http://ir.mu.ac.ke:8080/jspui/handle/123456789/70 2026-06-07T05:31:28Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10160 Incidence of hypertension and factors associated with blood pressure control among older adults living with HIV in Western Kenya: a retrospective cohort study Kiplagat, Jepchirchir; Mugo, Richard; Musick, Beverly; Mwangi, Ann; T. Yiannoutsos, Constantin; Wools-Kaloustian, Kara Background People living with HIV are living longer due to expanded access to antiretroviral treatment (ART). As they age, their risk of hypertension is greater due to HIV-immune activation and long-term use of some antiretrovirals. Screening and treatment of hypertension and monitoring hypertension control are key strategies for averting morbidity and mortality from cardiovascular disease and improving the health outcomes of older adults living with HIV (OALWH). We sought to estimate the incidence of hypertension and determine the proportion of blood pressure control among OALWH in western Kenya. Methods We analyzed deidentified clinical data for OALWH (≥ 50 years) attending a large HIV care and treatment program in western Kenya, between January 1, 2016, and August 24, 2021. Hypertension was defined by two consecutive blood pressure (BP) readings with systolic BP (SBP) ≥ 140 and diastolic BP (DBP) ≥ 90, a clinical diagnosis of hypertension, or the use of hypertension medication. Screening and monitoring were defined as having BP measurements in individuals without or with hypertension, respectively. Descriptive statistics and logistic regression assessed baseline characteristics and factors associated with hypertension. Linear mixed models estimated the rates of screening, monitoring, BP control, and sex differences. Results Of 6216 eligible OALWH, 52.5% were female and 23.0% were hypertensive at baseline. Baseline factors associated with hypertension included, age, body mass index, sex, prior ART exposure and having health insurance. On follow up, 91.1% (95% CI, 90.8%-91.4%) of non-hypertensive individuals were screened. The incidence of hypertension was 84 cases per 1000-person years. Of individuals with hypertension, 91.2% (95% CI, 90.9%-91.5%) were monitored and 47.9% (95% CI, 46.6%, 49.1%) achieved BP control. No gender differences were identified in BP screening, monitoring, or control rates. Conclusion The high incidence of hypertension with less than half of those with hypertension achieving controlled BP, reveals a significant gap between detection and effective management. This highlights the needs not only in the continuity of hypertension screening but also the need for strengthened hypertension management within HIV programs. 2026-03-30T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/9882 Socioeconomic status and partaking in air pollution monitoring are associated with cookstove usage across three peri-urban communities in sub-Saharan Africa Lorenzetti, Federico; Wilson, Daniel; Menya, Diana; Mangeni, Judith While transitioning from polluting cooking fuels (e.g. wood, charcoal) to cleaner fuels, like liquefied petroleum gas (LPG), can lead to time savings, the amount of time saved is uncertain due to minimal stove use monitoring (SUM) data. Approximately three months (mean:82 days (SD:41)) of SUM data from Geocene temperature sensors was collected from 186 households in Mbalmayo, Cameroon; Obuasi, Ghana and Eldoret, Kenya. Households exclusively using LPG (mean:1 h 22 min/day) cooked for two hours/day less than those stacking LPG and polluting fuels (3 h 19 min/day), and almost three hours/day less than those exclusively using polluting fuels (4 h 10 min/day). Financially insecure households exclusively using polluting fuels cooked for ~ 45 min longer (4 h 29 min) than financially secure households (3 h 45 min). During a 24-hour household air pollution (HAP) monitoring period, average cooking time was 38 min longer (3 h 48 min vs. 3 h 10 min) and households cooked nearly once more per day (3.63 events) than during the remaining SUM period (2.72 events). Longer cooking times among financially insecure polluting fuel users suggests that LPG access may disproportionately benefit poorer households via greater time savings. Households may cook for longer-than-normal when monitored for HAP. 2025-07-01T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/9881 Public health facility vulnerabilities, preparedness, and health outcomes for Plasmodium falciparum and dengue virus-infected children under 5 years with acute febrile illnesses in Western Kenya Ogony, Jack; Mangeni, Judith; Menya, Diana; Ayodo, George Introduction Climate change and infectious health risks are threatening healthcare systems, cascading into devastating consequences globally. This crisis is altering the footprints of many vector-borne disease control programs. Sub-Saharan countries face complex challenges as patterns of vector-borne diseases transform, causing more than 17% of the global mortality. Climate change-related disasters are increasing worldwide, with Sub-Saharan Africa being the most prone region. Although healthcare facilities should be on the front line in protecting lives, they are often under pressure and are vulnerable to extreme weather events. Public healthcare preparedness and the associated health outcomes are less frequently considered. Methodology This was a three-month follow-up prospective cohort study that determined public health facility vulnerability, preparedness, and health outcomes through a questionnaire administered to facilities in charge, guardians of children seeking health services, and those with acute febrile illnesses. Key Informant Interviews were conducted with selected members of the County's Health Management Team. Results A total of 378 participants were successfully followed. A total of 17 (81.0%) facilities were able to diagnose and treat malaria, while 4 (18.0%) were only able to diagnose and treat dengue virus cases. In Bunyala Sub-County, 6 of the 10 facilities were located on or near floodplains or wetlands, while 5 (45.0%) facilities in Kisumu had the same location. The longest hospitalizations (>5 days) were observed at the Kisumu site, while the highest recovery rate [184 (96.8%)] was noted in Bunyala Sub-County compared to 171 (91.0%) in Kisumu. Conclusion Public health facilities are not only vulnerable but also unprepared to contain the rising climate change-driven infectious disease burden. Even though healthcare facilities are fairly able to diagnose and treat malaria, the majority lack the ability to diagnose and treat dengue fever. Longer hospitalization was highest among children diagnosed with dengue fever. There is a need for enhanced arboviral disease surveillance and policies on integrated multisectoral approaches to reduce health system vulnerabilities and increase preparedness. 2025-07-01T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/9841 Socioeconomic status and partaking in air pollution monitoring are associated with cookstove usage across three periurban communities in sub-Saharan Africa Mangeni, Judith While transitioning from polluting cooking fuels (e.g. wood, charcoal) to cleaner fuels, like liquefied petroleum gas (LPG), can lead to time savings, the amount of time saved is uncertain due to minimal stove use monitoring (SUM) data. Approximately three months (mean:82 days (SD:41)) of SUM data from Geocene temperature sensors was collected from 186 households in Mbalmayo, Cameroon; Obuasi, Ghana and Eldoret, Kenya. Households exclusively using LPG (mean:1 h 22 min/day) cooked for two hours/day less than those stacking LPG and polluting fuels (3 h 19 min/day), and almost three hours/day less than those exclusively using polluting fuels (4 h 10 min/day). Financially insecure households exclusively using polluting fuels cooked for ~45 min longer (4 h 29 min) than financially secure households (3 h 45 min). During a 24-hour household air pollution (HAP) monitoring period, average cooking time was 38 min longer (3 h 48 min vs. 3 h 10 min) and households cooked nearly once more per day (3.63 events) than during the remaining SUM period (2.72 events). Longer cooking times among financially insecure polluting fuel users suggests that LPG access may disproportionately benefit poorer households via greater time savings. Households may cook for longer-than-normal when monitored for HAP. 2025-01-01T00:00:00Z