http://ir.mu.ac.ke:8080/jspui/handle/123456789/1 2026-07-21T01:21:19Z 2026-07-21T01:21:19Z Mugalo, Edward Kemboi, Mathew Kipkemboi, Kevin Abdulhai, Sophia Akute, Alma Langat, Caleb Axt, Jason Peter, Saula http://ir.mu.ac.ke:8080/jspui/handle/123456789/10373 2026-07-20T12:07:51Z 2025-12-01T00:00:00Z

NAVIGATING COMPLICATIONS FROM CULTURAL CIRCUMCISION: A QUALITATIVE CASE SERIES OF PATIENT EXPERIENCES AT A TERTIARY REFERRAL HOSPITAL IN KENYA Mugalo, Edward; Kemboi, Mathew; Kipkemboi, Kevin; Abdulhai, Sophia; Akute, Alma; Langat, Caleb; Axt, Jason; Peter, Saula Background: Male circumcision is widely practiced across Kenya through either voluntary medical circumcision, performed in healthcare facilities, or traditional cultural circumcision (CC), conducted within community settings. There has been an alarming increase in circumcision-related complications presenting to Kenyan hospitals, particularly associated with CC. These findings emphasize a need for evidence-based management protocols to reduce circumcision-related complications, but the culturally charged nature of CC demands respect and preservation of traditional practices. We aimed to explore patient and family experiences in managing post-circumcision complications to better understand key values and opportunities amenable to intervention for improving the safety of circumcision practices in our setting. Methods: This study is a case-series report anchored in qualitative interviews with a cohort of patients who presented to our hospital with three categories of circumcision-related complications including wound infection/sepsis, bleeding, and penile amputation. The study team completed phone interviews with December 2025 EAST AFRICAN MEDICAL JOURNAL 8997 families of eligible patients, and rapid qualitative matrix techniques were used to analyse data. Results: We enrolled six boys in our study with two representative patients in each main complication category. We identified four main thematic domains: “Lack of standardized practices increases risk for complications”, “families lack insight into qualifications of circumcision providers”, “families remain a major source of post-procedural care”, and “financial and psychological consequences of circumcision complications are significant”. We have also included a section for requests made by families regarding circumcision care. Conclusion: Societal pressure to conform to tradition drives a preference for CC, despite high practice variability which leads to increased complication risks. Collaborating with communities and traditional providers is key to developing standardized procedural methods. Empowering patients and families in their care, improving provider accountability, and providing multifaceted support in the presence of complications are critical to ensuring positive results from this important traditional rite.

2025-12-01T00:00:00Z Oduor, Charles Sore Mugalo, Edward Kirongo, Geoffrey http://ir.mu.ac.ke:8080/jspui/handle/123456789/10332 2026-07-14T12:43:05Z 2024-12-01T00:00:00Z

CLINICOPATHOLOGICAL FEATURES OF URINARY BLADDER CANCER MANAGED AT A TERTIARY HOSPITAL IN WESTERN KENYA Oduor, Charles Sore; Mugalo, Edward; Kirongo, Geoffrey Background: Urinary bladder cancer is the ninth leading cause of morbidity and mortality globally, necessitating characterization of clinical and pathological features for early detection and improved management. Objective: To profile and document the clinicopathological features of urinary bladder cancer at Moi Teaching and Referral Hospital (MTRH). Materials and methods: A prospective assessment of patients diagnosed with urinary bladder cancer. Patient characteristics and associated causal factors obtained from full clinical evaluation and review of clinical records. Tumour characterization was based on examination and review of radiological imaging and histopathology findings and documented in structured questionnaires. Descriptive statistics and tests of association used Fisher’s exact tests for socio-demographic characteristics, causal factors, histological type, and Tumor, Node, Metastasis (TNM) stage of bladder cancer. Results: Forty-five patients aged between 21 to 85 (mean: 61.84 ± 14.46) years with urinary bladder cancer were evaluated. Males were 68.9% and painless hematuria was most common symptom. Exposure to agrochemicals (60%) and cigarettes smoking (mean pack years = 9.43 ±6.198) in 31%. Clinical staging showed 71.1% with T1, while 6.7% had metastatic disease. 55.6% had TNM stage I, while 91.1% had low-grade tumors. Transitional cell carcinoma (51.1%) was the most common histological type. Agrochemicals exposure was associated with low-grade tumors (p=0.013), TNM clinical stage I (p=0.021), and adenocarcinoma (p=0.029). Conclusions: Urinary bladder cancer affected males over 60 years old with a history of smoking and agrochemical exposure. Majority presented with classical symptoms of early disease and low-grade tumors. History of exposure to agrochemicals was a significant risk factor.

2024-12-01T00:00:00Z Musau, Pius Mugalo, Edward Akello, Walter Rono, Dennis http://ir.mu.ac.ke:8080/jspui/handle/123456789/10329 2026-07-14T09:34:50Z 2024-10-10T00:00:00Z

THE EFFECTS OF ADVANCED PROSTATE CANCER MANAGEMENT ON HEALTH SERVICE CARE PROVIDERS IN WESTERN KENYA REGION Musau, Pius; Mugalo, Edward; Akello, Walter; Rono, Dennis Background: The management of advanced prostatic cancer patients in hospitals are known to impact on the patient as well as the core health care services providers, and patient’s relatives. This study was purposed to examine for the effects and put forward suggestions to ameliorate the negative impacts. Objective: To establish the effects of advanced prostate cancer management outcome on the involved health care service providers. Design: Cross-sectional study with in-depth interviews of core healthcare service providers. Setting: County Referral Hospitals of the 8 counties in western Kenya region. Subjects: Fifty-six healthcare service providers involved in the management of prostate cancer patients in the region. Results: The respondents’ ages ranged between 27 years and 59 years with a mean ±standard deviation of 40.1 ± 7.7 years. Majority of the patients (92.9%) presented with advanced disease. Major treatment options offered were palliative care and symptoms control. The stated effects on the healthcare providers included disappointment with the management processes, limited options of care, low morale, and poor job satisfaction. The suggested ways to improve the care were focused on cancer health support, improved human resources, and infrastructural quality for dedicated services. Conclusion: Advanced prostate cancer management in the Western region of Kenya was limited to palliative care and symptoms control. The health care service providers were negatively impacted by the poor outcome of management and the suggestions were to improve human and infrastructural support for better outcomes.

2024-10-10T00:00:00Z Hagembe, Mildred N Barasa, FA Njiru EW1, EW http://ir.mu.ac.ke:8080/jspui/handle/123456789/10231 2026-06-19T10:05:41Z 2018-09-01T00:00:00Z

Burden of Cardiac Disease among Patients Undergoing Chronic Haemodialysis at Moi Teaching and Referral Hospital, Eldoret, Kenya Hagembe, Mildred N; Barasa, FA; Njiru EW1, EW Cardiovascular Disease (CVD) is the leading cause of mortality in patients with End Stage Renal Disease (ESRD) globally. Renal replacement therapy improves the quality of life of these patients but CVD remains a threat to their survival. Whereas atherosclerotic coronary artery disease is the leading culprit in high income countries, this has not been characterized in Kenya. Objective: To determine the prevalence and spectrum of cardiac disease in patients with ESRD undergoing haemodialysis at Moi Teaching and Referral Hospital (MTRH), a tertiary medical centre in Western Kenya. Methods: This was a cross sectional study conducted at MTRH renal unit. Consenting consecutive adults with ESRD undergoing chronic heamodialysis were enrolled into the study after obtaining ethical approval from the institution’s review board. Data on socio demographics, medical and drug history was collected using a structured questionnaire followed by a focused cardiovascular examination. A standard trans-thoracic echocardiogram was done by a study dedicated sonographer and interpreted by a cardiologist using American Society of Echocardiography guidelines. A standard 12 lead resting ECG was also done and read by the same cardiologist. Outcomes of interest included Left Ventricular Hypertrophy (LVH), Left Ventricular Ejection Fraction (LVEF), pathological valve disease, pathological Q waves and arrhythmias. The prevalence estimates were reported with the corresponding 95% confidence intervals. Results: Seventy two participants were included in the final analysis. Their median age was 41 (29.8, 60) years and 51.3% were male. Majority (93%) were on two sessions of dialysis per week, with 97.2% being known hypertensives. Almost three quarters of them (72.2%) had some form of cardiac disease as follows; left ventricular hypertrophy 58%, left ventricular systolic dysfunction 49%, pathological valvular disease 15.3%, arrhythmias 9.7% and pathological Q waves 6.9%. Conclusion: There is a high burden of cardiac disease in patients with ESRD on heamodialysis at MTRH with the predominant lesions being LVH and left ventricular systolic dysfunction.

2018-09-01T00:00:00Z