Bio

Prof. Kigondu Sekadde

APPOINTMENTS

1974-1977 Lecturer, Department of Biochemistry,

 Medical School, Makerere University,

 Kampala, Uganda

 

1977-1979 Assistant Professor, Department of Biochemistry

 A.N. Dogliotti College of Medicine

 University of Liberia,

 Monrovia, Liberia

 

1980 -1996 Senior Research Fellow/Senior Lecturer

Publications


2015

T, L, C S-K, CF O, G W.  2015.  Glycated albumin and glycated haemoglobin levels as a measure of monitoring glycaemic control in diabetic patients attending out-patient clinic at Kenyatta National Hospital: a comparative study. East African Journal of Pathology. 2(1):25-29. Abstractglycated_albumin_and_glycated_haemoglobin_levels_as_a_measure_of_monitoring_glycaemic_control_in_diabetic_patients_attending_out-patient_clinic_at_kenyatta_national_hospital.pdf

Background: Diabetes mellitus (DM) is a chronic metabolic disease that is characterized by persistent hyperglycemia. Monitoring of glycaemic control ir individuals with DM is currently done by a combination of short term, that is daily monitoring of blood glucose and long term biochemical tests especially glycatec haemoglobin(HbA1c) which is done every 2-4 months. Glycated albumin (GA) is a new test for intermediate glycaemic control. It measures averaged plasma gluCOSE level over two to four weeks. This enables closer monitoring and evaluation ot treatment regimen faster than HbAlc.
Objectives: To compare glycated haemoglobin to glycated albumin levels as a measure of monitoring glycaemic control in diabetic patients.
Design: A prospective comparative study.
Methods: The study was carried out on diabetic patients attending the diabetic clinic
at Kenyatta National Hospital.
Results: A total of 260 patients were enrolled into the study. The mean age was 52 years with a standard deviation of 12.3. There was a female preponderance of 60.4%, Random blood sugar analysis showed that, the population with good glycaemic control constituted 156 (60%). Majority of the patients had good glycaemic control 170 (65.4%) based on the HbAlc assay, compared to 39.4% in GA.There was a good correlation between HbAlc and glycated albumin with R2value of 0.64.
Conclusion: More patients showed good glycaemic control based on HbAlc compared to glycated albumin. There was correlation between .HbAlc and glycated albumin with R2 value of 0.64. There is need to introduce glycated albumin as a method of intermediate glycaemic control in the hospital.

PJ, C, C S-K, W W, LW M.  2015.  Pap Smear Cytological findings in women with abnormal visual inspection test results referred to Kenyatta National Hospital. East African Journal of Pathology. 2(1):8-12. Abstractpap_smear_cytological_findings_in_women_with_abnormal_visual_inspection_test_results_referred_to_kenyatta_national_hospital.pdf

Background: The challenge of cost in establishing cytology and/or Human Papillomavirus (HPV) mass screening for cervical cancer in resource limited countries prompted adoption of visual inspection techniques as alternative tests despite them having low specificity.
Objectives: To determine the pattern of cervical intraepitheliallesions and infections in women with abnormal visual inspection test results referred to Kenyatta National Hospital (KNH).
Methodology: A descriptive cross-sectional study was conducted at KNH where women who were referred to this facility after having abnormal visual inspection test results were recruited.
Results: Of the 232 participants recruited, 57(24.6%) had a report of atypical squamous cells of undetermined significance (ASUCS) or worse as follows; 5(2.2%) were ASCUS, 13(5.6%) were low grade squamous intraepithelial lesions (LSIL), 4(1.7%) were atypical glandular cells (AGC), 1(0.4%) was atypical squamous cells cannot exclude high grade (ASC-H), 20(8.6%) were high grade squamous intraepithelial lesions (HSIL) and 18(7.8%) were reported as having carcinoma on cytology. Of these abnormal results 3(1.3%) were from 33 women (14.2%) more than 50 years of age who were also recruited in this study. Infections were detected in 1 (4.7%) of the study participants.
Conclusions and recommendations: Pap smear was useful as follow-up test as it reduced number of referrals for definitive diagnosis to 16.8% while sparing the rest (83.2%) from unnecessary treatment. Pap smear is therefore recommended as follow-up test in women with abnormal visual inspection test results. Increase awareness to service providers and the general public about the Government Policy on the use of visual inspection tests in women more than 50 years of age since 14.2% were inappropriately screened by the visual inspection test.

S, S, C S-K, er CS G, W W.  2015.  Prevalence of Cytotoxin-associated gene A (CagA) positive Helicopter pylori strains in asymptomatic H. pylori-infected children attending Kenyatta National Hospital, Nairobi and correlation with risk factors associated with infection acquisition. East African Journal of Pathology. 2(1):2-7. Abstractprevalence_of_cytotoxin-associated_gene_a_caga_positive_helicobacter_pylori_strains_in_asymptomatic_h._pylori-infected_children_attending_kenyatta_national_hospital_nairobi_and_correlatio.pdf

Background: Helicobacter pylori bacteria colonize the gastric mucosa of 20-80% of humans worldwide. Approximately 60-70% of H. pylori strains possess the Cytotoxinassociated gene A (CagA gene) and express the CagA protein, an oncoprotein and a highly immunogenic virulence factor that has been linked to gastric disease.
Objective: To determine the prevalence ofCagA positive H.pylori among asymptomatic children attending Kenyatta National Hospital (KNH), Nairobi.
Design: Cross-sectional descriptive study at KNH paediatric outpatient clinic and paediatric wards and at the immunology laboratory, University of Nairobi.
Subjects: Children aged 2-13 years attending KNH, presenting with non-gastrointestinal tract conditions.
Methods: Socio-demographic information was collected by direct interview of the participants' parents/guardians (respondents) and entered into a study questionnaire. Serum samples from the subjects were tested by ELISA for the anti-H. pylori IgG antibody. Those that tested positive were tested for anti-CagA IgG antibody.
Results: A total of 175 children with a mean age of 7.5 years were enrolled, 57.3 % being males. The overall prevalence of H. pylori was 50.3%. CagA positive H. pylori prevalence among those who tested positive for H. pylori was 64.8%. There was significant positive correlation of H. pylori seropositivity with age (p

2012

Sinei, S, Morrison CS, Sekadde-Kigondu C, Melissa A, okonya D.  2012.  Complications of use of intrauterine devices among HIV-1-infected women. AbstractWebsite

Background A WHO expert group and the International
Planned Parenthood Federation recommend against use of
intrauterine devices (IUDs) in HIV-1-infected women based
on theoretical concerns about pelvic infection and increased
blood loss. We investigated whether the risk of
complications after IUD insertion is higher in HIV-1-infected
women than in non-infected women.
Methods 649 (156 HIV-1 infected 493 non-infected) women in
Nairobi, Kenya, who requested and met local eligibility criteria
for insertion of an IUD were enrolled. We gathered information
on IUD-related complications, including pelvic inflammatory
disease, removals due to infection, pain, or bleeding,
expulsions, and pregnancies at 1 and 4 months after insertion.
Patients’ HIV-1 status was masked from physicians.
Findings Complications were identified in 48 of 615 women
(11 [7·6%] HIV-1-infected women, 37 [7·9%] non-infected).
Incident pelvic inflammatory disease (two [1·4%] HIV-1
infected, one [0·2%] non-infected) and infection-related
complications (any tenderness, removal of IUD for infection
or pain; ten [6·9%] HIV-1 infected, 27 [5·7%] non-infected)
were also rare and similar in the two groups. Complication
rates were similar by CD4 (immune) status. Multivariate
analyses suggested no association between HIV-1 infection
and increased risks for overall complications (odds ratio 0·8
[95% CI 0·4–1·7]) or infection-related complications (1·0
[0·5–2·3]), adjusted for marital status, study site, previous
IUD use, ethnic origin, and frequency of sexual intercourse,
but a slight increase cannot be ruled out.
Interpretation Our data suggest that IUDs may be a safe
contraceptive method for appropriately selected HIV-1-
infected women with continuing access to medical services.
Lancet 1998; 351: 1238–41

Lucy, MW, Christine S-KB, Benson EBA, Marleen TT.  2012.  Risk Association between Human Leucocyte Antigens (HLA) and Cervical Neoplasia in Kenyan Women. Abstract

Cervical cancer is the second most common cause of cancer mortality among women worldwide (Franco et al, 2003). Epidemiological studies have shown a strong link between human papilloma virus (HPV) infection and the development of cervical cancer (Franco et al, carcinogenic process (Chan et al, 2005). Most HPV infections are transient and regress spontaneously and only a minority of women develops persistent infection that with time may evolve into cervical intraepithelial neoplasia and/or progress to invasive cervical cancer(Villa, 1997; Franco et al, 1999). Given that host immune response to HPV is thought to be an important determinant of HPV acquisition and progression to high-grade cervical lesions and cancer, it is plausible that human leucocyte antigen (HLA) variations may affect pathogenesis of cervical neoplasia (Beskow et al, 2005; Clerici et al, 1997; Hildesheim et al, 1997). The major histocompatibility complex is a highly polymorphic gene cluster on the short arm of chromosome six. The genes in this cluster are divided into three classes with different roles in immune responses. HLA gene polymorphisms result in variations in peptide-binding cleft, therefore influencing the antigens bound and presented to T cells (Beskow et al, 2005; Wang e al, 2005). The HLA class I genes (HLAA, -B, and –C) present foreign antigens to CD8+ Cytotoxic T lymphocytes, while class II genes (HLA-DR, - DQ and –DP) present antigenic peptides to CD4+ T helper cells and are important in host immune responses to viruses and other pathogens (Wang et al, 2001).

2010

Thaimuta, ZL, Kigondu C, Makawiti DW.  2010.  Prevalence of nonthyroidal illness among HIV patients on HAART.
Qureshi, ZP, Sekadde-Kigondu C, Mutiso SM.  2010.  Rapid assement of partograph utilisation in selected maternity units in Kenya. Abstract

Prolonged labour causes maternal and perinatal morbidity and mortality. Its sequela include obstructed labour, uterine rupture, maternal exhaustion, postpartum haemorrhage, puerperal sepsis, obstetric fistula, stillbirths, birth asphyxia and neonatal sepsis. These complications can be reduced by using the partograph to assess the progress of labour. The Ministry of Health, Kenya has adopted this tool for labour management in the country and the standardised partograph is recommended for use in all delivery units. Objective: To determine the utilisation of the partograph in the management of labour in selected health facilities in Kenya. Design: A descriptive cross sectional study. Setting: Nine health facilities -ranging from a tertiary hospital to health centre, including public private and faith based facilities in four provinces in Kenya. Results: All facilities apart from Pumwani Maternity Hospital and one health centre were using the partograph. The correct use was low, the knowledge on the use of the tool was average and there was minimal formal training being provided. Staff shortage was listed as the most common cause of not using the tool. Contractions were recorded 30-80%, foetal heart rate 53-90% and cervical dilatation 70-97%. Documentation of state of the liquor, moulding and descent as well as maternal parameters such as pulse, and blood pressure and urinalysis were minimally recorded. Supplies for monitoring labour such as fetoscopes and blood pressure machines were in short supply and sometimes not functional. Overall, the poor usage was contributed to staff shortages, lack of knowledge especially on interpretation of findings, negative attitudes, conflict between providers as to their roles in filling the partograph, and senior staff themselves not acting as role models with regards to the use, advocacy and implementation of the partograph. Conclusion: The partograph was available in most units. However, accurate recording of parameters to monitor the foetus, the mother and progress of labour as recommended was mostly not done. Shortage of staff, lack of knowledge, lack of team work, lack of supplies and negative attitude among healthcare providers were some of the obstacles noted to hamper partograph use.

Thamuita, ZL, Sekadde-Kigondu C, Makawiti DW.  2010.  Thyroid function among HIV/AIDS patients on highly active anti-retroviral therapy. Abstract

To assess the thyroid function among Human Immunodeficiency Virus (HIV)/ Acquired Immunodeficiency Syndrome (AIDS) patients on anti-retroviral drugs: stavudine, lamivudine and nevirapine and to establish the prevalence of non-thyroid illness. Design: Laboratory based comparative cross-sectional study. Setting: Comprehensive care clinics at KNH and Mbagathi District Hospital. Subjects: Eighty four HIV-infected patients on treatment with ARVs (ARV +ve) and an ARV naive (ARV naive) group of 26 HIV-infected patients. Results: Thyroid stimulating hormone levels were not altered following treatment whereas the levels of FT4 decreased. The frequency of those with low FT4 were increasing with continued ARV use. The prevalence of non-thyroidal illness state defined by TSH within reference ranges and low FT4 was comparable among the ARV +ve and ARV naive groups (44 and 46% respectively). Conclusion: Progressive use of HAART causes decline in FT4 hormone levels. It is debatable whether interventions for low FT4 is necessary in ARV treatment but a longitudinal study would explain the progressive trend of thyroid hormones and implications with HAART treatment. The prevalence of NTI is comparable to both HAART users and non-users. Low levels of thyroid hormone (FT 4) may be an adaptive response by thyroid gland to minimize calorie utilisation as in chronic diseases

2009

Waithaka, SK, Njagi EN, Ngeranwa JN, Kigondu CS.  2009.  Reference Ranges for Some Biochemical Parameters in Adult Kenyans. Abstract

To establish the reference ranges of some biochemical parameters for adult Kenyan population. METHODS: In a prospective involving 1100 healthy blood donors (age: 18-55 yr) in Kenyatta National Hospital, Kenya reference ranges of some biochemical analytes were constructed by using the parametric methods to estimate 2.5 and 97.5 percentiles of distribution. RESULTS: The reference ranges of the analytes were: alanine aminotransferase (ALT) [males (0-39) U/L, females (0-34) U/L]; aspartate aminotransferase (AST) [males (6-40) U/L, females (3-37) U/L]; alkaline phosphatase (ALP) [males (13-201) U/L, females (5-227) U/L]; albumin (ALB) [males (29-52) g/L, females (28-50) g/L]; protein (PROT) [males (57-89) g/L, females (56-88) g/L]; creatinine (CREAT) [males (59-127) μmol/L, females (54-122) μmol/L]; glucose (GLU) [males (2.8-6.8) mmol/L, females (2.6-7) mmol/L]; phosphorus (PHOS) [males (0.5-2.0) mmol/L, females (0.2-2.4) mmo/L]; potassium (POT) [males (3-5.3), females (3.1-5.1) mmo/L]; sodium (SOD) [males (111-153) mmol/L, females (117-151) mmol/L]; Blood urea nitrogen BUN [males (1.5-5.9) mmol/L, females (1.2-6.0) mmol/L] and Uric acid (UA) [males (120-458) μmol/L, females (89-415) μmol/L]. Age differences in the established reference ranges were observed in ALT, ALB, CREAT, ALP and UA in males and in ALT, ALB, and CREAT in females. Gender differences were observed in ALT, AST, ALB, CREAT and UA in the 18-28 yr old, ALT, AST, ALB, SOD and UA in 29-39 yr old and AST, ALB, and UA in 40-50 yr old. CONCLUSION: Age and sex specific reference ranges of some biochemical parameters were established some of which were different from those reported in literature. There therefore the need for each clinical chemistry laboratory to establish its own ranges

2008

S, PROFKIGONDUCHRISTINE.  2008.  Njoroge GK, Njagi EN, Orinda GO, Sekadde-Kigondu CB, Kayima JK. Environmental and occupational exposure to lead. East Afr Med J. 2008 Jun;85(6):284-91.. East Afr Med J. 2002 Mar;79(3):163-4.. : uon press Abstract
OBJECTIVE: To determine the status of environmental and occupational lead exposure in selected areas in Nairobi, Kenya. DESIGN: Cross sectional study. SETTING: Kariobangi North, Babadogo, Waithaka and Pumwani for assessment of environmental exposure to lead (Pb) and Ziwani Jua Kali works for assessment of occupational lead exposure. Olkalou in Nyandarua District was the covariate study area. SUBJECTS: Three hundred and eight children and adults participated. RESULTS: Blood lead levels (BLLs) obtained for the entire sample (n = 308) ranged from 0.4 to 65 microg/dl of blood. One hundred and sixty nine (55%) of the total sample had levels equal to or below 4.9 microg/dl, while 62 (20%) of the sample had levels ranging from 5.0 to 9.9 microg/dl. Blood lead levels above 10 microg/dl were recorded in 77 (25%) of the total sample. Within Nairobi, 32 (15.3%) of the study subjects in areas meant for assessment of environmental lead exposure had levels above the WHO/CDC action levels of 10 microg/dl of blood. The mean BLL for the occupationally exposed (Ziwani Jua kali) was 22.6 +/- 13.4 microg/dl. Among the workers, 89% had BLLs above 10 microg/dl. In general, 15% of the entire sample (for both environmental and occupational groups) in Nairobi had BLLs above 15 microg/dl. The covariate group at Olkalou had a mean BLL of 1.3 +/- 0.9 microg/dl. CONCLUSION: The prevalence of environmental lead exposure to the general public is high in Nairobi compared to Olkalou where non exposure was reported. Occupational lead exposure has been identified to be at alarming levels and urgent intervention measures are recommended.

2006

S, PROFKIGONDUCHRISTINE.  2006.  Early perinatal outcome in cases delivered through Caesarian section following clinical diagnosis of severe foetal distress at Kenyatta National Hospital. East Afr Med J. 2006 May;83(5):250-8.. East Afr Med J. 2006 May;83(5):250-8.. : uon press Abstract
OBJECTIVES: To determine the value of clinical foetal distress in predicting early perinatal outcome. DESIGN: Prospective cohort study. SETTING: Kenyatta National Hospital. SUBJECTS: Fifty eight newborns delivered via Caesarian section with a diagnosis of clinical foetal distress were compared with another group of 58 newborns delivered similarly, but without clinical foetal distress. RESULTS: Newborn acidemia was found in 71% of newborns with clinical foetal distress in contrast to 17% in newborns without foetal distress. Low Apgar score at one minute was noted in about 59% of newborns with foetal distress compared with 31% in newborns without foetal distress. Similarly, 24.1% of neonates with clinical foetal distress had low Apgar score at five minutes compared with 3.4% in those without foetal distress. Thirty one percent of newborns with clinical foetal distress were admitted to newborn unit for more than 24 hours due to respiratory distress or birth asphyxia compared to 17% of those without foetal distress. The incidence of morbidity and or mortality in newborns exposed to foetal distress was twice the one of newborns without foetal distress. CONCLUSION: The results obtained in this study agreed with those who consider intrapartum passage of meconeum and abnormal foetal heart rate and rhythm to signify clinical foetal distress that carries bad prognostic outcome. These two parameters should still be used to indicate foetal distress which requires immediate institution of supportive therapy and immediate delivery.
S, PROFKIGONDUCHRISTINE.  2006.  Sang CK, Kigondu CS, Muchiri L.Correlation between cytology and thyroid function test.East Afr Med J. 2006 Oct;83(10):533-8. PMID: 17310678 [PubMed - indexed for MEDLINE]. East Afr Med J. 2006 Oct;83(10):533-8.. : uon press Abstract
BACKGROUND: Thyroid dysfunction can be evaluated by measuring serum thyroid stimulating hormone (TSH), total tri-iodothyronine (T3) and total thyroxine (T4) which will establish euthyroidism, hyperthyroidism and hypothyroidism. Fine needle aspiration (FNA) is the diagnostic test of choice in determining whether a nodule is benign or malignant. OBJECTIVE: To correlate hormonal levels to FNA cytologic findings. DESIGN: A cross-sectional study. SETTING: Kenyatta National Hospital (KNH). RESULTS: Forty two patients had their thyroid profiles done and the results were correlated with FNA diagnosis. Majority of patients had nodular goiter (83.3%), of which 47.6% had euthyroidism, 16.7% had biochemical euthyroidism, 11.9% had hyperthyroidism, 4.8% had sub-clinical hyperthyroidism and 2.4% had sub-clinical hypothyroidism. Three patients (7.1%) with FNA diagnosis of non-diagnostic sample had euthyroidism while 2.4% each with papillary carcinoma, thyroglossal cyst, and atypia, had a hormonal profile of euthyroidism. There was no significant statistical difference (p > 0.05) of the mean levels of T4 (0.406), T3 (0.311), and TSH (0.90), between and within the various groups of FNA cytological diagnoses. CONCLUSION: The study showed that there was no correlation between T4, T3, and TSH measurements and FNA cytological diagnoses.
S, PROFKIGONDUCHRISTINE.  2006.  Millennium development goal 5: a review of maternal mortality at the Kenyatta National Hospital, Nairobi. East Afr Med J. 2006 Jan;83(1):4-9.. East Afr Med J. 2006 Jan;83(1):4-9.. : uon press Abstract
OBJECTIVES: To review if there is a change in the maternal mortality rate at the Kenyatta National Hospital since the inception of the Millennium Development Goal strategy in 1990, compared to earlier reviews. DESIGN: A retrospective descriptive study. SETTING: Kenyatta National Hospital. SUBJECTS: Maternal deaths attributed directly to obstetric causes. MAIN OUTCOME MEASURES: Determination of maternal mortality rates of all patients admitted to the Kenyatta National Hospital Maternity and died after admission up till six weeks of admission. Also determine any avoidable causes of the same. RESULTS: During the period under review, there were 27,455 deliveries and 253 maternal deaths giving a maternal mortality ratio of 921.5 per 100,000 live births. Direct obstetric causes accounted for 71% of all maternal deaths with sepsis, haemorrhage, and hypertension being the leading causes. Respiratory tract infections associated with HIV/ AIDS infection was the prominent indirect cause. 67.5% of deaths occurred in women aged between 25 and 35 years and 78.7% were Para 2 or less. Evidently there was poor antenatal clinic attendance with only 28.6% having had any attendance at all. CONCLUSION: Antenatal clinic attendance needs to be re-emphasised if an impact is to be realised in curbing maternal mortality; moreover there is need for early referrals and encouraging mothers to deliver under skilled care.

2005

S, PROFKIGONDUCHRISTINE.  2005.  Ruminjo JK, Sekadde-Kigondu CB, Karanja JG, Rivera R, Nasution M, Nutley T. Comparative acceptability of combined and progestin-only injectable contraceptives in Kenya. Contraception. 2005 Aug;72(2):138-45.. Contraception. 2005 Aug;72(2):138-45. : uon press Abstract
OBJECTIVE: We compared 12-month continuation rates, menstrual bleeding patterns and other aspects of acceptability between users of Cyclofem and users of Depo-Provera. METHODS: The life-table method was used to calculate quarterly continuation rates. In all, 360 Kenyan women were randomly assigned to one of the two contraceptives. User-satisfaction questionnaires were administered at 6 and 12 months or at discontinuation, whichever occurred first. RESULTS: The 1-year continuation rate was 75.4% for Depo-Provera users versus 56.5% for Cyclofem users (p<.001). Main reasons for discontinuation included difficulty making clinic visits (45.1% for Cyclofem vs. 40% for Depo-Provera), menstrual changes (14.1% vs. 12.5%) and nonmenstrual problems (15.5% vs. 12.5%). None of the Depo-Provera users and 8.5% of the Cyclofem users claimed frequency of visits as the main reason for discontinuation. In all, 70.6% of the Depo-Provera users were amenorrheic after 12 months, as were 20.8% of the Cyclofem users. CONCLUSIONS: The 1-year continuation rate was higher for Depo-Provera than for Cyclofem. There was no important difference in discontinuation rates because of menstrual problems; the difference mainly reflected the frequency of visits required.
O, PROFORINDADA, A DRRAJABJAMILLA, S PROFKIGONDUCHRISTINE.  2005.  Rajab JA, Waithaka PM, Orinda DA, Scott CS. Analysis of cost and effectiveness of pre-transfusion screening of donor blood and anti-malarial prophylaxis for recipients. East Afr Med J. 2005 Nov;82(11):565-71.. East Afr Med J. 2005 Nov;82(11):565-71.. : uon press Abstract
OBJECTIVES: To determine the prevalence of malaria in donor units in a low and a high endemic region in Kenya and evaluate the cost effectiveness of recipient anti-malarial prophylaxis and pre-transfusion screening (using an automated method) as options to prevent post transfusion malaria. DESIGN: A descriptive cross-sectional study. SETTING: Two regional blood banks, Nairobi and its environs (National Blood Transfusion Services, Nairobi) a low malaria endemic region and western region (National Blood Transfusion Services, Kisumu) high malaria endemic region. SUBJECTS: All the donated units were included in the study for analysis, during the duration of study, from the two study sites. MAIN OUTCOME MEASURES: Prevalence of malaria in donor units in low endemic area (Nairobi) and high endemic area (Kisumu). Cost per case prevented for the two options, Option I Prophylactic administration of anti-malarial (sulfadoxine pyrimethamine SP) drugs to recipients, and Option II pre-transfusion screening using an automated technique. RESULTS: A malaria prevalence of 0.67% was found in Nairobi and its environments (low endemic) and 8.63% for Kisumu and its environments (high endemic area). The cost analysis showed a cost per case prevented of Ksh.105 (US$1.4) adult, Ksh.52.5 (US$0. 69) and paediatric for the option of recipient prophylaxis using an SP based drug. The cost escalated to Ksh.592 (US$7.79) adult Ksh.444 (US$5.84) paediatric if the prophylaxis was upgraded to the recommended artemisinin derivative (ACT-artemisinin based combination) and for the option of pre-transfusion screening using an automated technique the cost was Ksh.2.08 (US$0.03). CONCLUSION: The prevalence of malaria in donors showed the expected regional variation in the low and high endemic areas and was comparable to data obtained elsewhere. If malaria positive donor units were to be excluded from the national blood supply, an estimated 5% (compared to 1.3% for human Immunodeficiency virus, 3.6% for hepatitis B virus and 1.3% for hepatitis C virus) would be wasted. The cost per case prevented of transfusion-associated malaria is considerably higher for recipient antimalarial prophylaxis than pre-transfusion screening using an automated technique. The cost escalates by five to seven times if the newer artemesinin based combination antimalarial drugs are adopted.
S, PROFKIGONDUCHRISTINE.  2005.  Rajab JA, Muchina WP, Orinda DA, Scott CS. Blood donor haematology parameters in two regions of Kenya. East Afr Med J. 2005 Mar;82(3):123-7.. East Afr Med J. 2005 Nov;82(11):565-71.. : uon press Abstract
OBJECTIVES: To determine the status of blood donor haematology in two regional sites in Kenya and to assess the potential role of automated haematology in National blood bank process control. DESIGN: A cross sectional descriptive study. SETTING: Two regional blood banks–Nairobi and its environs (Blood Transfusion Services, Nairobi) and Western Region (National Blood Transfusion Services, Kisumu). MAIN OUTCOME MEASURES: Distribution, mean, median, and 95% percentile ranges of haemoglobin (Hb), red cell parameters (red cell count, haematocrit, MCV, MCH and MCHC), total and differential white blood cell (WBC) counts, and platelet counts in the two donor populations. RESULTS: A significant number of donations (16.5% in Kisumu and 3.4% in Nairobi) showed haemoglobin levels below the recommended National Blood Transfusion Service (NBTS) guideline of 42g/unit. Compared to Kisumu, Nairobi donors had significantly (p < 0.001) higher Hb, MCV and MCH values while the red blood cell counts and MCHC values were similar (p > 0.05). A low MCV (< 78 fl) was observed in 12.4% and 3.4% of Kisumu and Nairobi donors respectively. Both populations showed similar but significant frequencies (Kisumu, 21.3%; Nairobi, 18.7%) of mild neutropenia (< 1.5 x 10(9)/1), while eosinophilia (> 0.5 x 10(9)/1 in the tropics the cut off is > 0.6 x 109) was more prominent in Kisumu donors (18.8% versus 8.5%). Platelet counts were also significantly lower in Kisumu donors, with the prevalence of thrombocytopenia (< 150 x 10(9)/1) being considerably higher (15.9% versus 3.7%). CONCLUSIONS: A significant number of Kenyan donors showed abnormal haematology profiles that may indicate underlying pathology. Such abnormalities are not detected by current blood transfusion services screening practices and there may be a need to strengthen donor selection criteria to protect both donors and recipients.
S, PROFKIGONDUCHRISTINE.  2005.  J.K Ruminjo, C.B Sekadde-Kigondu et al. Comparative acceptability of combined and progestin-only contraception injectable contraceptives in Kenya. Contracetion. 72(2005) 138.1: Contraception. 2005 Aug;72(2):138-45. Contraception. 2005 Aug;72(2):138-45. : uon press Abstract
OBJECTIVE: We compared 12-month continuation rates, menstrual bleeding patterns and other aspects of acceptability between users of Cyclofem and users of Depo-Provera. METHODS: The life-table method was used to calculate quarterly continuation rates. In all, 360 Kenyan women were randomly assigned to one of the two contraceptives. User-satisfaction questionnaires were administered at 6 and 12 months or at discontinuation, whichever occurred first. RESULTS: The 1-year continuation rate was 75.4% for Depo-Provera users versus 56.5% for Cyclofem users (p<.001). Main reasons for discontinuation included difficulty making clinic visits (45.1% for Cyclofem vs. 40% for Depo-Provera), menstrual changes (14.1% vs. 12.5%) and nonmenstrual problems (15.5% vs. 12.5%). None of the Depo-Provera users and 8.5% of the Cyclofem users claimed frequency of visits as the main reason for discontinuation. In all, 70.6% of the Depo-Provera users were amenorrheic after 12 months, as were 20.8% of the Cyclofem users. CONCLUSIONS: The 1-year continuation rate was higher for Depo-Provera than for Cyclofem. There was no important difference in discontinuation rates because of menstrual problems; the difference mainly reflected the frequency of visits required.

2004

S, PROFKIGONDUCHRISTINE.  2004.  Kasilima YS, Wango EO, Kigondu CS, Mutayoba BM, Nyindo M. Plasma bioactive LH and testosterone profiles in male New Zealand rabbits experimentally infected with Schistosoma mansoni. Acta Trop. 2004 Nov-Dec;92(3):165-72.. Acta Trop. 2004 Nov-Dec;92(3):165-72.. : uon press Abstract
Department of Animal Physiology, Reproductive Biology Unit, University of Nairobi, P.O. Box 30197, Nairobi, Kenya. The effects of Schistosoma mansoni (S. mansoni) infection on plasma levels of bioactive luteinising hormone (LH) and testosterone in the New Zealand rabbit model were studied. S. mansoni infection significantly decreased the pulse frequency (P < 0.05), amplitude (P < 0.05), area under LH curve (P < 0.05) and mean plasma LH concentrations (P < 0.05) on days 42 and 70 post-infection, as compared to values for day 14 pre-infection. Areas under the response curves for plasma testosterone levels decreased significantly (P < 0.05) on days 42 and 70 post-infection in infected animals compared to day 14 pre-infection. In the praziquantel-treated group, the levels of LH and testosterone remained unchanged throughout the experimental period. The pulsatile secretion of LH was completely inhibited in S. mansoni-infected animals 70 days post-infection. These results suggest that the effects on reproductive gonadal hormones caused by S. mansoni in the rabbit model may partly be induced by alteration in pituitary synthesis or release of LH.

2003

Morrison, CS;, Sekadde-Kigondu C;, Sinei S;, Weiner DH;, Kwok C;, Kokonya D.  2003.  Is the intrauterine device appropriate contraception for HIV-1-infected women? Abstract

Objective To assess whether the risk of complications is higher in HIV-1-infected women compared with non-infected women in the two years following insertion of the intrauterine contraceptive device. Design Prospective cohort study. Population Six hundred and forty-nine women (156 HIV-1-infected, 493 non-infected) in Nairobi, Kenya who requested an intrauterine contraceptive device and met local eligibility criteria. Methods We gathered information on complications related to the use of the intrauterine contraceptive device, including pelvic inflammatory disease, removals due to infection, pain or bleeding, expulsions, and pregnancies at one, four, and 24 months after insertion by study physicians masked to participants’ HIV-1 status. Cox regression was used to estimate hazard ratios. Results Complications were identified in 94 of 636 women returning for follow up (14.7% of HIV-1-infected, 14.8% of non-infected). The incidence of pelvic inflammatory disease was rare in both infected (2.0%) and non-infected (0.4%) groups. Multivariate analyses suggested no association between HIV-1 infection and increased risk of overall complications (hazard ratio=1.0; 95% CI 0.6-1.6). Infection-related complications (e.g. any pelvic tenderness, removal for infection or pain) were also similar between groups (10.7% of HIV-1-infected, 8.8% of non-infected; P=0.50), although there was a non-significant increase in infection-related complications among HIV-1-infected women with use of the intrauterine contraceptive device longer than five months (hazard ratio=1.8; 95% CI 0.8-4.4). Neither overall nor infection-related complications differed by CD4 (immune) status. Conclusions HIV-1-infected women often have a critical need for safe and effective contraception. The intrauterine contraceptive device may be an appropriate contraceptive method for HIV-1-infected women with ongoing access to medical services.

S, PROFKIGONDUCHRISTINE.  2003.  Ochiel DO, Wango EO, Kigondu CS, Otsyula MG. Effect of menstrual cycle on mucosal immunity to SHIV within the reproductive tract of baboons (Papio anubis): preliminary findings.J Med Primatol. 2003 Jun;32(3):161-9.. J Med Primatol. 2003 Jun;32(3):161-9.. : uon press Abstract
Reproductive Biology Unit, Department of Animal Physiology, University of Nairobi, Kenya. dochiel@kisian.mimcom.net The presence of human immunodeficiency virus (HIV) in genital secretions is regarded as a risk factor for sexual and perinatal transmission of HIV. A better understanding of correlates of genital shedding of HIV is crucial to the development of effective strategies against transmission of this virus. Events during menstrual cycle are likely to influence local immune responses and viral load in genital secretions, and hence determine susceptibility to HIV or efficiency of virus transmission. We report, in this study, preliminary findings on the relationship of menstrual cycle to genital mucosal and systemic immunity in female olive baboons (Papio anubis) experimentally inoculated with simian/human immunodeficiency virus (SHIV)89.6P.
S, PROFKIGONDUCHRISTINE.  2003.  Ndavi,PM, Kyobe.j, Munyao,G., OyiekeBO, Sekadde-Kiogndu, CB. Coagulation studies in Hypertensive Disease of pregnancy.J.Obs Gyn, Centr. Africa. 16(2003),. J.Obs Gyn, Centr. Africa. 16(2003),. : uon press Abstract
The presence of human immunodeficiency virus (HIV) in genital secretions is regarded as a risk factor for sexual and perinatal transmission of HIV. A better understanding of correlates of genital shedding of HIV is crucial to the development of effective strategies against transmission of this virus. Events during menstrual cycle are likely to influence local immune responses and viral load in genital secretions, and hence determine susceptibility to HIV or efficiency of virus transmission. We report, in this study, preliminary findings on the relationship of menstrual cycle to genital mucosal and systemic immunity in female olive baboons (Papio anubis) experimentally inoculated with simian/human immunodeficiency virus (SHIV)89.6P.
S, PROFKIGONDUCHRISTINE.  2003.  C.O.Onuango, FW Maina C Sekadde-Kigondu and JKG Mati Effect of DMPA on Lipid and Lipoprotein Changes in the First three months and long term use. J.Obstet Gynaecol E.C. Afr. 16(10 54, 2003. J.Obstet Gynaecol E.C. Afr. 16(10 54, 2003. : uon press Abstract
The presence of human immunodeficiency virus (HIV) in genital secretions is regarded as a risk factor for sexual and perinatal transmission of HIV. A better understanding of correlates of genital shedding of HIV is crucial to the development of effective strategies against transmission of this virus. Events during menstrual cycle are likely to influence local immune responses and viral load in genital secretions, and hence determine susceptibility to HIV or efficiency of virus transmission. We report, in this study, preliminary findings on the relationship of menstrual cycle to genital mucosal and systemic immunity in female olive baboons (Papio anubis) experimentally inoculated with simian/human immunodeficiency virus (SHIV)89.6P.
S, PROFKIGONDUCHRISTINE.  2003.  JK Kyaligonza, EO Wango, C Sekadde-Kigondu and P Adayo The Acrosomee Reaction in Gray Mangbey. J.Med. Primatology., 23, 187, 2003. : uon press Abstract
The presence of human immunodeficiency virus (HIV) in genital secretions is regarded as a risk factor for sexual and perinatal transmission of HIV. A better understanding of correlates of genital shedding of HIV is crucial to the development of effective strategies against transmission of this virus. Events during menstrual cycle are likely to influence local immune responses and viral load in genital secretions, and hence determine susceptibility to HIV or efficiency of virus transmission. We report, in this study, preliminary findings on the relationship of menstrual cycle to genital mucosal and systemic immunity in female olive baboons (Papio anubis) experimentally inoculated with simian/human immunodeficiency virus (SHIV)89.6P.
S, PROFKIGONDUCHRISTINE.  2003.  D.O.Ochiel, EOWango, C Sekadde-Kigondu et al. Effect of Menstrual cycle on local mucosal imuunity to SHIV within the reproductive tract of Baboons (Papio anubis): preliminary findings. Journal of Medical Primatology 32, 161 2003.. Journal of Medical Primatology 32, 161 2003.. : uon press Abstract
The presence of human immunodeficiency virus (HIV) in genital secretions is regarded as a risk factor for sexual and perinatal transmission of HIV. A better understanding of correlates of genital shedding of HIV is crucial to the development of effective strategies against transmission of this virus. Events during menstrual cycle are likely to influence local immune responses and viral load in genital secretions, and hence determine susceptibility to HIV or efficiency of virus transmission. We report, in this study, preliminary findings on the relationship of menstrual cycle to genital mucosal and systemic immunity in female olive baboons (Papio anubis) experimentally inoculated with simian/human immunodeficiency virus (SHIV)89.6P.

2002

Stanback, J, Qureshi ZP, Sekkade-Kigondu C.  2002.  Advance provision of oral contraceptives to family planning clients in Kenya. AbstractWebsite

In sub-Saharan Africa, many family planning programmes do not encourage advance provision of oral contraceptives to clients who must wait until menses to initiate pill use. Since some resistance to advance provision of pills is due to provider fears that the practice may be harmful, we conducted a study in Kenya in 1997 to compare pill-taking outcomes between 20 "advance provision" clients and 280 "standard" clients.

Prospective observational study.

Six family planning clinics in Central and Western Kenya.

Women presenting as new clients at MOH family planning clinics.

Researchers used prospective tracking to compare indicators of pill-taking success between non-menstruating clients given pills to carry home for later use and menstruating clients who began pill use immediately.

Pill-taking outcomes such as side effects, compliance, knowledge, satisfaction, and a continuation proxy.

Among clients returning for re-supply, those receiving advance provision of pills did no worse than, and often had superior outcomes to, their counterparts who started taking pills immediately after the clinic visit.

Advance provision of pills, already practiced worldwide, is safe and feasible. Explicit mention should be made of advance provision of pills in national family planning guidance documents and training curricula in Kenya and throughout sub-Saharan Africa.

S, PROFKIGONDUCHRISTINE.  2002.  101. Wango, E.O, Tabifor, H.N, Muchiri, L.W., Sekadde-Kigondu, C. Progesterone, Estradiol and their receptors in leiomyomata and the adjacent normal myometria of black Kenyan women .Afr. J.Health Sci. 9:123, 2002. E.A.M.J vol 79 (10) 530, 2002. : uon press Abstract
Reproductive Biology Unit, Department of Animal Physiology, University of Nairobi, Kenya. dochiel@kisian.mimcom.net The presence of human immunodeficiency virus (HIV) in genital secretions is regarded as a risk factor for sexual and perinatal transmission of HIV. A better understanding of correlates of genital shedding of HIV is crucial to the development of effective strategies against transmission of this virus. Events during menstrual cycle are likely to influence local immune responses and viral load in genital secretions, and hence determine susceptibility to HIV or efficiency of virus transmission. We report, in this study, preliminary findings on the relationship of menstrual cycle to genital mucosal and systemic immunity in female olive baboons (Papio anubis) experimentally inoculated with simian/human immunodeficiency virus (SHIV)89.6P.
S, PROFKIGONDUCHRISTINE.  2002.  EgziabhleTekle, J.K.Ruminjo and C.B. Sekadde-Kigondu. Pain relief using Paracervical block in patients undergoing manual vacuum aspiration of the uters. E.A.M.J vol 79 (10) 530, 2002. E.A.M.J vol 79 (10) 530, 2002. : uon press Abstract
Reproductive Biology Unit, Department of Animal Physiology, University of Nairobi, Kenya. dochiel@kisian.mimcom.net The presence of human immunodeficiency virus (HIV) in genital secretions is regarded as a risk factor for sexual and perinatal transmission of HIV. A better understanding of correlates of genital shedding of HIV is crucial to the development of effective strategies against transmission of this virus. Events during menstrual cycle are likely to influence local immune responses and viral load in genital secretions, and hence determine susceptibility to HIV or efficiency of virus transmission. We report, in this study, preliminary findings on the relationship of menstrual cycle to genital mucosal and systemic immunity in female olive baboons (Papio anubis) experimentally inoculated with simian/human immunodeficiency virus (SHIV)89.6P.

2000

S, PROFKIGONDUCHRISTINE.  2000.  Kokonya DA, Sinei SK, Sekadde-Kigondu CB, Morrison CS, Kwok C, Weiner DH. Experience with IUCD insertion outside of menses in Kenya. East Afr Med J. 2000 Jul;77(7):369-73.. Int. J. of STDs and AIDS 11 257, 2000. : uon press Abstract
OBJECTIVE: To determine if women receiving intrauterine devices (IUCDs) outside of menses have an acceptable rate of insertion problems and subsequent IUCD-related complications. DESIGN: Cross-sectional and prospective cohort study of insertions at times other than during menses. SETTING: The study was carried out in two government family planning (FP) clinics in Nairobi, Kenya. SUBJECTS: After appropriate pre-test and post-test HIV counselling, 1686 women requesting IUCDs at two FP clinics between 1994 and 1995 in Nairobi were enrolled at baseline into a study examining the effect of human immuno-deficiency virus (HIV) infection on IUCD-related complications. Six hundred and forty nine women (156 HIV-infected and 493 HIV-uninfected) were selected for the four month follow up study. They were classified according to their menstrual cycle status at time of IUCD insertion. MAIN OUTCOME MEASURES: Problems at the time of insertion (pain, bleeding, immediate expulsion) and IUCD-related complications through four months. RESULTS: Rates of immediate insertion problems were low in the women who had insertions during menses (7.0%), outside of menses (4.0%) or had oligomenorrhea/amenorrhea (2.6%). The adjusted odds ratios for IUCD insertion problems outside of menses and in oligomenorrhea/amenorrhea (versus women with insertion during menses) were 0.54 (95 % CI 0.18-1.59) and 0.39 (95% CI 0.12-1.29) respectively. IUCD-related complications were higher in the oligomenorrhea/amenorrhea (11.5%) or insertion outside of menses (6.9%), than the within menses (4.3%) groups. However, the differences were not statistically significant. Adjusted odds ratios for IUCD outside of menses and oligomenorrhoea/amenorrhea groups were 1.65 (95% CI 0.21-12.91) and 2.72 (95% CI 0.34-21.71) respectively. CONCLUSION: The results confirm that the IUCD can be safely inserted outside of menses with minimal insertion difficulties and subsequent complications. Availability of IUCDs outside of menses may enhance IUCD acceptance in Kenya and create better opportunity for visual screening of the cervix for sexually transmitted infections.
S, PROFKIGONDUCHRISTINE.  2000.  Kokonya D.A., Sinei S.K.A., Sekadde-Kigondu C.B., Morrison C.S., Kwok C, and Waner D.H. Experience with IUCD insertion outside Of menses in Kenya, E.A. Med J. 77 (7) 369, 2000.. E.A. Med J. 77 (7) 369, 2000.. : uon press Abstract
Reproductive Biology Unit, Department of Animal Physiology, University of Nairobi, Kenya. dochiel@kisian.mimcom.net The presence of human immunodeficiency virus (HIV) in genital secretions is regarded as a risk factor for sexual and perinatal transmission of HIV. A better understanding of correlates of genital shedding of HIV is crucial to the development of effective strategies against transmission of this virus. Events during menstrual cycle are likely to influence local immune responses and viral load in genital secretions, and hence determine susceptibility to HIV or efficiency of virus transmission. We report, in this study, preliminary findings on the relationship of menstrual cycle to genital mucosal and systemic immunity in female olive baboons (Papio anubis) experimentally inoculated with simian/human immunodeficiency virus (SHIV)89.6P.
S, PROFKIGONDUCHRISTINE.  2000.  P. Gichangi, Forick K., Sekadde-Kigondu C.B., Ndinya-Achola J, Bwayo J, Kiragu D., Claeyo P., Temmerman M. Partner notification of pregnant women infected with syphilis in Nairobi, Kenya. Int. J. of STDs and AIDS 11 257, 2000. Int. J. of STDs and AIDS 11 257, 2000. : uon press Abstract
Reproductive Biology Unit, Department of Animal Physiology, University of Nairobi, Kenya. dochiel@kisian.mimcom.net The presence of human immunodeficiency virus (HIV) in genital secretions is regarded as a risk factor for sexual and perinatal transmission of HIV. A better understanding of correlates of genital shedding of HIV is crucial to the development of effective strategies against transmission of this virus. Events during menstrual cycle are likely to influence local immune responses and viral load in genital secretions, and hence determine susceptibility to HIV or efficiency of virus transmission. We report, in this study, preliminary findings on the relationship of menstrual cycle to genital mucosal and systemic immunity in female olive baboons (Papio anubis) experimentally inoculated with simian/human immunodeficiency virus (SHIV)89.6P.

1999

S, PROFKIGONDUCHRISTINE.  1999.  Gichangi PB, Karanja JG, Kigondu CS, Fonck K, Temmerman M. Knowledge, attitudes, and practices regarding emergency contraception among nurses and nursing students in two hospitals in Nairobi, Kenya.Contraception. 1999 Apr;59(4):253-6.. Contraception. 1999 Apr;59(4):253-6.. : uon press Abstract
Department of Obstetrics and Gynecology, University of Nairobi, Kenya. medmicro@ken.healthnet.org A cross-sectional descriptive study on knowledge, attitudes, and practice about emergency contraception (EC) was conducted among nurses and nursing students using a self-administered questionnaire. One-hundred-sixty-seven qualified nurses and 63 nursing students completed the questionnaire. Over 95% listed at least one regular contraceptive method but only 2.6% spontaneously listed EC as a contraceptive method, whereas 48% of the respondents had heard of EC. Significantly more nursing students than qualified nurses were familiar with EC. Knowledge about the types of EC, applications, and side effects was poor and 49% of the respondents considered EC as an abortifacient. Of those familiar with EC, 77% approved its use for rape victims and 21% for adolescents and schoolgirls. Only 3.5% of all respondents had personally used EC in the past, 23% of those familiar with EC intend to use it in the future, whereas 53% intend to provide or promote it. The view that EC was abortifacient negatively influenced the decision to use or provide EC in the future. The present findings suggest that the level of knowledge of EC is poor and more information is needed. These findings indicate the potential to popularize emergency contraception in Kenya among nurses and nursing students. PIP: A descriptive research study on knowledge, attitudes and practices with regard to emergency contraception (EC) was conducted using a questionnaire among 167 nurses and 63 nursing students in Nairobi, Kenya. Results revealed that 95% recorded at least one regular contraceptive method. About 48% of the respondents had heard about EC, but only 2.6% had used it. More nursing students than qualified nurses were aware of EC. There was poor knowledge about the types, applications and side effects of EC. Some 49% of the subjects regarded EC as an abortifacient. About 77% of those knowledgeable about EC approved its use for rape victims and 21% for adolescents and schoolgirls. Only about 3.5% had personally used it. Some 23% of those aware of EC intended to use it in the future. About 53% planned to provide or promote it. The perception that EC is abortifacient affected the decision whether to use or provide it. The data imply that there is potential for effective promotion of EC among nurses and nursing students in Kenya.
S, PROFKIGONDUCHRISTINE.  1999.  Ataya, W.M.. Sekadde-Kigondu C.B., Ruminjo J.K., Wanjala S.M., Munyao G. The onset of spermaturia and the development of Pubertal changes among urban boys in Kenya. J. Obstet, Gynaecol. E.C. Afric 15 (1) 19 (1999).. J. Obstet, Gynaecol. E.C. Afric 15 (1) 19 (1999).. : uon press Abstract
OBJECTIVE: To determine if women receiving intrauterine devices (IUCDs) outside of menses have an acceptable rate of insertion problems and subsequent IUCD-related complications. DESIGN: Cross-sectional and prospective cohort study of insertions at times other than during menses. SETTING: The study was carried out in two government family planning (FP) clinics in Nairobi, Kenya. SUBJECTS: After appropriate pre-test and post-test HIV counselling, 1686 women requesting IUCDs at two FP clinics between 1994 and 1995 in Nairobi were enrolled at baseline into a study examining the effect of human immuno-deficiency virus (HIV) infection on IUCD-related complications. Six hundred and forty nine women (156 HIV-infected and 493 HIV-uninfected) were selected for the four month follow up study. They were classified according to their menstrual cycle status at time of IUCD insertion. MAIN OUTCOME MEASURES: Problems at the time of insertion (pain, bleeding, immediate expulsion) and IUCD-related complications through four months. RESULTS: Rates of immediate insertion problems were low in the women who had insertions during menses (7.0%), outside of menses (4.0%) or had oligomenorrhea/amenorrhea (2.6%). The adjusted odds ratios for IUCD insertion problems outside of menses and in oligomenorrhea/amenorrhea (versus women with insertion during menses) were 0.54 (95 % CI 0.18-1.59) and 0.39 (95% CI 0.12-1.29) respectively. IUCD-related complications were higher in the oligomenorrhea/amenorrhea (11.5%) or insertion outside of menses (6.9%), than the within menses (4.3%) groups. However, the differences were not statistically significant. Adjusted odds ratios for IUCD outside of menses and oligomenorrhoea/amenorrhea groups were 1.65 (95% CI 0.21-12.91) and 2.72 (95% CI 0.34-21.71) respectively. CONCLUSION: The results confirm that the IUCD can be safely inserted outside of menses with minimal insertion difficulties and subsequent complications. Availability of IUCDs outside of menses may enhance IUCD acceptance in Kenya and create better opportunity for visual screening of the cervix for sexually transmitted infections.
S, PROFKIGONDUCHRISTINE.  1999.  Mutungi A.K., Sanghvi H.C.G., Ojwang S.B.O., Sinei S.K. Sekadde-Kigondu C.B. Utilization of maternal and peri-natal Outcome of Twins Delivered at Two Public Hospitals in Nairobi, Kenya. J. Obstet. Gynaecol, E.C. Africa Vol 15 (5) 20, 1999.. J. Obstet. Gynaecol, E.C. Africa Vol 15 (5) 20, 1999.. : uon press Abstract
OBJECTIVE: To determine if women receiving intrauterine devices (IUCDs) outside of menses have an acceptable rate of insertion problems and subsequent IUCD-related complications. DESIGN: Cross-sectional and prospective cohort study of insertions at times other than during menses. SETTING: The study was carried out in two government family planning (FP) clinics in Nairobi, Kenya. SUBJECTS: After appropriate pre-test and post-test HIV counselling, 1686 women requesting IUCDs at two FP clinics between 1994 and 1995 in Nairobi were enrolled at baseline into a study examining the effect of human immuno-deficiency virus (HIV) infection on IUCD-related complications. Six hundred and forty nine women (156 HIV-infected and 493 HIV-uninfected) were selected for the four month follow up study. They were classified according to their menstrual cycle status at time of IUCD insertion. MAIN OUTCOME MEASURES: Problems at the time of insertion (pain, bleeding, immediate expulsion) and IUCD-related complications through four months. RESULTS: Rates of immediate insertion problems were low in the women who had insertions during menses (7.0%), outside of menses (4.0%) or had oligomenorrhea/amenorrhea (2.6%). The adjusted odds ratios for IUCD insertion problems outside of menses and in oligomenorrhea/amenorrhea (versus women with insertion during menses) were 0.54 (95 % CI 0.18-1.59) and 0.39 (95% CI 0.12-1.29) respectively. IUCD-related complications were higher in the oligomenorrhea/amenorrhea (11.5%) or insertion outside of menses (6.9%), than the within menses (4.3%) groups. However, the differences were not statistically significant. Adjusted odds ratios for IUCD outside of menses and oligomenorrhoea/amenorrhea groups were 1.65 (95% CI 0.21-12.91) and 2.72 (95% CI 0.34-21.71) respectively. CONCLUSION: The results confirm that the IUCD can be safely inserted outside of menses with minimal insertion difficulties and subsequent complications. Availability of IUCDs outside of menses may enhance IUCD acceptance in Kenya and create better opportunity for visual screening of the cervix for sexually transmitted infections.

1998

Ojwang, SBO, Mutungi AK, Sinei SK, Kigondu CS, Ndavi PM.  1998.  Post Abortive Acceptence Among Post-abortion in Kenyatta National Hospital, Nairobi,Kenya.
S, PROFKIGONDUCHRISTINE.  1998.  Jeldesa, G.W., Qureshi, Z.P., Sekadde-Kigondu, C.B.,Wanjala, S.M.H., Maternal Mortality in Garissa Provincial Hospital. J. Obstet. Gynaecol. E. and Centre. Afr. 14: 68, 1998. J. Obstet. Gynaecol. E. and Centre. Afr. 14: 68, 1998. : uon press Abstract
Aga Khan Hospital, Nairobi. Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.
S, PROFKIGONDUCHRISTINE.  1998.  Jeldesa, G.W., Qureshi, Z.P., Sekadde-Kigondu, C.B., Factors Enhansing the Practice of Female Genital Mutilation among Kenyan Somalis. J. Obstet.Gynaecol.E. and Centr. Afr. 14: 110, 1998. J. Obstet.Gynaecol.E. and Centr. Afr. 14: 110, 1998. : uon press Abstract
Aga Khan Hospital, Nairobi. Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

UoN Websites Search