https://repository.seku.ac.ke/handle/123456789/1817 2026-08-05T06:33:46Z 2026-08-05T06:33:46Z Muthiani, Alice N. Shariff, Nilufa Jivraj Kyalo, Mutisya https://repository.seku.ac.ke/handle/123456789/8411 2026-07-31T08:14:37Z 2020-07-01T00:00:00Z

Institutional related factors influencing emergency preparedness among nurses at Machakos level 5 hospital Machakos County, Kenya Muthiani, Alice N.; Shariff, Nilufa Jivraj; Kyalo, Mutisya BACKGROUND An emergency plan is a dynamic document that frequently set and adapt to the changing trends of emergencies. Prioritizing and anticipating for situations that are not easily predicted requiring immediate action can be challenging. Health care institutions should continually remain prepared in order to handle emergencies and disasters effectively. Machakos Level 5 Hospital serves as a link to health facilities in the Eastern part of Kenya and the main referral centre for it's neighbouring counties. With the overwhelming influx of patients, quality nursing care delivery is a hospital responsibility to support its professionals. OBJECTIVES To recognize an emergency management plan as an essential framework for providing quality nursing care to the affected victims in case of an emergency This study chose to determine the institutional related factors at Machakos Level 5 Hospital (ML5H). METHODOLOGY Utilizing a descriptive cross-sectional design between October and December 2018, 132 nurses’ working at ML5H were enrolled using stratified and systemic random sampling after consenting to participate in the study. Data was collected using a self-administered questionnaire and an observation checklist. Cochrane’s formula was used to calculating the sample size, after which duty rosters were used to pick every third nurse on the roster. The questionnaire was divided into 2 parts; the first part consisted Institutional related factors influencing emergency preparedness and the second contained an observation checklist used to measure the level of emergency preparedness in the health facility. A pre-test was carried out at the Accident and Emergency Unit of Makueni Level 5 Hospital to measure the validity and reliability of the research instruments using the Cronbach alpha coefficient. The Data was coded and entered into Statistical Package for Social Science (SPSS) version 25. RESULTS The study highlight how the hospital management supported over 70% of emergency preparedness unlike 76.5% of the respondents reporting that the hospital did not provide regular emergency drills while 23.5% reported there were regular drills. CONCLUSION The results showed that, 83.3% of emergency preparedness measures were available while 16.7% of emergency preparedness measures were not available. The study recommends that the 36 African Journal of Health Sciences Volume 33, Issue No.4, July - August, 2020 hospital liaise with the County Government of Machakos to provide regular drills to all health workers working in the hospital.

2020-07-01T00:00:00Z Muthiani, Alice N. Kagwaini, Hellen M. Mwenda, Catherine S. https://repository.seku.ac.ke/handle/123456789/8410 2026-07-31T07:57:54Z 2022-05-01T00:00:00Z

Factors influencing adherence to Asthma control measures among patients in mama Lucy Kibaki hospital, Nairobi Kenya Muthiani, Alice N.; Kagwaini, Hellen M.; Mwenda, Catherine S. BACKGROUND Asthma is an obstructive respiratory disease characterized by wheezing, chest tightness, cough and shortness of breath that is evidenced by expiratory airflow limitation. Patient awareness of asthma control measures is key in ensuring compliance with asthmatic drugs. The main aim of the study was to assess determinants of adherence to asthma control measures among adult asthmatic clients attending chest clinics in Mama Lucy Kibaki Hospital. MATERIALS AND METHOD We employed a descriptive cross-sectional study design involving asthmatic patients interviewed at Mama Lucy Kibaki Hospital in Nairobi, Kenya. The study participants had to have been diagnosed with asthma for at least three months preceding the study, attend the chest clinic and consent to participate in the study. We pretested the study tools at Mbagathi county hospital on 11 asthmatic patients. A systematic random sampling method was used to select 110 study participants and data was collected using a modified questionnaire and lung function test between March to June 2018. Quantitative data was analyzed using SPSS 22.0. The Chi-square test was used to establish the association between independent variables and asthma adherence control measures at a 95% confidence interval. RESULTS Our findings report a response rate of 89% (98). The majority (58.2%) of participants were females. On average 57.1% had good adherence to asthma control measures. Control of asthma was poor, with well-controlled being 27.5%, moderately controlled at 53.1% and poorly controlled at 19.4%, respectively P (0.003). Respondents with adequate knowledge were 56.1% and positive attitude with 71.2%. There was a significant association between adherence to asthma control measures and participants’ attitude (P-value=0.000), knowledge (P-value=0.000), level of education (P-value=0.000), level of asthma control (P-value=0.003). Environmental factors were cleaning carpets/curtains (P-value=0.001), type of fuel (P-value=0.003), and use of carpet (P-value=0.014). CONCLUSION Adherence to asthma control measures was suboptimal resulting in a generally poor asthma control. Adequate knowledge was associated with a positive attitude. Adherence was strongly associated with attitude, knowledge, education and asthma control.

2022-05-01T00:00:00Z Mangare, Caroline Tischer-Zimmermann, Sabine Bonifacius, Agnes Riese, Sebastian B. Dragon, Anna C. Blasczyk, Rainer Maecker-Kolhoff, Britta Eiz-Vesper, Britta https://repository.seku.ac.ke/handle/123456789/8408 2026-07-24T08:28:49Z 2022-02-01T00:00:00Z

Variances in antiviral memory T-cell repertoire of CD45RA- and CD62L-depleted lymphocyte products reflect the need of individual T-cell selection strategies to reduce the risk of GvHD while preserving antiviral immunity in adoptive T-cell therapy Mangare, Caroline; Tischer-Zimmermann, Sabine; Bonifacius, Agnes; Riese, Sebastian B.; Dragon, Anna C.; Blasczyk, Rainer; Maecker-Kolhoff, Britta; Eiz-Vesper, Britta Introduction: Viral infections and reactivations still remain a cause of morbidity and mortality after hematopoietic stem cell transplantation due to immunodeficiency and immunosuppression. Transfer of unmanipulated donor-derived lymphocytes (DLI) represents a promising strategy for improving cellular immunity but carries the risk of graft versus host disease (GvHD). Depleting alloreactive naïve T cells (TN) from DLIs was implemented to reduce the risk of GvHD induction while preserving antiviral memory T-cell activity. Here, we compared two TN depletion strategies via CD45RA and CD62L expression and investigated the presence of antiviral memory T cells against human adenovirus (AdV) and Epstein-Barr virus (EBV) in the depleted fractions in relation to their functional and immunophenotypic characteristics. Methods: T-cell responses against ppEBV_EBNA1, ppEBV_Consensus and ppAdV_Hexon within TN-depleted (CD45RA−/CD62L−) and TN-enriched (CD45RA+/CD62L+) fractions were quantified by interferon-gamma (IFN-γ) ELISpot assay after short- and long-term in vitro stimulation. T-cell frequencies and immunophenotypic composition were assessed in all fractions by flow cytometry. Moreover, alloimmune T-cell responses were evaluated by mixed lymphocyte reaction. Results: According to differences in the phenotype composition, antigen-specific T-cell responses in CD45RA− fraction were up to 2 times higher than those in the CD62L− fraction, with the highest increase (up to 4-fold) observed after 7 days for ppEBV_EBNA1-specific T cells. The CD4+ effector memory T cells (TEM) were mainly responsible for EBV_EBNA1- and AdV_Hexon-specific T-cell responses, whereas the main functionally active T cells against ppEBV_Consensus were CD8+ central memory T cells (TCM) and TEM. Moreover, comparison of both depletion strategies indicated that alloreactivity in CD45RA− was lower than that in CD62L− fraction. Conclusion: Taken together, our results indicate that CD45RA depletion is a more suitable strategy for generating TN-depleted products consisting of memory T cells against ppEBV_EBNA1 and ppAdV_Hexon than CD62L in terms of depletion effectiveness, T-cell functionality and alloreactivity. To maximally exploit the beneficial effects mediated by antiviral memory T cells in TN-depleted products, depletion methods should be selected individually according to phenotype composition and CD4/CD8 antigen restriction. TN-depleted DLIs may improve the clinical outcome in terms of infections, GvHD, and disease relapse if selection of pathogen-specific donor T cells is not available. https://doi.org/10.1159/000516284

2022-02-01T00:00:00Z Mangare, Caroline Tischer-Zimmermann, Sabine Riese, Sebastian B. Dragon, Anna C. Prinz, Immo Blasczyk, Rainer Maecker-Kolhoff, Britta Eiz-Vesper, Britta https://repository.seku.ac.ke/handle/123456789/8407 2026-07-24T08:00:54Z 2019-03-20T00:00:00Z

Robust identification of suitable T-cell subsets for personalized CMV-specific T-cell immunotherapy using CD45RA and CD62L microbeads Mangare, Caroline; Tischer-Zimmermann, Sabine; Riese, Sebastian B.; Dragon, Anna C.; Prinz, Immo; Blasczyk, Rainer; Maecker-Kolhoff, Britta; Eiz-Vesper, Britta Viral infections and reactivations remain a serious obstacle to successful hematopoietic stem cell transplantation (HSCT). When antiviral drug treatment fails, adoptive virus-specific T-cell transfer provides an effective alternative. Assuming that naive T cells (TN) are mainly responsible for GvHD, methods were developed to generate naive T-cell-depleted products while preserving immune memory against viral infections. We compared two major strategies to deplete potentially alloreactive T cells: CD45RA and CD62L depletion and analyzed phenotype and functionality of the resulting CD45RA−/CD62L− naive T-cell-depleted as well as CD45RA+/CD62L+ naive T-cell-enriched fractions in the CMV pp65 and IE1 antigen model. CD45RA depletion resulted in loss of terminally differentiated effector memory T cells re-expressing CD45RA (TEMRA), and CD62L depletion in loss of central memory T cells (TCM). Based on these differences in target cell-dependent and target cell-independent assays, antigen-specific T-cell responses in CD62L-depleted fraction were consistently 3–5 fold higher than those in CD45RA-depleted fraction. Interestingly, we also observed high donor variability in the CD45RA-depleted fraction, resulting in a substantial loss of immune memory. Accordingly, we identified donors with expected response (DER) and unexpected response (DUR). Taken together, our results showed that a naive T-cell depletion method should be chosen individually, based on the immunophenotypic composition of the T-cell populations present. doi:10.3390/ijms20061415

2019-03-20T00:00:00Z