculum, and assigned to expectant mothers to provide health education and advocacy for SBC, EBF, PPFP, and IVC. The control group received standard MOH care. Attrition was 13.2% (n=27) in the intervention group and 21.1% (n=43) in the control group, with a total of 338 participants (177 control, 161 intervention) completing the end-line survey. Analysis progressed from bivariate (Pearson's chi-square) to multivariate (binary logistic regression with three hierarchical models). The intervention group demonstrated significantly better outcomes across all four MNCH strategies. For SBC, 81.4% of intervention mothers delivered in a health facility versus 58.2% in the control group (p<0.001). Bivariate analysis yielded an unadjusted odds ratio (UOR) of 3.137 (95% CI: 1.909–5.155), and after controlling for confounders, the adjusted odds ratio (AOR) was 3.180 (95% CI: 1.790–5.651; p<0.001). For EBF, 95.0% of intervention mothers practiced exclusive breastfeeding for six months compared to only 23.3% in the control group (p<0.001). The effect was very large (UOR=62.561; 95% CI: 28.330 138.152; AOR=71.423; 95% CI: 30.247–168.651; p<0.001). For PPFP, 50.3% of intervention mothers were on modern family planning methods versus 13.0% in the control group (p<0.001), with consistent effects (UOR=6.779; 95% CI: 3.966–11.588; AOR=6.514; 95% CI: 3.543–11.976; p<0.001). For IVC, 92.3% of intervention group children were fully immunized per KEPI schedules compared to 37.3% in the control group (p<0.001), with strong effects (UOR=20.200; 95% CI: 10.337–39.474; AOR=13.935; 95% CI: 2.708–71.699; p=0.002). The overall model explained 55.2% of the variance in combined outcomes (R²=0.552, p<0.001). In conclusion, the TBA-led health education intervention significantly improved the utilization of SBC, practice of EBF, use of modern PPFP, and IVC in West Pokot County. The effects ranged from moderate to very large (3-fold for SBC to 71-fold for EBF) and remained significant after controlling for potential confounders. These findings demonstrate that TBAs, when properly trained and recognized, can serve as effective community champions for MNCH strategies (SBC, EBF, PPFP & IVC) in remote, under-resourced settings. The study recommends that the MOH and county governments recognize the role of TBAs as MNCH champions and referral agents rather than birth attendants. Policy reforms should also address barriers such as distance to facilities, low maternal literacy, and male involvement in family planning decisions. Future longitudinal research is warranted to assess the sustainability of these gains over time. PhD in Public Health 2026-08-11T00:00:00Z http://localhost/xmlui/handle/123456789/7091 Incidence of Prosthetic Joint Infection, Functional Recovery and Rehabilitation Progress among Orthopaedic Patients at Metropolitan Hospital, Nairobi County, Kenya Vutiya, Wycliffe The incidence of total knee replacement (TKR) is increasing due to factors such as heightened patient satisfaction, an ageing population, increased number of TKR expertise, and advancement in technology, and increase in the obesity epidemic which lead to more significant stress on weight-bearing joints. This study determined the incidence of prosthetic knee joint infection, evaluated functional recovery, and analysed rehabilitation progress among orthopaedic patients who underwent Total Knee Replacement at Metropolitan Hospital in Nairobi County, Kenya. This study employed a longitudinal study design for five months, following 75 patients who had undergone TKR at Metropolitan Hospital in Nairobi County. Each patient was observed for a period of 6 weeks therefore; a total of 450 observations were made for all the 75 patients. Data collection methods included medical record reviews, patient interviews, and clinical assessments. Specifically, standardized questionnaires and assessment tools were utilized, including the short form health survey (SF-12) for quality-of-life assessment, the visual analogue scale (VAS) for pain measurement, and relevant scales for activities of daily living (ADL) assessment. The incidence density of prosthetic joint infection was calculated using the conventional formula, accounting for new cases and patient time at risk. We observed that functional outcomes post-TKR are generally favourable, with patients who were followed up resuming their daily activities in a relatively short timeframe of less than six weeks. By the sixth week, 60% of the patients had undergone excellent rehabilitation progress. The incidence of prosthetic knee infection was notably low (9 cases per 1000 patient weeks) and was only associated with age, perhaps highlighting the effectiveness of the applied surgical techniques and postoperative care. Additionally, we identified that comorbid conditions, particularly diabetes and hypertension, are the primary factors that contributed to delayed healing and resumption of daily activities following TKR. Favourable outcomes and low infection rates indicate that total knee replacement (TKR) is a safe and effective option for patients with severe knee pain, significantly improving quality of life and mobility. However, the association between age and infection risk necessitates thorough preoperative assessments and age-specific care protocols, especially for older patients. Additionally, comorbidities like diabetes and hypertension can delay healing, highlighting the need for targeted preoperative interventions. Optimizing the management of these conditions may enhance recovery and reduce complications. Further research is essential to explore how these comorbidities affect healing post-TKR and to assess the effectiveness of specific interventions. Key Words: Total Knee Replacement (TKR), Clinical outcomes, Functional outcomes, Kenya. MSc in Global Health 2026-08-07T00:00:00Z http://localhost/xmlui/handle/123456789/7087 Development of a Facility-Based Intervention Model on Male Partner Involvement in Maternal and Neonatal Health in A Public Health Facility, Kiambu County, Kenya Okwako, Joseph Mukobe The 1994 International Conference on Population and Development (ICPD) emphasized the need for men to actively participate in sexual and reproductive health. However, male partner involvement in maternal, newborn and child health (MNCH) in Kenya remains limited. This study aimed to develop, implement, and evaluate the effectiveness of a facility-based intervention model to promote male partner involvement (MPI) in maternal and neonatal health at Thika County and Referral Hospital. An exploratory sequential mixed-methods design was employed. The qualitative phase involved three focus group discussions (FGDs) with nurses and two FGDs with male partners to explore barriers and enablers to male involvement. Thematic analysis was conducted using MAXQDA 2022 software, which revealed key themes including limited awareness, traditional gender norms, and logistical constraints as major barriers. These insights informed the design of a structured health facility-based intervention, tested using a quasi-experimental pre-test/post-test design. Ethical approval was sought from Jomo Kenyatta University of Agriculture and Technology (Ref. No. JKU/ISERC/02316/1113) and informed consent from participants. A total of 60 women (30 intervention, 30 control) between 17–28 weeks’ gestation were recruited via systematic random sampling. Male partners in the intervention group received formal invitations to attend antenatal care (ANC) and were followed through six months postpartum. Quantitative data were collected using pre tested semi-structured questionnaires and analysed using SPSS v27.0. Statistical tests included chi-square, Fisher’s exact test, and Mann–Whitney U test, with a significance threshold of p < 0.05. The primary outcome male accompaniment to ANC was significantly higher in the intervention group (U = 11.000, p < 0.001), with a large effect size (r = 0.98). Significant improvements were also observed in male support during pregnancy and childbirth (p < 0.001), knowledge of danger signs in pregnancy (p < 0.001), awareness of exclusive breastfeeding recommendations (p = 0.005), and uptake of couple HIV counselling and testing (p < 0.001). These findings demonstrate that a context-specific, structured, facility-based intervention model can effectively enhance male partner involvement in MNCH and contribute to improved maternal and infant health outcomes. This study recommends that the National and County governments should consider adapting the intervention model to promote MPI in MNCH services. PhD in Nursing 2026-08-06T00:00:00Z