Purpose: In low-resourced settings such as Turkana County, diarrhoeal disease is a leading cause of morbidity and mortality among children under five years of age (WHO.,2024). The burden of diarrhoeal disease is particularly high in settings with poor Water, Sanitation and Hygiene (WASH) conditions in arid and semi-arid (ASAL) areas, such as Turkana County (WHO, 2024). In Kenya, despite the critical role Community Health Promoters (CHPs) play as the first point of contact for caregivers at the community level in community case management of diarrhoeal disease under Kenya’s Community Health Policy (2020–2030), knowledge gaps persist in maintaining consistent adherence to integrated community case management of diarrhoeal disease. While Short Message Service (SMS) mobile Health (mHealth) interventions have shown promise in bridging the knowledge gap by reinforcing knowledge in community case management of common childhood diseases. The effectiveness of SMS-supported interventions in low-literacy settings remains limited (Greve et al., 2022). Kakuma Ward in Turkana West Sub-County was purposively selected for its population dynamics and the burden of diarrhoeal disease. This study addressed CHPs gaps in community case management by documenting the experiences and perceived impact of an SMS intervention on community case management of diarrhoeal disease. The findings are expected to benefit CHPs, caregivers of children under five, Sub-County Health Management Teams (SCHMT), and mHealth program designers working in similar low-resource settings. Methodology: This study was underpinned by the Social Cognitive Theory and the Capability, Opportunity, Motivation - Behaviour (COM-B) model. The Social Cognitive Theory is described in Bandura’s book, The Social Foundations of Thought and Action (Bandura, 1986), and the COM-B model is a behavioural framework by Michie et al (Michie et al., 2011). Data was collected through focus group discussions with caregivers (n = 16) and CHPs (n = 32) and Key Informant Interviews (n = 6) with Community Health Officers and Assistants within four community units in Kakuma Ward. The FGD and KII transcripts were analysed using the six phases of thematic analysis outlined by Braun and Clarke (2006). Thematic saturation was reached across all participant groups. Findings: Participants in the study viewed the SMS messages as a way to reinforce existing knowledge on community case management of diarrhoeal disease, build confidence as they perform their roles in the community, and support decision-making when they visit households with children under 5 years of age who have diarrhoeal disease. The SMS supported intervention was associated with improved recognition of danger signs and improved community case management practices, through increased use of Oral Rehydration Salt (ORS) and zinc as standard commodities for managing diarrhoea among children under 5 years of age at the community level. Unique Contribution to Theory, Practice and Policy: SMS supported interventions should integrate literacy inclusive features, such as interactive voice response and pictorial aids, with in-person training. Supportive supervision by Community Health Assistants (CHAs) and a reliable supply of ORS and Zinc should also be emphasised in mHealth community health programs. Future longitudinal qualitative research is recommended to assess the behavioural sustainability and knowledge retention across different literacy levels among CHPs in mHealth programs in low-resource settings.
Purpose: This study sought to investigate the caregiver’s level of knowledge of trachoma control among children aged 1-9 years in Kajiado County. Methodology: Cross-sectional analytical research design was used. 428 participants were selected from the study area. The survey encompassed the gathering of quantitative as well as qualitative data. Multi-stage sampling was used to select the study area and the research participants. Data was analyzed using both descriptive and inferential statistics. Regression analysis, chi square test and correlation analysis was used to determine the significance of the study variables and in hypothesis testing. The study will be useful in policy formulation on Trachoma programs. Findings: The mean knowledge level of the caregivers was 6.73 with a standard deviation of 1.50. Notably, 63.1% (n=270) had good knowledge level of trachoma because they scored above the mean while 36.9% (n=158) scored below the mean (low knowledge level). Unique Contribution to Theory, Practice and Policy: To eliminate trachoma, the government and policy makers should not only invest in awareness creation on the disease but also focus on reducing the barriers to access of safe water and sanitation facilities.
Background: Physical fatigue is a significant issue in the palm oil plantation sector, marked by a decline in physical performance that increases the risk of workplace accidents. Intense physical activity in palm oil workers can elevate lactate levels, contributing to muscle fatigue. Red ginger is known to contain gingerol and shogaol, potent antioxidants that help reduce oxidative stress, thus accelerating muscle recovery and lactate metabolism. However, no research has yet demonstrated that red ginger can reduce lactate levels in palm oil workers. This study aims to analyze the difference in lactate levels before and after consumption of red ginger herbal drink in palm oil harvesters experiencing fatigue. Method: This study employed a quasi-experimental design with a one-group pretest-posttest design. The sample was selected using total sampling from a population of 138 palm oil harvesters, with 57 respondents meeting the inclusion criteria. Lactate levels were measured before and 30 minutes after the intervention using an Accutrend Plus device. Data analysis was performed using the non-parametric Wilcoxon Signed-Rank test. Results: The study found a decrease in the average lactate level after consumption of the red ginger herbal drink by 0.78 mmol/L. Before the intervention, the average lactate level was 2.75 mmol/L, and after the intervention, it decreased to 1.97 mmol/L. A statistically significant difference was found with a p-value of 0.000. Conclusion: The consumption of red ginger herbal drink was significantly effective in reducing lactate levels in palm oil harvesters experiencing work-related fatigue. This intervention could potentially serve as a natural solution for managing work fatigue caused by lactate accumulation in physically demanding work environments.
Background: Patients who have undergone surgery generally experience sleep disturbances caused by various factors, such as physical discomfort due to pain, anxiety about postoperation health recovery, fully hospital environments, and other factors. The purpose of this study is to identify factors related to the fulfillment of sleep rest needs in postoperation patients at RSUD Meuraxa. Methode: This study is a quantitative research using a cross-sectional design involving 40 individuals. The study was conducted from April 17th to April 23rd, 2023, using an accidental sampling method and chi-square statistical test. Result: The research results indicate a significant relationship between pain, anxiety, and environmental comfort with the fulfillment of sleep rest needs in postoperation patients, with ρ values of (0.001, 0.005, 0.039) < alpha value of 0.05. This study establishes a significant connection between pain, anxiety, and environmental comfort with sleep fulfillment in postoperation patients at RSUD Meuraxa in Banda Aceh. Conclusion: Based on the research findings, nurses need to pay more attention to meeting the sleep rest needs of postoperation patients.
Purpose: Burnout among allied health workers represents a growing crisis affecting workforce sustainability, patient safety, employee mental health, and institutional liability. This mixed qualitative and quantitative manuscript evaluates burnout prevalence across professional sectors, examines longitudinal healthcare trends, and models relationships between burnout, suicide risk, sentinel events, and insurance claims. Methodology: Comparative quantitative modeling indicates healthcare workers experience significantly higher burnout levels than workers in finance, technology, manufacturing, and education sectors. Qualitative case simulations illustrate how early detection may prevent suicide events and costly liability exposure, while also demonstrating how early detection of burnout-related physiological distress may reduce sentinel occurrences and minimize organizational financial loss. The study also evaluates the potential benefits of implementing a wearable neurophysiological detection technology known as the NeuroPulse Burnout Device. This manuscript also introduces the NeuroPulse Burnout Detection System, presented strictly as a hypothetical pilot-stage wellness technology currently under conceptual development and early implementation planning. The purpose of introducing NeuroPulse within this research is to model how emerging predictive physiological monitoring technologies may contribute to burnout prevention strategies. Findings: Regression modeling demonstrates statistically significant correlations between burnout prevalence and liability risk indicators. Implementation of predictive monitoring systems may reduce sentinel events, improve workforce wellness, enhance organizational resilience, improve workforce resilience, enhance patient safety outcomes, reduce absenteeism, and lower institutional liability exposure. All projected benefits described in this manuscript represent theoretical modeling assumptions, not confirmed clinical outcomes. Unique Contribution to Theory, Practice and Policy: These findings support further exploration of predictive burnout monitoring pilot programs within healthcare organizations. The manuscript follows JHMN–IPRJB formatting guidelines including structured sections, tables, figures, and references formatted in APA style.
Purpose: Nurse burnout, especially emotional exhaustion (EE), negatively impacts job satisfaction (JS), staff retention, and the quality of patient care worldwide. EE presents as persistent fatigue resulting from extended work-related stressors, such as excessive workloads, inadequate staffing, and emotional demands. In the UAE, the rapid expansion of healthcare, dependence on foreign nurses, and elevated patient-to-nurse ratios exacerbate these issues. Abu Dhabi's Vision 2031 emphasizes the importance of the healthcare workforce’s well-being and retention; nonetheless, empirical research linking EE and JS remains scarce. This study combines international and UAE-related literature using the Job Demands-Resources (JD-R) framework to analyze factors affecting EE, its effects on JS, and mitigation strategies. Methodology: The study employs a literature synthesis approach, integrating findings from international and UAE-specific studies within the JD-R framework to identify determinants of EE, its impact on JS, and evidence-based mitigation strategies. Findings: Findings emphasize the importance of supportive leadership, ethical workplace cultures, effective workload management, and nurse residency programs in improving satisfaction and retention. Key factors contributing to EE include heavy workloads, lack of leadership backing, and ethical pressure. Interventions based on evidence empowering leadership, inclusive governance, and organized mentorship, successfully reduce EE. Unique Contribution to Theory, Practice and Policy: This study provides practical recommendations for hospital leaders and decision-makers to enhance employee well-being and ensure sustainable, high-quality healthcare services in line with the UAE Vision 2031, while adapting the JD-R framework to the healthcare environment in the United Arab Emirates.
Purpose: The purpose of this study is to determine clinical factors associated with under-nutrition among adult Tuberculosis patients in Nairobi, county, Kenya. Methodology: A cross-sectional study was conducted in Nairobi City County, Kenya, across ten health centers providing TB diagnostic and treatment services. A total of 367 adult TB patients were selected through stratified random sampling. Data collection involved structured questionnaires (socio-demographics and clinical record reviews (TB type, treatment duration, co-morbidities. The questionnaire was pre-tested at Kariobangi North Health Centre. Data analysis included descriptive statistics and inferential tests (Chi-square, logistic regression) to assess associations between clinical factors and under-nutrition, with significance set at p<0.05. Findings: The multivariate logistic regression analysis identified treatment phase, adherence, disease duration, and comorbidities as significant determinants of under-nutrition, aligning with and extending previous research on the interplay between TB and malnutrition. Patients in the continuation phase of TB treatment were significantly more likely to be under-nourished than those in the intensive phase (AOR = 2.80, 95% CI: 1.30–6.00, p = 0.007). Poor treatment adherence also emerged as a strong predictor of under-nutrition, with affected patients showing nearly triple the risk compared to those with good adherence (AOR = 2.90, 95% CI: 1.30–6.60, p=0.009). The presence of comorbidities dramatically increased the likelihood of under-nutrition (AOR = 3.90, 95% CI: 1.80–8.50, p < 0.001). Unique contribution to Theory, Practice and Policy: This study finding points out the important of incorporating regular assessment of nutritional status into TB protocols. The study recommends screening for HIV and other co-morbidities early and consistently, monitoring of patients with advanced TB disease closely for nutritional decline, counseling into TB treatment plans. Finding of this study may contribute to formulation of policies to promote collaboration between TB programs, HIV programs, and nutrition services to ensure continuity of care.
Purpose: The current study aimed at establishing infant care practices and their influence on mother-to-child HIV transmission among HIV-exposed infants aged 6 weeks to 18 months in Machakos Level 5 Hospital. Methodology: A cross-sectional study was conducted in Machakos Level 5 Hospital. Data were collected from thirty-two mother-infant pairs using a focus group discussion guide. Four focus group discussions were conducted, each with 8 participants. The data were thematically analyzed and presented using narratives and quotes. Ethical approval and research permit were obtained from the JKUAT Institutional Scientific and Ethics Review Committee, and the National Commission for Science, Technology, and Innovation. Written informed consent was obtained from all the participants. Findings: Mothers had a good understanding of MTCT of HIV and its prevention. However, they faced challenges in adhering to infant prophylaxis. The participants had inadequate knowledge of teething signs, where diarrhea and fever were reported as signs and symptoms. Some of the potentially harmful practices practiced by mothers were gum cutting, rubbing the gums with goat's excreta or Ashton and soda-mint mixture for teething, and administering alcohol and herbs to manage colic. They also reported inadequate healthcare provider support in managing teething and colic. Unique Contribution to Theory, Practice and Policy: Despite mothers' adequate knowledge of MTCT and its prevention, significant gaps persist between knowledge and practice. Difficulties in adhering to infant prophylaxis, compounded with non-disclosure and insufficient support from healthcare providers, contributed to the adoption of unsafe infant care practices. These challenges need to be addressed through strengthened healthcare guidance, culturally sensitive counselling, community health education, and continuous support to promote safe infant care practices. The study recommends that the government should integrate safe teething and colic management into PMTCT protocols.
Purpose: The purpose of this study determines behavioral correlates associated with diabetes and hypertension among people living with HIV/AIDS attending Isiolo county referral hospital comprehensive care clinic, Kenya Methodology: A cross-sectional analytical design was applied using data from 231 respondents selected through systematic sampling. Data were collected using structured questionnaires and analyzed using descriptive statistics and chi square tests. Findings: The findings showed behavioral correlates such as, tobacco use and alcohol consumption were significantly associated with hypertension and overall noncommunicable disease outcomes, while tobacco use was also significantly associated with diabetes. The association between alcohol use and diabetes was statistically significant but marginal. Physical activity and dietary variety were not significantly associated with disease outcomes. The study concludes that substance use behaviors are key drivers of cardiometabolic risk and recommends strengthening integrated behavioral screening and intervention strategies within HIV care. Unique Contribution to Theory, Practice and Policy: Theoretically, the study highlights the critical role of substance use behaviors, especially tobacco and alcohol, as key pathways driving cardiometabolic risks like hypertension and diabetes among people living with HIV, suggesting that models of disease risk in this population must integrate behavioral factors more explicitly. In clinical practice, the evidence supports prioritizing systematic screening and comprehensive, patient-centered cessation interventions for substance use within routine HIV care, alongside consistent lifestyle counseling for physical activity and diet, to mitigate these risks effectively. From a policy perspective, aligning HIV programs with broader noncommunicable disease initiatives is essential; this includes incorporating behavioral risk indicators into monitoring frameworks, enhancing provider training in integrated care, and scaling community-based health promotion tailored to the specific regional context, all to improve early risk detection, preventive care continuity, and ultimately reduce the burden of hypertension and diabetes in this vulnerable population.
Purpose: The purpose of the study is to determine socio-demographic factors influencing human waste disposal practices in Kibra sub-county, Kenya Methodology: A cross-sectional study was conducted at Kibra Sub-County, comprising 17 villages. Study Population was Household heads residing in Kibra for ≥6 months. Data was collected among 365 participants. A simple random sampling technique was employed from a household listing developed with local administrators. Quantitative data were collected via structured questionnaires. Data analysis involved descriptive statistics, Chi-square tests, and binary logistic regression to identify factors associated with safe disposal practices. Statistical significance was set at p < 0.05. Ethical Approval number was obtained from the JKUAT Ethical Review Board and NACOSTI. Written informed consent was obtained from all participants, with assurances of anonymity and voluntary participation. Findings: Multivariable logistic regression was performed to identify independent predictors of safe human waste disposal among residents of Kibera Constituency. Paying for sanitation was a strong independent predictor of safe disposal. Respondents who paid for sanitation services were over seven times more likely to practice safe disposal compared to those who did not pay Adjusted OR 7.21 (95% CI: 3.52–14.78, p < 0.001). Higher household income significantly increased the likelihood of safe disposal. Respondents earning more than 30,000 KES were nearly twenty times more likely to practice safe disposal compared to those earning less than 10,000 KES Adjusted OR 19.84 (95% CI: 4.12–95.62, p < 0.001). Unique Contribution to Theory, Practice and Policy: The social demographic factors, education level, household income, employment status among those able to pay were significantly associated with positive human waste disposal. This study recommends continues education campaign to residents of Kibra by leaders and ministry of health on importances of doing work to earn income and practice safe human waste disposal.
Purpose: Organ donations can save or prolong life. Clinicians play a key role in promoting organ donation and transplant; hence, their knowledge may have positive effect on organ donation. The aim of this study was to assess the knowledge, attitude and practices about organ donation among students undertaking training in Clinical Medicine and Community health at Mount Kenya University, Kenya. Methodology: A cross-sectional descriptive survey among students undertaking an undergraduate course in Clinical Medicine at Mount Kenya University using a pre-tested questionnaire conducted between January and April 2017. The study used purposive sampling methodology of the students. Findings: Seventy-six participants, mean (sd) age of 22 (2.1) years and thirty-nine (51%) females were recruited. Only 3 (4.0%, 95% CI 0.8 to 11%) students had ever made a donation, all of them blood donation. Although sixty-seven (88%) of the study participants had heard the term organ donation only 15 (20%) of them knew someone who had donated organ. The most common source of information about organ donation was from internet/online according to thirty-three participants (43%). Seventy-one (93%) of the participants reported that organ donation was for saving life and fifty-eight (84%) were aware that organ donation involved risk and that the most important risk was infection. Only 4% were aware of local legislation guiding organ donation and transplantation in Kenya while 53% unaware. Forty-nine of the participants 64% agreed that they would receive organ for transplantation. Of the participants, thirty-nine (51%) considered `health status of the recipient’ as the main factor of the greatest importance when donating organ. Forty-three (57%) and forty-nine (64%) of the participants reported the donor and family member should consent for living donation and after death respectively. Thirty-one (41%) and twenty-six (34%) of the respondents think medical doctors and judges should make decisions about organ donation for unclaimed dead bodies respectively. Unique Contribution to Theory, Practice and Policy: Clinical medicine students have significant gaps in knowledge regarding the organ donation and transplantation. There is a low rate of donation even for blood despite the awareness of the need to save lives and therefore need to increase awareness on importance and promote laws to govern organ donation. Addressing these gaps would provide valuable insights to guide education, policy, and advocacy strategies aimed at improving organ donation practices in Kenya.
Purpose: Over the past two decades, global maternal mortality has decreased by 34%, from 339 to 223 deaths per 100,000 live births. However, the rate of decline has slowed, and remains insufficient to achieve the Sustainable Development Goal (SDG) 3.1. This study aims to evaluate the effectiveness of a digital antenatal risk stratification tool in improving the functionality of maternal referral systems in selected healthcare facilities, with the goal of enhancing maternal and neonatal health outcomes. Methodology: A randomized controlled trial (RCT) was conducted in level 4 healthcare facilities. Eligible pregnant women were randomized into an intervention group or a standard of care group with an equal sample size of 175 in each group. Modified Coopland’s Scoring System was employed to categorize maternal risk levels. Descriptive and inferential statistical analysis to summarize the data. Multivariable logistic regression was employed to evaluate the impact of the intervention on the functionality of a referral system controlling sociodemographic outcomes and mode of delivery. Findings: The median age was 26 years (IQR:23-31) in the controls and 25 (22-29) in the intervention group (p-value=0.039). SVD was the most common mode of delivery in both groups. Significant higher proportion of participants reported adequate human resource support during referral in intervention group as compared to the standard of care group (p-value < 0.001). Overall, 27.7% reported the system as function, all of whom were in the intervention group. Functionality of the referral system was associated with assignment to the intervention group, household monthly income of KES 10,000-50,0000 and delivery through caesarean section. Unique Contribution to Theory, Practice and Policy: Digital interventions can strengthen maternal referral systems by facilitating timely and appropriate referral of high-risk pregnancies, which suggest that establishing a national digital referral coordination framework to enable real-time tracking and accountability and integrating risk stratification tools into routine antenatal care protocols could improve perceived quality of the referral system within Siaya county.
Purpose: The lack of an adequate number of registered midwives has resulted in a serious management and professional problem for labor and delivery units at maternity hospitals. In addition, the main issue examined in this working document concerns how insufficient staffing among registered midwives affects the quality of care in labor and delivery units, relative to patient safety, patient experience, and staff workload. This subject matter is important to address because maternity care is extremely time-sensitive, and unstaffed shifts or positions may adversely affect timely clinical observation, appropriate communication among caregivers, respectful care, and emergency preparedness. Methodology: To examine this issue, this working document employed a qualitative evidence synthesis approach based on recent systematic review articles, multi-center observational study articles, qualitative research articles, and articles related to the midwifery workforce literature concerning staffing levels, workload, patient safety, patient satisfaction, and workforce retention. In addition, the working document applied Donabedian's (1966) structure-process outcome model to illustrate how structural weaknesses, such as midwife shortages, affected care processes and patient and workforce outcomes. Findings: The results indicate that midwife shortages were associated with longer times to receive care; higher rates of adverse events during care; higher rates of postpartum readmission; greater utilization of certain medical interventions; lower ratings from patients regarding their experiences; decreased access to respectful maternity care; and increased staff dissatisfaction and intentions to leave. An additional finding was that midwife shortages created a self-fulfilling cycle. When there were fewer midwives on duty, the workload per nurse increased, which in turn diminished the quality of care provided to women and negatively affected nurses' physical and mental wellbeing, reducing their capacity to continue providing high-quality care. Unique Contribution to Theory, Practice and Policy: For both the midwifery profession and leaders of maternity hospitals, the implications of these findings are clear: workforce planning will need to focus on creating sustainable improvements rather than simply replacing personnel who are absent. Therefore, developing evidence-based staffing models, improving working conditions for registered midwives, fairly compensating them, providing continuing education opportunities, supporting them through effective leadership, and implementing retention-fostering policies to enable registered midwives to provide safe, respectful, and woman-centered care are essential.
Purpose: This study sought to establish characterization of immunization messaging for HPV vaccine uptake for cervical cancer prevention among caregivers of young adolescent girls aged 10 -14 years in Kajiado County, Kenya. Methodology: The study applied a mixed method research design. It combined qualitative and quantitative study approaches. This study utilized Health Belief Model (HBM) and Protection Motivation Theory (PMT). The population of the study included all the parents/caregivers of the young adolescent girls 10 – 14 years in Kajiado County who passed the inclusion and exclusion criteria. The study adopted multi-stage sampling to select the respondents and the location of study. Purposive sampling was applied to choose Kajiado County. Four out of all the 5 sub counties/constituencies namely; Kajiado Central, Kajiado South, Kajiado East and Kajiado West were included in the study. Findings: The study found that message characterization strongly influenced HPV vaccine uptake by framing cervical cancer prevention as empowering and manageable, encouraging caregivers to take action. Messages that were clear, culturally appropriate, and delivered by trusted health workers, which enhanced understanding and acceptance. Within the conceptual framework, this reflects the role of HPV immunization messages and communication strategies (independent variables) in directly influencing HPV vaccine uptake (dependent variable), with positive framing increasing uptake and negative perceptions reducing it, while government policy moderates this relationship. Unique Contribution to Theory, Practice and Policy: The study recommended that the characterization of immunization messaging for cervical cancer prevention should be culturally sensitive and aligned with the beliefs and values of the Kajiado County community. It emphasized that messages should be framed in an empowering, clear, and relatable manner to enhance understanding, acceptance, and positive perception among caregivers, thereby improving HPV vaccine uptake.
Purpose: Burn care management is a critical aspect of healthcare, particularly in low-resource settings where access to specialized care may be limited. The aim of the study was to assess factors associated with management of burns in children under five years among nurses at the Burns Unit, Kiruddu National Referral Hospital. Methodology: A cross-sectional health facility study with a quantitative approach was conducted among 32 nurses. Data were analyzed using Fisher’s exact test and binary logistic regression at 95% confidence. Findings: The study revealed that 32% of respondents reported burn care was not well managed. Training (AOR=6.33, 95% CI=1.53–26.31, p=0.01), work experience (AOR=3.17, 95% CI=1.11–9.03, p=0.03), urban residence (AOR=2.91, 95% CI=1.03–8.23, p=0.04), timely arrival (AOR=3.89, 95% CI=1.23–12.31, p=0.02), and belief in medical therapy (AOR=4.56, 95% CI=1.23–16.91, p=0.03) were significantly associated with good management. Unique Contribution to Theory, Practice and Policy: Training, experience, timely arrival, and belief in medical therapy are crucial to improving burn care outcomes.
Background: Indoor microbiomes are an emerging determinant of respiratory health. Environmental factors such as humidity, ventilation, and material type influence the diversity, abundance, and activity of airborne fungi and bacteria. Objective: This meta-analysis identifies bacterial and fungal signature microbiology patterns in indoor air and household dust, linking their ecological and functional indicators with respiratory health outcomes. Methods: Twenty peer-reviewed studies (2019–2025) were analysed using random-effects models (REML). Extracted data included log₂ fold-changes or standardised mean differences (SMDs) for gene expression (sporulation, biofilm, toxin pathways), hydrophilic/mesophilic fungal ratios, and Gram-negative/positive bacterial ratios. Results: Elevated equilibrium relative humidity (ERH ≥ 85 %) was associated with increased hydrophilic fungal taxa and higher expression of growth and sporulation genes (brlA, rodA, catA), secondary metabolites (stcC, Alt a 7), and bacterial inflammation markers (LPS, rpoS). The pooled SMD for hydrophilic fungi was +0.84 (95 % CI 0.59–1.08; p < 0.001); bacterial Gram-negative enrichment showed SMD +0.67 (95 % CI 0.41–0.93). Conclusion: Functional and ecological indicators are more reliable than single-species markers. Combined bacterial–fungal signatures can serve as robust biomarkers for assessing indoor air microbiological quality and respiratory risk.
Background: Diarrhea and gut dysbiosis are closely related gastrointestinal disorders that remain major public health problems worldwide. Herbal-based therapies, particularly leaf and fruit juices, have long been used as complementary treatments. However, recent scientific evidence regarding their mechanisms and clinical relevance remains fragmented. Objective: This systematic review aimed to evaluate recent scientific evidence on the potential of herbal leaf and fruit juices as antidiarrheal agents, modulators of gut dysbiosis, and prebiotics, with a particular focus on Muntingia calabura (cherry tree) leaves and fruits. Methods: A systematic literature search was conducted in PubMed, Scopus, and Google Scholar following PRISMA 2020 guidelines. Studies published between 2021 and 2025 that investigated aqueous extracts or juices of herbal leaves and fruits in relation to diarrhea, gut dysbiosis, or prebiotic activity were included. In vitro, in vivo, food product development studies, and systematic reviews were eligible. Results: A total of 25 studies met the inclusion criteria. Herbal leaves, particularly Muntingia calabura and Psidium guajava leaves, demonstrated antidiarrheal potential through antibacterial, anti-inflammatory, antimotility, and antisecretory mechanisms. In contrast, herbal fruits such as Muntingia calabura fruit, green banana (Musa spp.), and pomegranate (Punica granatum) primarily modulated gut microbiota composition and enhanced short-chain fatty acid (SCFA) production, indicating prebiotic activity. Conclusion: Herbal leaf and fruit juices exhibit complementary roles in diarrhea management and gut health. Leaves appear more effective for acute antidiarrheal effects, while fruits support microbiota restoration and dysbiosis prevention. Further well-designed clinical trials are required to confirm their efficacy and safety in humans.
Purpose: The World Health Organization (WHO) defined triage as the action of sorting and prioritizing patients based on the estimation of the urgency for intervention. This approach is used as the basis for identification of those patients who require immediate medical intervention and those who can safely wait. Locally triage is the process including the initial assessment followed by the prioritization of patients needing emergency care and assigns them according to their actual need or likely benefit from immediate medical treatment. To assess the compliance with triage protocols among healthcare providers managing traumatic patients attending the emergency and outpatient surgery department at University Teaching Hospital of Butare. Methodology: The total sample size were 109 but the participants enrolled in the study were 101because 8 participants voluntary did not want to participate to the study (they refused to sign consent form) a prospective cross-sectional study was conducted among health workers in the surgical department (CHUB staff 70), and the emergency department (CHUB staff 31), making a total of 101 participants across both departments. The participants ’knowledge of triage tool was assessed and their level of compliance with triaging. The training on the triage tool was provided among healthcare providers managing traumatic patients attending the emergency and outpatient surgery department at University Teaching Hospital of Butare, and after one moth of intervention the reassessment was also done about the level of compliance with triage tool following training received. Findings: A total of 101 participants were included, the majority being nurses (63.4%). Most respondents reported that the current triage protocols effectively addressed the needs of trauma patients (86.1%) and that adherence to these protocols significantly or somewhat improved patient outcomes (95%). Compliance monitoring was limited, with over one-third (36.6%) stating that outcomes were never reviewed. However, urgent cases were largely well prioritized (89.1%). About one-fifth (20.8%) acknowledged adverse outcomes due to non-compliance with triage protocols. Nearly half (49.5%) of participants reported challenges to implementation, mainly related to lack of training, monitoring, and updated tools. Training interventions were associated with improvements in outcome review practices, prioritization of urgent cases, and reduction of adverse outcomes related to non-compliance. Unique Contribution to Theory, Practice and Policy: In both department participants emphasized the need for ongoing training and to increase staffing as key strategies for further enhance level of compliance and strengthen the triage process in both the emergency and outpatient surgery departments.
Waiting time is a key indicator of healthcare service quality, particularly in radiology units where CT scans are in high demand. Prolonged waiting not only delays diagnosis and treatment but also contributes to patient dissatisfaction, anxiety, and negative perceptions of hospital performance. This study aims to explore patients’ experiences of waiting time for CT scan examinations at the Radiology Unit of Tk. II Pelamonia Hospital, Makassar. Using a qualitative design with a phenomenological approach, data were collected through in-depth semi-structured interviews with 8–12 patients who had undergone CT scans. Thematic analysis was employed to identify emerging themes related to patients’ perceptions, emotions, coping strategies, and expectations. The findings revealed that most patients perceived the waiting time as excessively long, often exceeding one hour, and associated it with physical discomfort, stress, and disruption of personal activities. Emotional responses varied, with many experiencing anxiety due to medical uncertainty, while others expressed acceptance influenced by cultural and religious values. Coping mechanisms such as using smartphones or engaging in conversations helped alleviate boredom, whereas the absence of activities worsened the waiting experience. Additionally, waiting negatively impacted patients’ perceptions of hospital service quality, though clear communication and supportive waiting facilities were found to mitigate dissatisfaction. The study highlights that waiting is not merely a technical duration but a multidimensional experience shaped by physical, psychological, and social factors. These insights underscore the importance of patient-centered management strategies, including transparent queuing systems, comfortable waiting environments, and empathetic communication.
Purpose: The purpose of the study was to determine the socio-demographic factors associated with utilization of modern contraceptives among adult women of reproductive age (18-49 years) in West Pokot County, Kenya. Methodology: The study adopted a cross-sectional household survey and targeted 42,015 households in Pokot West sub–county. The study targeted one adult women of reproductive age (18-49 years) per household with a sample size of 396 adult women. The study utilized a questionnaire during collection of data. The study analyzed data descriptively and inferentially and the output is presented in tabular and pictographic formats. Findings: The findings indicated that utilization of modern contraceptives stands at 24.5% among women aged 18 years to 49 years.The demographic characteristics associated with the utilization of modern contraceptives among women are Age (OR = 4.8248, t = 4.15, p < 0.05), Age is associated with increased likelyhood of utilizing modern contraceptives, while education levels (OR = 0.5055, t = -2.05, p < 0.05), occupation (OR = 0.5965, t = -3.50, p < 0.05) and the parity levels (OR = 0.5744, t = -2.72, p < 0.05) are associated with decreased likelihood of utilization of modern contraceptive. The income levels (OR = 0.8744, t = -0.40, p > 0.05) and marital status (OR = 0.9844, t = --0.03, p < 0.05), are not significantly associated with utilization of modern contraceptive. Unique Contribution to Theory Practice and Policy: This study contribute to the body of knowledge that social demographic factors such as age, education lever, occupation, economic status are associated with utilization of modern contraceptives. This low lever of utilization of modern contraceptives noted in this study calls for targeted strategies such as health education to this risk population by health care workers and ministry of health dealing with reproductive services to improve modern contraceptive use among adult women of reproductive age. There is need to conduct further research on other counties combining social demographic factors and other social health care determinants associated with of use of health care services such as modern contraceptive use among women.
