Publications


2012

Jenkins, R, Njenga F, Okonji M, Kigamwa P, Baraza M, Ayuyo J, Singleton N, McManus S, Kiima D.  2012.  Psychotic symptoms in Kenya--prevalence, risk factors, and relationship with common mental disorders.

2011

Mundan, VK, Muiva MN, Kimani ST, F BM.  2011.  Prevalence and risk factors associated with hypertension among armed-forces personnel in Kenya. Abstract

Hypertension remains a major risk factor for the development of cardiovascular diseases (CVDs) worldwide. Statistics show a rising morbidity and mortality in developing countries, especially in sub-Saharan Africa, as a result of hypertension. Military personnel are physically fit as a result of engaging in physical activities and regular exercise, thus reducing chances of developing CVDs. However, hypertension has been observed to be on the rise among the armed-forces population. Objective: To determine the prevalence and risk factors associated with hypertension among military personnel in Kenya. Methods: This was a cross-sectional, randomised case-control study carried out at Armed Forces Memorial Hospital in Nairobi. A total of 340 (170 hypertensive and 170 normotensive) subjects were recruited into this study. A structured questionnaire based on the WHO stepwise approach for surveillance of chronic diseases was used for data collection. Physiological and anthropometric measurements were obtained from subjects in the two groups. Data were analysed using STATA version 11 to compare the two groups and determine the influence of diverse risk factor on hypertension. Results: The mean age SD of hypertensive and normotensive subjects was 45.1, 7.7 and 40.8, 7.3 years, respectively. On average the hypertensive patients were 4.82 older than the normotensives (p 0.0001). There was a strong (2=34.33, d.f.=3; p<0.0001) statistical association between the frequency of alcohol consumption and hypertension. Approximately 11% of cases were current smokers compared to 4.2% in the control group. There was a significant association between current smoking and hypertension (OR =0.17; 95% CI: 0.14–0.89). The findings show that cases of hypertension had poor nutritional indicators compared to the controls. In addition, cases were more likely to be overweight (59.76 vs 28.24%) or obese (19.53 vs 3.53%) compared to the controls. Conclusion: Our study findings revealed that higher anthropometric measurements, cigarette smoking and certain dietary habits are significant risks for hypertension among the armed forces. The level of physical fitness among this population was 95% (excellent) as per the fitness index results. Our study findings provide an impetus for the urgent need to encourage healthy lifestyles as a primary-prevention strategy and explore other possible risk factors for the development of CVDs and hypertension among this population.

2009

O., DRBUKACHIFREDERICK.  2009.  Pakenham-Walsh N, Bukachi F. Information needs of health care workers in developing countries: a literature review with a focus on Africa. Hum Resour Health. 2009 Apr 8;7:30. East Afr Med J. 2001 Jul;78(7 Suppl):S43-7.. : UN-HABITAT Abstract

Health care workers in developing countries continue to lack access to basic, practical information to enable them to deliver safe, effective care. This paper provides the first phase of a broader literature review of the information and learning needs of health care providers in developing countries.A Medline search revealed 1762 papers, of which 149 were identified as potentially relevant to the review. Thirty-five of these were found to be highly relevant. Eight of the 35 studies looked at information needs as perceived by health workers, patients and family/community members; 14 studies assessed the knowledge of health workers; and 8 looked at health care practice.The studies suggest a gross lack of knowledge about the basics on how to diagnose and manage common diseases, going right across the health workforce and often associated with suboptimal, ineffective and dangerous health care practices. If this level of knowledge and practice is representative, as it appears to be, it indicates that modern medicine, even at a basic level, has largely failed the majority of the world's population. The information and learning needs of family caregivers and primary and district health workers have been ignored for too long. Improving the availability and use of relevant, reliable health care information has enormous potential to radically improve health care worldwide.

PMID: 19356239 [PubMed - in process]

2008

Bukachi, F, Waldenstrom A, Mörner S, Lindqvist P, Henein MY, Kazzam E.  2008.  Age dependency in the timing of mitral annular motion in relation to ventricular filling in healthy subjects: Umea General Population Heart Study. AbstractWebsite

AIMS:

Peak left ventricular (LV) relaxation normally precedes peak filling (E), which supports the hypothesis that LV suction contributes to early-diastolic filling. The significance of similar temporal discordance in late diastole has previously not been studied. We describe the time relationships between mitral annular motion and LV filling in early and late diastole and examine the effect of normal ageing on these time intervals.

METHODS AND RESULTS:

A total of 128 healthy subjects aged 25-88 years were studied. Transmitral and pulmonary venous flow reversals (Ar) were recorded by Doppler echocardiography. Mitral annular diastolic displacement-early (E(m)) and late (A(m))-were recorded by Doppler tissue imaging. With reference to electrocardiographic R and P-waves, the following measurements were made: R to peak E-wave (R-E) and E(m) (R-E(m)); onset P to peak A-wave (P-pA), A(m) (P-pA(m)), and Ar (P-pAr). The differences between [(R-E) and (R-E(m))] for early-diastolic temporal discordance (EDTD) and [(P-A) and (P-A(m))] for late-diastolic temporal discordance (LDTD) were calculated. Isovolumic relaxation time (IVRT) was also measured. Early-diastolic temporal discordance was approximately 26 ms in all age groups. Late-diastolic temporal discordance, however, was inversely related to age (r = -0.35, P < 0.001) and IVRT (r = -0.34, P < 0.001) and therefore decreased in the elderly vs. young (13 +/- 10 vs. 23 +/- 10 ms; P < 0.001). In multivariate analysis, age failed to predict LDTD in the presence of IVRT. A, A(m), and Ar were simultaneous at onset, and peak A(m) coincided with peak Ar in all age groups (r = 0.97, P < 0.001). No significant differences were noted in the RR intervals.

CONCLUSIONS:

Sequential prolongation of IVRT with ageing reduces LDTD, thus converging the peaks of A(m), A, and Ar (atrial mechanical alignment)-a potential novel method to identify subjects at increased dependency on atrial contraction for late-diastolic filling

O., DRBUKACHIFREDERICK.  2008.  Bukachi F, Waldenstr. East Afr Med J. 2001 Jul;78(7 Suppl):S43-7.. : UN-HABITAT Abstract
Department of Medical Physiology, College of Health Sciences, Nairobi, Kenya. AIMS: Peak left ventricular (LV) relaxation normally precedes peak filling (E), which supports the hypothesis that LV suction contributes to early-diastolic filling. The significance of similar temporal discordance in late diastole has previously not been studied. We describe the time relationships between mitral annular motion and LV filling in early and late diastole and examine the effect of normal ageing on these time intervals. METHODS AND RESULTS: A total of 128 healthy subjects aged 25-88 years were studied. Transmitral and pulmonary venous flow reversals (Ar) were recorded by Doppler echocardiography. Mitral annular diastolic displacement-early (E(m)) and late (A(m))-were recorded by Doppler tissue imaging. With reference to electrocardiographic R and P-waves, the following measurements were made: R to peak E-wave (R-E) and E(m) (R-E(m)); onset P to peak A-wave (P-pA), A(m) (P-pA(m)), and Ar (P-pAr). The differences between [(R-E) and (R-E(m))] for early-diastolic temporal discordance (EDTD) and [(P-A) and (P-A(m))] for late-diastolic temporal discordance (LDTD) were calculated. Isovolumic relaxation time (IVRT) was also measured. Early-diastolic temporal discordance was approximately 26 ms in all age groups. Late-diastolic temporal discordance, however, was inversely related to age (r = -0.35, P < 0.001) and IVRT (r = -0.34, P < 0.001) and therefore decreased in the elderly vs. young (13 +/- 10 vs. 23 +/- 10 ms; P < 0.001). In multivariate analysis, age failed to predict LDTD in the presence of IVRT. A, A(m), and Ar were simultaneous at onset, and peak A(m) coincided with peak Ar in all age groups (r = 0.97, P < 0.001). No significant differences were noted in the RR intervals. CONCLUSIONS: Sequential prolongation of IVRT with ageing reduces LDTD, thus converging the peaks of A(m), A, and Ar (atrial mechanical alignment)-a potential novel method to identify subjects at increased dependency on atrial contraction for late-diastolic filling.

2007

O., DRBUKACHIFREDERICK.  2007.  Kanter AS, Negin J, Olayo B, Bukachi F, Johnson E, Sachs, SE. Millennium Global Village-Net: Bringing together Millennium Villages throughout Africa. HELINA 2007. East Afr Med J. 2001 Jul;78(7 Suppl):S43-7.. : UN-HABITAT Abstract
The Millennium Villages Project (MVP), based at the Earth Institute at Columbia University, is a new bottom-up approach to lift developing country villages out of the poverty trap that afflicts more than a billion people worldwide, and help them get on the path of self-sustaining development. Millennium Villages are either existing or being developed in 10 countries throughout Africa (there are 12 millennium village sites running in 10 countries in Sub-Saharan Africa). MVP is an important development process for empowering communities in a manner which is replicable and sustainable. It fosters an integrated approach,whereby issues of food security, education, nutrition and health, environment and energy are addressed in combination to alleviate poverty and hunger. It does so at a modest external financial input. MVP is committed to a science-based approach to assess and monitor the progress of the communities towards clear objectives; the Millennium Development Goals (MDGs). This approach offers much more than simply collecting and analyzing data since the mechanism used for recording progress will provide a bridge over the divide which separates the haves and the havenots (by facilitating the sharing of solutions from one community to another bidirectionally). By so doing, it allows people to enhance their own futures in a sustainable manner. Solutions found in one community are transferable to similar communities in other MVP villages. To achieve this goal, the MVP requires an information and communication system which can provide both necessary infrastructure for monitoring and evaluation, and tools for communicating among the villages, cities and countries. This system is called the Millennium Global Village-Net (MGV-Net). It will take advantage of the latest in open source software (OpenMRS), databases (MySQL), interface terminology, centralized concept dictionary, and use appropriate technology locally for data entry.
O., DRBUKACHIFREDERICK.  2007.  Bukachi F, Pakenham-Walsh N. Information technology for health in developing countries. Chest. 2007 Nov;132(5):1624-30. East Afr Med J. 2001 Jul;78(7 Suppl):S43-7.. : UN-HABITAT Abstract
Poverty has deepened the crisis in health-care delivery in developing countries, particularly sub-Saharan Africa, which is a region facing a disease burden that is unmatched in the world. Whether access to proven and powerful information and communication technologies (ICTs) can improve health indicators is an ongoing debate. However, this brief review shows that in the last decade there has been significant growth in Internet access in urban areas; health-care workers now use it for communication, access to relevant health-care information, and international collaboration. The central message learned during this period about the application of ICTs is that infrastructural and cultural contexts vary and require different models and approaches. Thus, to harness the full potential of ICTs to the benefit of health systems, health workers, and patients will demand an intricate mix of old and new technologies. PMID: 17998362 [PubMed - indexed for MEDLINE

2005

O., DRBUKACHIFREDERICK.  2005.  Bukachi F, Waldenstr. East Afr Med J. 2001 Jul;78(7 Suppl):S43-7.. : UN-HABITAT Abstract
AIMS: Although pulmonary venous flow reversal (Ar) is useful in the evaluation of left ventricular (LV) diastolic function, it is often difficult to study with transthoracic echocardiography (TTE). We determined the relationship between Ar and left atrial (LA) mechanical function and sought to define surrogate measurements for Ar. METHODS AND RESULTS: A total of 130 healthy subjects, mean age 54.3+/-18.3 years, 62 women, were studied and classified into three groups: [young (Y), 25-44 years; n=44], [middle-age (M), 45-64 years; n=43] and [elderly (E), > or =65 years; n=43]. Pulmonary venous flow and LV inflow studies were performed by TTE and LV basal free-wall motion was studied by Doppler tissue imaging (DTI). All images were acquired with a superimposed electrocardiogram. RR interval was similar in all groups while LA dimension and PR interval were increased in Group E vs. Y (P<0.001). LA contraction (A(m)) on DTI, transmitral A-wave (A) and Ar were simultaneous and started 84ms after onset of P wave and this interval increased with age (P=0.02). Similarly, the time intervals from the same landmark to peak A(m), A, and Ar were prolonged with age (all, P<0.001). Despite this prolongation, peak A(m) coincided with peak Ar in every age group (r=0.97, P<0.001) and Ar acceleration and deceleration times were consistently equal. CONCLUSION: The timing of A(m) obtained by DTI can be used to accurately estimate corresponding measurements of Ar recorded by TTE in subjects without cardiac disease. PMID: 15760687 [PubMed - indexed for MEDLINE

2004

O., DRBUKACHIFREDERICK.  2004.  Bukachi F. Ventricular long axis function: amplitudes and timings. East Afr Med J. 2001 Jul;78(7 Suppl):S43-7.. : UN-HABITATfrederick_bukachi.pdf

2003

O., DRBUKACHIFREDERICK.  2003.  Bukachi F, Kazzam, E, Clague JR, Waldenstr. East Afr Med J. 2001 Jul;78(7 Suppl):S43-7.. : UN-HABITAT Abstract

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OBJECTIVE: To assess the clinical outcome of successful percutaneous transluminal coronary angioplasty (PTCA) in patients with poor ventricular function. METHODS: Analysis of angiographic, echocardiographic and clinical records of patients with severe LV dysfunction who underwent PTCA from January 1, 1995 to December 31, 1997 was undertaken. Forty-one patients aged 63+/-10 years, 36 men, all with significant coronary artery disease and impaired LV function (fractional shortening, FS<or=20%) were identified. Patients' data before and after angioplasty were analyzed. RESULTS: Post PTCA: angiographic success was 95.2%. Major complications occurred in 19.5% and hospital mortality was 2.7%. At 6 months after PTCA:LV fractional shortening (FS) increased from 15.9+/-3.4% to 19.6+/-6.6%

2001

Lown, B;, Bukachi F;, Xavier R.  2001.  Health information in the developing world. Abstract

OBJECTIVE: To assess the clinical outcome of successful percutaneous transluminal coronary angioplasty (PTCA) in patients with poor ventricular function. METHODS: Analysis of angiographic, echocardiographic and clinical records of patients with severe LV dysfunction who underwent PTCA from January 1, 1995 to December 31, 1997 was undertaken. Forty-one patients aged 63+/-10 years, 36 men, all with significant coronary artery disease and impaired LV function (fractional shortening, FS

2000

O., DRBUKACHIFREDERICK.  2000.  Bukachi F, Henein MY, Underwood SR. Predicting the outcome of revascularization in ischaemic left ventricular dysfunction. Eur Heart J. 2000 Aug;21(16):1290-2. [Editorial]. East Afr Med J. 2001 Jul;78(7 Suppl):S43-7.. : UN-HABITAT Abstract

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OBJECTIVE: To assess the clinical outcome of successful percutaneous transluminal coronary angioplasty (PTCA) in patients with poor ventricular function. METHODS: Analysis of angiographic, echocardiographic and clinical records of patients with severe LV dysfunction who underwent PTCA from January 1, 1995 to December 31, 1997 was undertaken. Forty-one patients aged 63+/-10 years, 36 men, all with significant coronary artery disease and impaired LV function (fractional shortening, FS<or=20%) were identified. Patients' data before and after angioplasty were analyzed. RESULTS: Post PTCA: angiographic success was 95.2%. Major complications occurred in 19.5% and hospital mortality was 2.7%. At 6 months after PTCA:LV fractional shortening (FS) increased from 15.9+/-3.4% to 19.6+/-6.6%

1998

O., DRBUKACHIFREDERICK.  1998.  Lown B, Bukachi F, Xavier R. Health information in the developing world. Lancet. 1998 Oct;352 Suppl 2:SII34-8.. East Afr Med J. 2001 Jul;78(7 Suppl):S43-7.. : UN-HABITAT Abstract

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OBJECTIVE: To assess the clinical outcome of successful percutaneous transluminal coronary angioplasty (PTCA) in patients with poor ventricular function. METHODS: Analysis of angiographic, echocardiographic and clinical records of patients with severe LV dysfunction who underwent PTCA from January 1, 1995 to December 31, 1997 was undertaken. Forty-one patients aged 63+/-10 years, 36 men, all with significant coronary artery disease and impaired LV function (fractional shortening, FS<or=20%) were identified. Patients' data before and after angioplasty were analyzed. RESULTS: Post PTCA: angiographic success was 95.2%. Major complications occurred in 19.5% and hospital mortality was 2.7%. At 6 months after PTCA:LV fractional shortening (FS) increased from 15.9+/-3.4% to 19.6+/-6.6%

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