Bio

Short biography of Dr. Andrew Odhiambo

Current Positions:

  1. Assistant Lecturer in Internal Medicine, Medical Oncology &Haematology - University of Nairobi (UoN), Department of Clinical Medicine & Therapeutics
  2. Honorary Consultant at the Kenyatta National Hospital (KNH)
  3. Clinical lead Consultant at the Nairobi Radiotherapy and Cancer Centre

Education/Experience/Training

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Publications


2016

Njoroge, J, Oyoo GO, Kitonyi G, Barasa A, Odhiambo AO.  2016.  Haematological parameters in systemic lupus erythematosus patients at Kenyatta National Hospital, Nairobi. African Journal of Rheumatology. 4(2):57-62. Abstracthaematological parameters SLEWebsite

ABSTRACT

Background
Systemic lupus erthematosus (SLE) is a multisystem, autoimmune and often severe disease. Its aetiology is still poorly understood. Factors such as genetic, environmental, hormonal and immunological have been implicated in its pathogenesis. Patients with SLE are subject to myriad symptoms, complaints, and inflammatory involvement that can affect virtually every organ including the hemopoietic system.
Hematological abnormalities are common among patients with SLE. The most frequent hematological abnormalities include anemia, leucopenia and thrombocytopenia. These abnormalities are markers of disease activity and have been found to be independent determinants of mortality therefore understanding their prevalence is important in patient evaluation.

While these abnormalities have been widely studied in other parts of the world, no study has been conducted on Kenyan patients afflicted by SLE thus there exist a gap regarding hematological parameters in SLE patients and hence the need for this study. We performed this study to understand hematological parameters in a tertiary hospital in Nairobi, Kenya.

Objective:
The main objective of this study was to determine the prevalence of hematological parameters abnormalities, among SLE patients on follow up at Rheumatology and Renal Outpatient clinics at Kenyatta National Hospital. Specifically, the study aimed to describe the prevalence of anemia, leucopenia, and thrombocytopenia and identify patient factors associated with these abnormalities.

Methods

A cross-sectional descriptive study was carried out on SLE patients attending the Rheumatology and Renal outpatient clinics at KNH. Seventy one consecutive SLE patients were screened for eligibility between 5th March 2015 and 5th of June 2015, of these sixty five were recruited and enrolled into the study. Clinical and social demographic data was captured and recorded in a pre-designed questionnaire. Subsequently, four millilitres of blood was collected for measurement of a complete blood count, reticulocyte count, erythrocyte sedimentation rate and peripheral blood film examination. The tests were undertaken at the KNH Department of Human Pathology, Unit of Haematology and blood transfusion using a CELL-DYN 3700 automated blood counter. ESR interpretation was undertaken at the same laboratory by the Wintrobe method and a PBF was reported after staining with maygrunwald / giemsa stain by direct visualization on a microscope at various powers of magnification by hematologists who were supervisors for this study and the PI

Results

Sixty five eligible SLE patients were recruited into the study. The mean (SD) age was 36. 5(± 12) years. There were 3 (5%) males and 62 (95%) females. Forty nine (75%) patients had at least one abnormality. The abnormalities involved all the three cell lines. The prevalence of abnormalities were; anemia 43%, leucopenia 26% and thrombocytopenia 20%. Disease duration less than one year was significantly associated with anemia, p=0.035, OR = 3.5 (95% CI 0.9-15.1).

Conclusion

Hematological abnormalities are the second most common manifestation of the disease after arthritis and arthralgia among SLE patients on follow up at Kenyatta National Hospital Rheumatology and Renal clinic. Though majority of these abnormalities were mild to moderate and clinically asymptomatic, the proportions of anemia, leucopenia and thrombocytopenia were substantially high. There was a significant association between anemia and duration of disease.

Recommendations

I. A larger longitudinal study to correlate thrombocytopenia and leucopenia with demographics and drugs. . This may require a multicenter approach to avail sufficient number of patients.
II. Routine screening for hematological abnormalities, careful long-term monitoring and prompt therapeutic intervention.
III. Multidisplinary approach in management of SLE patients and input from a hematologist.
IV. Need to review the current treatment regimens of our patients to a steroid sparing regimen.
V. Lastly a study to correlate these hematological abnormalities with disease activity in patients with SLE.

2015

2014

Odhiambo, AO, Kiarie GG, Joshi MD, Ngugi PM.  2014.  Serum Vitamin D profile in black African men with Prostate Cancer in a tertiary refferal facility in sub-saharan Africa. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS). 13(4 vers III):60-64., Nairobi: University of Nairobi Abstractvitamin_d_prostate_cancer_iosr_jdms.pdf

Abstract:

Background: Considerable epidemiological, in vitro, in vivo and clinical data support an association between vitamin D deficiency and prostate cancer risk and outcome. Few studies have examined this association in African men with prostate cancer.The vitamin D status in patients with prostate cancer in Kenya is unknown. This study aimed to determine the profile of vitamin D levels in patients with prostate cancer and to correlate this to patient and disease characteristics.

Methods: Hospital-based cross-sectional study that evaluated black African men with incident or 3-month prevalent histologically confirmed prostate cancer seeking ambulatory care at KNH. Medical history was obtained by direct interview and the information recorded in questionnaires. Treatment history, pre-diagnostic serum PSA and Gleason score were abstracted from patient records. Every participant had their anthropometric measurements taken and plasma samples drawn for 25-hydroxyvitamin D (25-VD) concentrations using the LIAISON® 25-OH automated chemiluminescent immunoassay method. The relationship between age, body mass index, pre-diagnostic serum PSA and Gleason score on vitamin D status was evaluated using bivariate and multivariate analysis.

Results: 162 black African men were evaluated. The mean 25-VD was 19.15 ng/ml and 144 (88.9%) men had vitamin D deficiency (25-VD < 30ng/ml). 29 (17.9%) were severely deficient (25-VD < 10ng/ml), 115 (71%) were moderately deficient (10-<30 ng/ml) and 18 (11.1%) were normal (30-100ng/ml). Gleason scores >7 (OR 2.9; 95% CI 1.5-5.5, p = 0.001) and serum PSA ≥ 50ng/ml (OR 2.2; 95% CI 1.7-5.1, p = 0.014) were associated with vitamin D deficiency (25-VD < 20ng/ml) whereas age and BMI were not. Adjusted for age, BMI and serum PSA levels, having Gleason scores > 7 was independently associated with vitamin D deficiency (OR 2.5; 95% CI 1.2 – 4.9, p = 0.01).

Conclusion: Vitamin D deficiency is very common in black African men with prostate cancer, particularly in those with higher Gleason scores.

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