Publications


2012

Kamau, JW, Kuria W, Mathai M, Atwoli L, Kangethe R.  2012.  Psychiatric morbidity among HIV-infected children and adolescents in a resource-poor Kenyan urban community. Abstract

The course of HIV / AIDS in children has been transformed from an acute to a chronic one with the advent of Anti-Retroviral Therapy. The aim of this study was to determine the prevalence and pattern of psychiatric morbidity in HIV-infected children and adolescents between 6 and 18 years of age and the relationship between their socio-demographic factors, immune suppression and psychiatric morbidity. The study was conducted at a paediatric HIV clinic in Nairobi, between February and April 2010. One hundred and sixty-two HIV-infected children and adolescents aged between 6 and 18 years and their guardians were interviewed. Seventy-nine (48.8%) of the study participants were found to have psychiatric morbidity. The most prevalent Diagnostic Statistical Manual, 4th Edition TR psychiatric disorders were: Major depression (17.8%), Social phobia (12.8%), Oppositional Defiant Disorder (12.1 %) and Attention Deficit Hyperactivity Disorder (12.1 %). Twenty-five per cent of the study participants had more than one psychiatric disorder. The prevalence of psychiatric morbidity in HIV-infected children is higher than that found in children in the general population. There is therefore a need to integrate psychiatric services into the routine care of HIV-infected children.

2006

Dhadphale, M, Kangethe R.  2006.  Prevalence Of Psychiatric Illness Among Kenyan Children.
Kang'ethe, RN, Nguithi AN, Njenga FG.  2006.  War and mental disorders in Africa. Abstract

Many wars continue to engulf Africa, from east to west and from north to south, leaving many Africans severely traumatized (1). Musisi (2), in his chapter in the recently published volume "Essentials of clinical psychiatry for sub- Saharan Africa", reports significant physical and psychological war-related trauma inflicted to the Ugandans in their homes, at military checkpoints and in detention. The most commonly encountered mental disorders were found to be post-traumatic stress disorder (PTSD) at 39.9%, depression at 52%, anxiety at 60% and somatization disorder at 72.2%. The prevalence of suicidal behaviour was recorded as 22.7% and that of alcohol abuse as 18.2%. These incredibly high figures for mental disorders in war-affected Ugandans are reflected by another recent study among internally displaced Kenyans following ethnic clashes in parts of the country. Njau (3) found, in this highly traumatized population, a prevalence rate of 80.2% of PTSD amongst the heads of households. Neuner et al (4) studied a random sample of 3,339 refugees in the west Nile region, including Ugandans and Sudanese, and found that 31.6% of the male and 40.1% of the female respondents fulfilled the criteria for a DSM-IV PTSD diagnosis. He also found a near linear rise of psychological strain with the increasing number of traumatic events, ranging from a 23% prevalence of PTSD in those who reported three or fewer pre-defined traumatizing experiences to a 100% prevalence in those who reported 28 or more traumatic events. In a recent study, Pham et al (5) found that, among the 2091 participants who survived the 1994 genocide in Rwanda, 24.8% met the symptom criteria for PTSD. All these studies support the fact of the existence of recognizable PTSD within African populations. This reality, however, is in contrast to that held by some experts (6) who state that PTSD in Africa is a pseudo-diagnosis by Western agencies who medicalize understandable social consequences of war and who bring about Western models of management that are inappropriate. It is precisely this type of misconception that sets Africa aside and apart from the rest of the world when it comes to the conceptualization of PTSD. There is ample evidence in support of the fact that Western conceptualizations of PTSD have validity in Africans, and that war survivors in Africa can and do show symptoms of PTSD (7-9). It is expected that this Forum will stimulate thinking and action not only among African academics but also among aid agencies. These ought to wake up to the reality that the prevalence of mental disorders in Africa is likely to be extremely high, as a direct result of the wars that have caused many to lead lives as refugees. While attention of the Africans and the world have (correctly) in the last few decades focused on infectious diseases including HIV/AIDS, it would seem reasonable to now accept that mental health consequences of war and displacement are contributing significantly in setting back the continent from achieving the millennium development goals. A number of questions arise from Murthy and Lakshminarayana's paper, and in the African context demand answers. The first relates to the longterm outcome of those traumatized by the various wars. Whereas there is some suggestion from Mozambique (10) that PTSD rates go down over time, other long-term studies would suggest otherwise (11,12). Indeed, eight years after the genocide in Rwanda, a quarter of the studied population showed diagnosable PTSD (7). This, projected to the actual numbers of Africans traumatized in Sudan, Sierra Leone, Democratic Republic of Congo, Ivory Coast, Somalia and other parts of Africa, translates to millions of people in need of help. Community interventions such as those tried in Mozambique (10) hold some promise, as do initiatives such as the South Africa Truth and Reconciliation Commission (13).

2005

N, DRKANGETHERACHEL.  2005.  Kangethe et al. Obsessive-Compulsive Personality Disorder: The African Dilemmas, in the book . WPA Series, Evidence and Experience in Psychiatry Volume 8. Wiley. 2005.. : Journal of School of Continuous and Distance Education Abstract
Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]
N, DRKANGETHERACHEL.  2005.  Kangethe R ...Child and Adolescent Psychiatry Chapter in textbook, . Essentials of Clinical Psychiatry in Sub Saharan Africa. : Journal of School of Continuous and Distance Education Abstract
Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

2004

N, DRKANGETHERACHEL.  2004.  Njenga, F.G., Kang. East African Medical Journal. Vol.8.No.4., pp188.. : Journal of School of Continuous and Distance Education Abstract
Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

2003

N, DRKANGETHERACHEL.  2003.  Njenga, F.G., Kang. East African Medical Journal. June. Vol.80 No.6, 281.. : Journal of School of Continuous and Distance Education Abstract
Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

1991

N, DRKANGETHERACHEL.  1991.  Kang. East African Medical Journal. 68, 526-531.. : Journal of School of Continuous and Distance Education Abstract
Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

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