Browsing by Author "Said, Jamil"

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    Integrating community-based HIV and non-communicable disease care with microfinance groups: a feasibility study in Western Kenya
    (BMC, 2022-12-28) Kafu, Catherine; Wachira, Juddy; Omodi, Victor; Said, Jamil; Pastakia, Sonak D.; Tran, Dan N.; Adongo Onyango, Jael; Aburi, Dan; Wilson‑Barthes, Marta; Galárraga, Omar; Genberg, Becky Lynn; Medicine, School of Medicine
    Background: The Harambee study is a cluster randomized trial in Western Kenya that tests the effect, mechanisms, and cost-effectiveness of integrating community-based HIV and non-communicable disease care within microfinance groups on chronic disease treatment outcomes. This paper documents the stages of our feasibility study conducted in preparation for the Harambee trial, which include (1) characterizing the target population and gauging recruitment capacity, (2) determining community acceptability of the integrated intervention and study procedures, and (3) identifying key implementation considerations prior to study start. Methods: Feasibility research took place between November 2019 and February 2020 in Western Kenya. Mixed methods data collection included surveys administered to 115 leaders of 105 community-based microfinance groups, 7 in-person meetings and two workshops with stakeholders from multiple sectors of the health system, and ascertainment of field notes and geographic coordinates for group meeting locations and HIV healthcare facilities. Quantitative survey data were analyzed using STATA IC/13. Longitude and latitude coordinates were mapped to county boundaries using Esri ArcMap. Qualitative data obtained from stakeholder meetings and field notes were analyzed thematically. Results: Of the 105 surveyed microfinance groups, 77 met eligibility criteria. Eligible groups had been in existence from 6 months to 18 years and had an average of 22 members. The majority (64%) of groups had at least one member who owned a smartphone. The definition of "active" membership and model of saving and lending differed across groups. Stakeholders perceived the community-based intervention and trial procedures to be acceptable given the minimal risks to participants and the potential to improve HIV treatment outcomes while facilitating care integration. Potential challenges identified by stakeholders included possible conflicts between the trial and existing community-based interventions, fear of group disintegration prior to trial end, clinicians' inability to draw blood for viral load testing in the community, and deviations from standard care protocols. Conclusions: This study revealed that it was feasible to recruit the number of microfinance groups necessary to ensure that our clinical trial was sufficient powered. Elicitation of stakeholder feedback confirmed that the planned intervention was largely acceptable and was critical to identifying challenges prior to implementation.
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    Neurological conditions among pediatric patients seeking care at a tertiary level hospital in western Kenya
    (Public Library of Science, 2025-04-15) Oyungu, Eren; McHenry, Megan Song; Oduor, Chrispine; Said, Jamil; Kyololo, O’Brien; von Gaudecker, Jane R.; School of Nursing
    Neurological disorders significantly contribute to the global burden of diseases, especially in sub-Saharan Africa. However, within local contexts in Kenya, little is known about the pattern of neurological and neurosurgical disorders within pediatric populations. A 3-month cross-sectional observational study was conducted at a tertiary-level hospital in western Kenya to describe these patterns and basic characteristics of the patient population. Consecutive pediatric patients presenting for neurological and neurosurgical care in inpatient and outpatient settings at Moi Teaching and Referral Hospital were included in the study. A total of 485 patients were included in the study. The average age of the patients was 6.2 years, and most were male (57%). Out of these, 30.3% (n=147) were inpatients, and 69.7% (n=338) were outpatients. Inpatients traveled longer distances compared to outpatients (P<0.001), and most were from rural areas (P<0.0001), while outpatients were mostly from peri-urban areas (P<0.0001). The majority of the inpatients (25%) and outpatients (69%) had a diagnosis of epilepsy. Other common neurological conditions were neurodevelopmental delays and meningitis/encephalitis. Given the burden of these diseases, there is a need to improve the health infrastructure for better access to quality healthcare. Specifically, improving epilepsy care, supporting neurodevelopmental programs, managing infectious diseases, and expanding neurosurgical services can enhance health infrastructure for this population.
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    Pattern and frequency of neurological and neurosurgical care of adult inpatients and outpatients at a tertiary referral hospital in Kenya
    (Elsevier, 2020-12) von Gaudecker, Jane; Oduor, Chrispine; Ofner, Susan; Oyungu, Eren; Said, Jamil; Buelow, Janice
    Objective: To describe the patterns and burden of neurological and neurosurgical disorders at a national tertiary level referral hospital in western Kenya. Methods: We conducted a three-month period prevalence study. We recruited consecutive adult patients seeking neurological-neurosurgical care in both inpatient and outpatient settings at Moi Teaching and Referral Hospital. Results: 833 participants were included. The age range was between 19 year and 99 years (mean age = 45.3 years). The most common diagnoses among neurology inpatients were meningitis (12%), ischemic stroke (11.0%) and epilepsy/seizure (6.7%). Among neurology outpatients, epilepsy (35.1%) and ischemic stroke (18.8%) were the most common diagnoses. The most common neurosurgery inpatient diagnosis was hemorrhagic stroke (16.3%) and among outpatients, the most common diagnoses were traumatic brain injury (17.4%) and hemorrhagic stroke (16.3%). Overall, 471 (56.5%) patients underwent HIV testing, of which, 89 (18.9%) were HIV positive and 382 (81.1%) were HIV negative. Thirty-one inpatient deaths (male 58%), attributable to neurological and neurosurgical disorders, occurred during the study period. Meningitis was the most common cause of death. Conclusions: The findings suggest that meningitis, stroke, epilepsy, and traumatic brain injury were the most common diagnosis. More resources and efforts should be directed towards prevention, diagnosis and management of these conditions in the region.