Bio

Publications


2018

Nyirakanani, C, Chibvongodze R, Habtu M, Masika M, Mukoko D, Njunwa KJ.  2018.  Prevalence and risk factors of asymptomatic malaria among under-five children in Huye District, Southern Rwanda.. Tanzania Journal of Health Research. 20(1) AbstractWebsite

Background: Enhanced malaria control has resulted in its reduction in some areas of Sub Saharan Africa including Rwanda. However, asymptomatic hosts serve as a reservoir for the malaria parasite for communities. The objective of this study was to determine the prevalence of malaria parasites and risk factors associated with malaria infection among children underfive years in Huye district, Rwanda.

Methods: This community-based cross sectional study was conducted from May to June 2016 among underfive years children. Asymptomatic children underfive years of age were randomly selected from 13 villages. Thick and thin blood smears were prepared from each child for malaria parasite diagnosis. Interviews with parents or guardians were conducted to collect data on malaria associated risk factors. Observations were made of the presence of mosquito breeding sites near and around the homestead.

Results: A total of 222 children were included in the study. Nearly a third (28.8%) of the children were within the age of 25-36 months. The majority (54%) of the children were females. Most of the parents/guardians were married (95.9%), nearly all (99.5%) had attended primary school and most (97.3%) were peasants. The overall Plasmodium falciparum prevalence in children was 12.2%. Children aged 1 to 12 months were 3.5 times more likely to have malaria parasites than children aged 13 to 59 months [AOR=3.56; 95%CI=1.18-10.71; p=0.024]. Children who were not sleeping under insecticide treated nets were 15 times more likely to be infected with malaria parasites compared to those who were sleeping under nets [AOR=15.27; 95%CI=4.42-52.82; p<0.001].

Conclusion: Malaria parasite prevalence in under-five year children in Huye District, Rwanda is moderate. The asymptomatic infections in the community forms a reservoir for transmission in the area. Young age of the child and not sleeping under mosquito net were associated with malaria parasite infection. The continuing use of mosquito nets needs to be emphasized.

2017

Masika, M, Wachihi C, Muriuki F, Kimani J, R K.  2017.  Hypertension and obesity among HIV patients in a care programme in Nairobi. East African Medical Journal. 94(5) AbstractWebsite

Objective: To determine the prevalence of hypertension and obesity among HIV patients enrolled in the Sex Worker Outreach Programme (SWOP), Nairobi, Kenya.

Design: A retrospective a study.

Setting: SWOP managed by the University of Manitoba, Nairobi team.

Subjects: We selected clinic visit records from HIV patients seen between 2011 and 2014, which had valid blood pressure and age entries.

Interventions: We analysed data to determine prevalence and correlates of hypertension and obesity in the study population. Associations were tested using chi-square for categorical variables and t-test for continuous variables.

Main outcome measures: Hypertension and obesity.

Results: Three thousand one hundred ninety seven subjects were included in the study. All were HIV-positive and most (97.8%) were on ART. The mean age was 39.7 years (standard deviation = 8.8) and 72.4% of the subjects were female. The prevalence of hypertension was 7.7% (246/3197) and 31% of the study cases (798/2590) were either overweight or obese. Males were more likely to have hypertension (p < 0.001) while females were more predisposed to obesity (p < 0.001).

Conclusion: Hypertension and obesity are important co-morbidities among HIV patients. Preventive and management strategies should be adopted as part of the comprehensive packages on offer at all existing HIV care and ART centres targeting those enrolled for services as well as their relatives and the community at large.

Nyirakanani, C, Chibvongodze R, Kariuki L, Habtu M, Masika M, Mukoko D, Njunwa KJ.  2017.  Characterization of malaria vectors in Huye District, Southern Rwanda. Tanzania Journal of Health Research. 19(3) AbstractWebsite

Background: Effective control of malaria requires knowledge of vector species, their feeding and resting behaviour as well as breeding habitats. The objective of this study was to determine malaria vector species abundance and identify their larval habitats in Huye district, southern Rwanda.

Methods: Adult mosquitoes were collected indoors using light trap and pyrethrum spray catch techniques, and outdoors using light traps. Female Anopheles mosquitoes were identified to species level by morphological characteristics. Enzyme-linked Immunosorbent Assay (ELISA) was used to screen for Plasmodium falciparum circumsporozoite protein and host blood meal sources. Anopheles larvae were sampled using dippers and raised into adult mosquitoes which were identified morphologically.

Results: Anopheles gambiae sensu lato comprised of 70% of the 567 Anopheles collected. Other Anopheles species identified were An. funestus 4%, An. squamosus 16.5%, An. maculipalpis 6.5%, An. ziemanni 1.7%, An. pharoensis 1.2 % and An. coustani 0.1%. The majority, 63.5% of the collected mosquitoes were from indoors collections. The overall human blood index was 0.509. The P. falciparum circumsporozoite protein was found in 11 mosquitos including 8 Anopheles gambiae s.l. and 3 secondary vectors out of the 567 tested. The overall sporozoite rate was 1.9%. A total of 661 Anopheline larvae from 22 larval habitats were collected. They comprised of An. gambiae s.l. (89%) and An. ziemanni (11%). The absolute breeding index was 86.4%. The most common larval habitats were in full sunlight with still water like rice paddies and pools of stagnant water.

Conclusion: These findings show that Anopheles gambiae s.l. is the dominant malaria vector in the area with other vectors playing a secondary role in malaria transmission. Malaria interventions need to be strengthened to reduce even further the malaria transmission in the area.

2016

Ondari, JN, Masika MM, Ombachi RB, Ating’a JE.  2016.  Unblinded randomized control trial on prophylactic antibiotic use in gustilo II open tibia fractures at Kenyatta National Hospital, Kenya. AbstractWebsite

Objective

To determine the difference in infection rate between 24 h versus five days of prophylactic antibiotic use in management of Gustilo II open tibia fractures.
Design

Unblinded randomized control trial.
Setting

Accident and Emergency, orthopedic wards and outpatient clinics at Kenyatta National Hospital (KNH).
Patients

The study involved patients aged 18–80 years admitted through accident and emergency department with Gustilo II traumatic open tibia fractures.
Intervention

Patients were randomized into either 24 hour or five day group and antibiotics started for 24 hours or five days after surgical debridement. The wounds were exposed and scored using ASEPSIS wound scoring system for infection after 48 h, 5 days and at 14 days.
Outcome measures

The main outcomes of interest were presence of infection at days 2, 5 and 14 and effect of duration to antibiotic administration on infection rate.
Results

There was no significant difference in infection rates between 24-hour and 5-day groups with infection rates of 23% (9/40) vs. 19% (7/37) respectively (p = 0.699). The infection rate was significantly associated with time lapsed before administration of antibiotics (p = 0.004).
Conclusion

In the use of prophylactic antibiotics for the management of Gustilo II traumatic open tibia fractures, there is no difference in infection rate between 24 hours and five days regimen but time to antibiotic administration correlates with infection rate. Antibiotic use for 24 hours only has proven adequate prophylaxis against infection. This is underlined in our study which we hope shall inform practice in our setting. A larger, more appropriately controlled study would be useful.

2015

Masika, M, Omondi G, Natembeya D, Mugane E, Bosire K, Kibwage I.  2015.  Use of mobile learning technology among final year medical students in Kenya. Pan African Medical Journal. 21 Abstractabstract_-_use_of_mobile_learning_technology_among_final_year_medical_students_in_kenya.pdfeducational_use_of_smartphones.jpg

Use of mobile learning technology among final year medical students in Kenya.
Masika MM, Omondi GB, Natembeya DS, Mugane EM, Bosire KO, Kibwage IO.

INTRODUCTION: Mobile phone penetration has increased exponentially over the last decade as has its application in nearly all spheres of life including health and medical education. This study aimed at assessing the use of mobile learning technology and its challenges among final year undergraduate students in the College of Health sciences, University of Nairobi.

METHODS:This was a cross-sectional descriptive study conducted among final year undergraduate students at the University of Nairobi, College of Health Sciences. Self-administered, anonymous questionnaires were issued to all final year students in their lecture rooms after obtaining informed consent. Data on demographics, mobile device ownership and mobile learning technology use and its challenges was collected. Data entry and analysis was done using SPSS(®). Chi-square and t-test were used for bivariate analysis.

RESULTS: We had 292 respondents; 62% were medical students, 16% were nursing students, 13% were pharmacy students and 9% were dental surgery students. The majority were female (59%) and the average age was 24 years. Eighty eight percent (88%) of the respondents owned a smart device and nearly all of them used it for learning. 64% of the respondents used medical mobile applications. The main challenges were lack of a smart device, lack of technical know-how in accessing or using apps, sub-optimal internet access, cost of acquiring apps and limited device memory.

CONCLUSION: Mobile learning is increasingly popular among medical students and should be leveraged in promoting access and quality of medical education.

KEYWORDS: Smartphone; medical education; mobile application; mobile learning; mobile-device

Pan Afr Med J. 2015 Jun 15;21:127. doi: 10.11604/pamj.2015.21.127.6185. eCollection 2015.

Masika, MM, Ogembo JG, Chabeda SV, Wamai RG, Mugo N.  2015.  Knowledge on HPV Vaccine and Cervical Cancer Facilitates Vaccine Acceptability among School Teachers in Kitui County, Kenya. PloS one. 10:e0135563. Abstractknowledge_on_hpv_vaccine_and_cervical_cancer_facilitates_vaccine_acceptability.pdfschool_teachers_attitudes_toward_hpv_vaccine.jpg

Knowledge on HPV Vaccine and Cervical Cancer Facilitates Vaccine Acceptability among School Teachers in Kitui County, Kenya.

Masika MM, Ogembo JG, Chabeda SV, Wamai RG, Mugo N

BACKGROUND: Vaccines against human papillomavirus (HPV) infection have the potential to reduce the burden of cervical cancer. School-based delivery of HPV vaccines is cost-effective and successful uptake depends on school teachers' knowledge and acceptability of the vaccine. The aim of this study is to assess primary school teachers' knowledge and acceptability of HPV vaccine and to explore facilitators and barriers of an ongoing Gavi Alliance-supported vaccination program in Kitui County, Kenya.
METHODS: This was a cross-sectional, mixed methods study in Central Division of Kitui County where the Ministry of Health is offering the quadrivalent HPV vaccine to grade four girls. Data on primary school teachers' awareness, knowledge and acceptability of HPV vaccine as well as facilitators and barriers to the project was collected through self-administered questionnaires and two focus group discussions.
RESULTS: 339 teachers (60% female) completed the survey (62% response rate) and 13 participated in 2 focus group discussions. Vaccine awareness among teachers was high (90%), the level of knowledge about HPV and cervical cancer among teachers was moderate (48%, SD = 10.9) and females scored higher than males (50% vs. 46%, p = 0.002). Most teachers (89%) would recommend the vaccine to their daughter or close relatives. Those who would recommend the vaccine had more knowledge than those who would not (p = <0.001). The main barriers were insufficient information about the vaccine, poor accessibility of schools, absenteeism of girls on vaccine days, and fear of side effects.
CONCLUSIONS: Despite low to moderate levels of knowledge about HPV vaccine among school teachers, vaccine acceptability is high. Teachers with little knowledge on HPV vaccine are less likely to accept the vaccine than those who know more; this may affect uptake if not addressed. Empowering teachers to be vaccine champions in their community may be a feasible way of disseminating information about HPV vaccine and cervical cancer.

PLoS One. 2015 Aug 12;10(8):e0135563. doi: 10.1371/journal.pone.0135563. eCollection 2015.

2014

Masika, M.  2014.  A Teachers’ Perspective of School-based Human Papillomavirus Vaccination of Girls in Kitui County: Knowledge, Acceptability, Facilitators, Barriers & Opportunities. Abstractabstract_msc_thesis_-_teachers_perspective_on_hpv_vaccination_in_kitui_county.pdf

A Teachers’ Perspective of School-based Human Papillomavirus Vaccination of Girls in Kitui County: Knowledge, Acceptability, Facilitators, Barriers & Opportunities

Masika MM

Background: Cervical cancer is the leading cause of cancer-related morbidity and mortality among women in sub-Saharan Africa. Two effective Human papillomavirus vaccines are available as means of preventing the disease. School-based vaccination has been identified as a viable delivery method but there is need understand the local environment for optimal vaccine delivery and uptake among adolescent girls in schools.

Objective: To assess knowledge and acceptability of HPV vaccine in primary school teachers in Kitui County and explore the facilitators, barriers and opportunities presented by the HPV vaccination of class four girls.

Methods: This was a cross-sectional, mixed methods study conducted in Kitui Central Division of Kitui County where the Ministry of Health is administering the quadrivalent HPV vaccine to all class four girls. Self-administered questionnaires were filled by 339 primary school teachers and two focus group discussions with a total of 13 participants were held. We collected data on awareness, knowledge and acceptability of HPV vaccine as well as facilitators, barriers and opportunities presented by the project. Analysis was done using SPSS® (quantitative data) and ATLAS.ti® (qualitative data) testing associations using chi-square for categorical variables and t-test for numerical variables.

Results: Sixty percent of the respondents were female. The mean age was 40 years (standard deviation (SD) = 10.7). Nearly all were Christians (99%), 1% were Muslims. Most respondents (90%) were aware of the vaccination exercise. The average score on knowledge was 48% with women scoring significantly higher than men (50% vs 46%, p=0.002). The level of knowledge about HPV and cervical cancer among teachers was moderate (48%, SD = 10.9). Most teachers would recommend the vaccine to their daughter or close relative (89%). Teachers who would recommend the vaccine had more knowledge than those who would not (49% vs 40% p=<0.001). Nearly all teachers wanted to know more about HPV vaccine (98%). Most felt that the vaccine was safe (79%) and should be continued (93%). The main barriers reported by the teachers were insufficient information about the vaccine, poor accessibility of schools, absenteeism of school girls on vaccine days and fear of side effects.

Conclusion and Recommendations: Despite low to moderate levels of knowledge about HPV vaccine in the study population, vaccine acceptability is high. Nevertheless, knowledge and awareness had a significant effect on whether teachers would recommend the vaccine to their daughter or close relative or not. There is need to come up with cost-effective means of disseminating information on HPV vaccine among teachers, parents and pupils in our settings.

Thesis submitted as part of the requirements for a Master of Science degree in Tropical and Infectious Diseases at the University of Nairobi Institute of Tropical & Infectious Diseases

2009

Gituma, A, Masika M, Muchangi E, Nyagah L, Otieno V, Grace Irimu, R W Nduati, Nduati Ruth, Wasunna A, Ndiritu M, English M.  2009.  Access, sources and value of new medical information: views of final year medical students at the University of Nairobi. Abstractabstract_accesssources_and_value_of_new_medical_information.pdf

Access, sources and value of new medical information: views of final year medical students at the University of Nairobi.
Gituma A, Masika M, Muchangi E, Nyagah L, Otieno V, Irimu G, Wasunna A, Ndiritu M, English M
OBJECTIVE: To evaluate final year medical students' access to new medical information.
METHOD: Cross-sectional survey of final year medical students at the University of Nairobi using anonymous, self-administered questionnaires.
RESULTS: Questionnaires were distributed to 85% of a possible 343 students and returned by 44% (152). Half reported having accessed some form of new medical information within the previous 12 months, most commonly from books and the internet. Few students reported regular access; and specific, new journal articles were rarely accessed. Absence of internet facilities, slow internet speed and cost impeded access to literature; and current training seems rarely to encourage students to seek new information.
CONCLUSION: Almost half the students had not accessed any new medical information in their final year in medical school. This means they are ill prepared for a career that may increasingly demand life-long, self-learning.

Trop Med Int Health. 2009 Jan;14(1):118-22. doi: 10.1111/j.1365-3156.2008.02209.x.

2006

Obonyo, N, Cheroigin K, Kariuki M, Sumuni K, Lang’at O, Njogu B, Masika M, Patel N.  2006.  The Effects of MÛGÛKA (Catha edulis vahl) on the Behaviour of Rats. Nairobi Journal of Medicine. Abstractabstract_-_the_effects_of_muguka_on_rats.pdfeffects_of_muguka_catha_edulis_vahl_on_the_behavior_of_rats-_nairobi_journal_of_medicine_jun_2006.pdf

The Effects of MÛGÛKA (Catha edulis vahl) on the Behaviour of Rats

N.G Obonyo, K.S Cheroigin, M.M Kariuki, K.M Sumuni, O Lang’at, Njogu, M.M Masika, N.B Patel

INTRODUCTION: Mûgûka (Catha edulis vahl) are ‘residue’ leaves, which are chewed to elicit a stimulant effect. It is grown in Eastern province (mostly in Mbeere and Embu districts) of Kenya and is very popular with the local residents in this part of the country. It is closely related to miraa (Catha edulis forsk), which is reported to be one of the most recklessly abused drugs in Kenya by NACADA (National Agency for the Campaign Against Drug Abuse). Whereas lots of research has been done on miraa, little, if any, research has been done on mûgûka.

OBJECTIVE: To determine the effects of mûgûka on the behaviour of Sprague Dawley rats.

MATERIALS AND METHODS: Five Sprague Dawley rats were used. The experiment was divided into three phases: Baseline, Normal saline and Mûgûka. Baseline phase established the normal behaviour of the rats before injection of mûgûka plant extract (mûgûka phase). Normal saline was used as a control. We conducted an Open field Test. The behaviours exhibited during a 30-minute trial were recorded for each of the experimental phases. The four behavioural parameters recorded for each experimental phase were line crossings, rearing counts, grooming time and defecation pellets count.

RESULTS: The behavioural changes noted after injection of mûgûka plant extract were; the line crossing counts increased but the grooming time, rearing counts and defecation pellet counts decreased. However, none of these changes was statistically significant. Sniffing behaviour was also markedly increased when the mûgûka was administered.

DISCUSSION: The results obtained above suggest that there are changes in the behavioural parameters although they are not statistically significant. The sample size probably needs to be increased and serial dose-response measurements for the injected mûgûka plant extract need to be done.

Keywords: Mûgûka (Catha edulis vahl), miraa (Catha edulis forsk), NACADA (National Agency for the Campaign Against Drug Abuse) in Kenya

Published in the Nairobi Journal of Medicine, June 2006

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