Matheka, DM, Mokaya J, Maritim M.  2013.  Overview of Influenza Virus infections in Kenya: Past, Present and Future. PanAfrican Medical Journal. 14(138) Abstract

The World Health Organisation (WHO) Estimates that acute lower respiratory infections account for 4 million deaths per year. The rates are even higher in developing countries. However there is paucity of data on its epidemiology, seasonality and burden in most developing countries. In the contrary, Kenya (a developing country) has an elaborate national epidemio-surveillance network of influenza, where a lot of data is generated on the epidemiology and seasonality of influenza in Kenya and East African region. Several steps have been taken to control influenza in Kenya, including vaccination and surveillance programs. However, some challenges still exist. This article explores the pattern of influenza and existing interventions in Kenya, and highlights suggestions on what can be done to adequately control this virus in future.


Kamau, E, Kayima J, Otieno C, Maritim MC, Wanzala P.  2012.  Health related quality of life of patients on maintenance haemodialysis at Kenyatta National Hospital. East African Medical Journal. 89(3):39-45. Abstract

Background: Health related quality of life is increasingly being recognized as a primary outcome measure in treatment of end stage renal disease. The health related quality of life of patients on maintenance haemodialysis is reduced. Several interventions directed at modifiable risk factors have been shown to improve quality of life of patients on haemodialysis.
Objective: To assess the health related quality of life of patients on maintanance haemodialysis at Kenyatta National Hospital.
Design: Cross sectional descriptive study
Setting: Kenyatta National Hospital, Renal Unit.
Subjects: The study was conducted on 96 patients with end stage renal disease on maintenance haemodialysis. Socio-Demographic and clinical factors were recorded for all patients. Health-related quality of life was assessed using the Kidney Disease Quality of Life-36 questionnaire. Two summary scores and three sub-scale scores were calculated.
Results: The mean physical composite summary and mental composite summary scores were 39.09+/- 9.49 and 41.87+/- 10.56 respectively. The burden of kidney disease sub-scale, symptom and problems sub-scale and effect of kidney disease on daily life sub-scale score were 16.15+/- 21.83, 73.46+/-18.061 and 67.63+/-23.45 respectively.
Conclusion: Health related quality of life of patients on maintenance hemodialysis is reduced. The physical quality of life is more affected than the mental quality of life. The burden of kidney disease sub-scale is the most affected sub-scale score.


B Ganda, GO Oyoo, KMJM.  2011.  Peripheral arterial disease in rheumatoid arthritis patients at the Kenyatta National Hospital, Kenya . East African Medical Journal. 88(12) Abstract

Objective: To determine the magnitude of the rosclerotic arterial disease in Rheumatoid Arthritis(RA) patients at Kenyatta National Hospital.
Design: hospital based cross-sectional study.
Setting: Kenyatta National Hospital Rheumatology outpatient clinic.
Subjects: Rheumatoid Arthritis patients.
Results: We obtained ABI measurements in 90 RA patients, among them 23(25.5% 95% CI 17.2-36.1) had obstructed lower limb arteries. Among the 23, 21(91.3%) had mild PAD, two (8.7%) had moderate PAD; none had severe PAD nor incompressible vessels. The obstruction of vessels was independent of diabetes, hypertension, dyslipidemia and cigarette smoking though these factors increased the likelihood of having PAD. Risk age( ≥45 males, ≥55 females), Established RA(> 5 year duration) and severe RA were found to be significantly associated with the likelihood of having PAD. These trends remained significant after multivariable adjustment for potential confounders. twenty five (27.7%) of the study subjects exhibited symptoms of intermittent claudication, 13(52%) of them had PAD on ABI measurements, The Edinburgh claudication questionnaire was found to have 56.5% sensitivity and 82% specificity in detection
of PAD in RA patients. Conclusion: There seems to be an association between PAD in RA with chronicity and severity of the RA. This association may support the pathogenic role of accumulated systemic inflammation in atherosclerosis. Clinicians should be alert to the possibility of impared arterial function and thus subsequent cardiovascular morbidity and mortality in this group of patients.


Etyang, AO, Amayo EO, Bhatt SM, Wamola IA, Maritim MC.  2009.  Comparison of Bedside innoculation of culture media with conventional cerebrospinal fluid culture methods in patients with bacterial meningitis. . East African Medical Journal. 86(10):476-479. Abstract

Background: The yield of bacterial culture from cerebrospinal fluid (CSF ) at Kenyatta Notational Hospital (KNH) is very low. Bedside inoculation of culture media with CSF may improve yields
Objective: To compare the culture yield of CSF inoculated on to culture medium at the bedside to that of CSF inoculated onto culture medium in the microbiology laboratory.
Design: Cross-sectional comparative study.
Setting: Accidental and emergency Department and medical wards at Kenyatta National Hospital.
Subjects: CSF from patients at KNH with a clinical diagnosis of acute meningitis.
Results: Two hundred and twenty CSF specimens were obtained during a four month period. S. pneumoniae was isolated from 24 CSF samples and H. influenzae from one. Bacterial cultures were positive in 25(11.4%, 95% CI 7.0-15.6%) samples inoculated at the bedside and 23(10.5%, 95% CI 6.5-14.5%) samples inoculated at the laboratory. Bacteria were isolated 5 hours earlier in samples inoculated at the bedside( 95% CI 4.34- 6.86 hrs, p<0.05). Four percent of S. pneumoniae isolate were resistant to crystalline penicillin.
Conclusion: There was no significant difference in culture yield after bedside inoculation of culture media. with CSF compared to traditional CSF culture method. Bedside inoculation of culture media with CSF resulted in faster time to positive culture.


CHERONO, DRMARITIMMARYBETH.  2008.  Adam AM, Maritim MC.Pseudoxanthoma elasticum in a patient with sickle cell disease: case report.East Afr Med J. 2008 Feb;85(2):98-101.. : University of Nairobi. Abstract

An 18 year female sickler (HbSS) presented with repeated history of epistaxis and bleeding gums. Features consistent with pseudoxanthoma elasticum were observed, such as hyper-extensile redundant skin folds in the neck, axilla, inguinal areas and abdomen. The skin biopsy showed swollen, clumped and fragmented elastic fibres and calcium deposits in the deep and mid reticular dermis, consistent with pseudoxanthoma elasticum. This is a well recognised complication of sickle cell disease which has not been described in Kenya.


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