Daystar University Repository :: Browsing by Author "Kihara, Michael"

Browsing by Author "Kihara, Michael"

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Auditory and Visual Novelty Processing in Normally-Developing Kenyan Children
(Clinical Neurophysiology, Elsevier, 2010) Kihara, Michael; Hogan, Alexandra M.; Newton, C. R.; Garrashi, Harrun H.; Neville, Brian R.; Haan, Michelle
Objective: The aim of this study was to describe the normative development of the electrophysiological response to auditory and visual novelty in children living in rural Kenya. Methods: We examined event-related potentials (ERPs) elicited by novel auditory and visual stimuli in 178 normally-developing children aged 4–12 years (86 boys, mean 6.7 years, SD 1.8 years and 92 girls, mean 6.6years, SD 1.5 years) who were living in rural Kenya. Results: The latency of early components (auditory P1 and visual N170) decreased with age and their amplitudes also tended to decrease with age. The changes in longer-latency components (Auditory N2, P3a and visual Nc, P3a) were more modality-specific; the N2 amplitude to novel stimuli decreased with age and the auditory P3a increased in both latency and amplitude with age. The Nc amplitude decreased with age while visual P3a amplitude tended to increase, though not linearly. Conclusions: The changes in the timing and magnitude of early-latency ERPs likely reflect brain maturational processes. The age-related changes to auditory stimuli generally occurred later than those to visual stimuli suggesting that visual processing matures faster than auditory processing. Significance: ERPs may be used to assess children’s cognitive development in rural areas of Africa
Behavioral Problems in Children with Epilepsy in Rural Kenya.
(Elsevier, 2012) Kariuki, Symon M.; Abubakar, Amina; Holding, Penny A.; Mung'ala-Odera, Victor; Chengo, Eddie; Kihara, Michael; Neville, Brian G.; Newton, C. R.
The aims of this study were to record behavioral problems in children with epilepsy (CWE), compare the prevalence with that reported among healthy children without epilepsy, and investigate the risk factors. A child behavioral questionnaire for parents comprising 15 items was administered to the main caregiver of 108 CWEand108controls matchedfor age inKilifi, Kenya. CWE had a higher mean score for reported behavioral problems than controls (6.9 vs 4.9, t=4.7, Pb0.001). CWE with active epilepsy also recorded more behavioral problems than those with inactive epilepsy (8.2 vs 6.2, t=−2.9, P=0.005). A significantly greater proportion of CWE (49% vs 26% of controls) were reported to have behavioral problems. Active epilepsy, cognitive impairment, and focal seizures were the most significant independent covariates of behavioral problems. Behavioral problems in African CWE are common and need to be taken into consideration in planning comprehensive clinical services in this region
Challenges and Coping Strategies of Parents of Children with Autism on The Kenyan Coast
(The International Electronic Journal of Rural and Remote Health Research, Education Practice and Policy., 2016) Kihara, Michael; Gona, J. K.; Newton, C. R.; Rimba, K. K.; Mapenzi, R.; Vijver, F. V.; Abubakar, A.
Introduction: Research on the challenges of raising a child with autism is mostly conducted in Europe, North America and Australia, and has revealed that parents have to come to terms with living with a lifelong developmental disability. In addition, parents are faced with numerous concerns, such as caring burdens, poor prognosis, and negative public attitudes. Virtually no research has been conducted in Africa on this subject. Methods: Thirty-seven interviews and eight focus group discussions were conducted with parents of children with autism and professionals in regular contact with these parents from rural and urban counties of the Kenyan coast. The study investigated challenges faced by parents and how they cope with those challenges. A purposive–convenience sampling procedure was used in selecting the study participants. A digital recorder was used to record all the interviews and focus group discussions. Transcriptions were done in Swahili, translated into English, and then imported to the NVivo software program for content analysis. Results: The results indicate that parents of children with autism on the Kenyan coast experience common challenges including stigma, lack of appropriate treatment, financial and caring burdens regardless of their religious and cultural backgrounds. Coping strategies applied by parents comprised problem-focused aspects that involve diet management and respite care, and emotion focused aspects that consist of beliefs in supernatural powers, prayers and spiritual healing. Consideration of these outcomes is vital as they could impact the initiation of a community-based rehabilitation service delivery in rural settings where parents play an active role. Conclusions: This qualitative study reveals a range of challenges that could have significant impact when caring for a child with autism. Coping strategies applied by parents target the physical health of the child and the psychological wellbeing of the parent.
Co-morbidity of Anxiety, alcohol and substance abuse among students at the Kenya Medical Training Colleges in Kenya
(2014-12) Muriungi, Susan K.; Kihara, Michael; Ndetei, David Musyimi; Matheka, Wambua C.; Kipturgo, Mathew
Objectives: to determine the co-morbidity between anxiety and risk ofstudents at the Kenya Medical Training CollegeMethodology:A Social Demographic, BAI and the WHO ASSIST questionnaires were administered to 3107 consenting KMTC students, of whom 1181 (group A) were in Nairobi campus and the remaining1926 (group B) were in peripheral campuses across the country.Results:Prevalence of anxiety in groups A and B were 24.4% and 23.6% for moderate anxiety and 32.1% and 31.5% for severe anxiety. The risk of abuse of all the substances had similar lin alcohol which had a significant difference between the 2 groups (p=0.016). There was significant association between co morbidity of anxiety and risk of abuse of; alcohol (p=0.040, P=0.036 in group A and B respectively) and tobacco and cannabis (p=0.022 and p=0.024 in group B respectively). Conclusion:Anxiety and risk of alcohol and drug abuse was prevalent and significantly coamong the KMTC students. These findings were similar to those from other regions of the world among college students. This calls for appropriate interventions to promote prevention, control and clinical practices.
Emotion Dysregulation Associated with Suicide Risk in Adolescent University Students: A Case Study of USIU-Africa
(African Journal of Clinical Psychology, 2023) Nderitu, Bernice Nyokabi; Kihara, Michael; Brown, Dana Basnight
Suicide is a major mental health burden, and Africa has the highest burden globally. Adolescence is a turbulent developmental period with multiple transitions, growth, maturation, and emotional lability. Emotional dysregulation is a transdiagnostic risk factor associated with suicide risk. The current study examined associations between emotion dysregulation and suicide risk in a community sample of adolescents using descriptive-analytic, cross-sectional design. The study participants were 352 adolescents aged 18 and 19 and enrolled at the United States International University-Africa (USIU-Africa). The instruments used were the Difficulties in Emotion Regulation Scale (DERs) and The Columbia Suicide Severity Rating Scale Short Version (C-SSRS). Results indicated that 75.8% had low risk, 2% had moderate risk, and 22.5% had a high risk of suicide. In addition, participants with high suicidal risk had significantly higher emotion regulation difficulties than those with low suicidal risk, p = 0.003. In conclusion, emotion dysregulation is associated with suicide risk in adolescent university students.
Impaired Everyday Memory Associated with Encephalopathy of Severe Malaria: The Role of Seizures and Hippocampal Damage.
(Malaria Journal, 2009) Kihara, Michael; Carter, Julie A.; Holding, Penny A.; Vargha-Khadem, Faraneh; Scott, Rod C.; Idro, Richard; Fegan, Greg W.
Background: Seizures are common in children admitted with severe falciparum malaria and are associated with neuro-cognitive impairments. Prolonged febrile seizures are associated with hippocampal damage and impaired memory. It was hypothesized that severe malaria causes impaired everyday memory which may be associated with hippocampal damage. Methods: An everyday memory battery was administered on 152 children with cerebral malaria (CM) (mean age, 7 y 4 months [SD 13 months]; 77 males) 156 children (mean age, 7 y 4 months [SD, 14 months]; 72 males) with malaria plus complex seizures (MS) and 179 children (mean age, 7 y 6 months [SD, 13 months]; 93 males) unexposed to either condition. Results: CM was associated with poorer everyday memory [95% CI, -2.46 to -0.36, p = 0.004] but not MS [95% CI, -0.91 to 1.16, p = 1.00] compared to unexposed children. Children with exposure to CM performed more poorly in recall [95% CI, -0.79 to -0.04, p = 0.024] and recognition subtests [95% CI, - 0.90 to -0.17, p = 0.001] but not in prospective memory tests compared to controls. The health factors that predicted impaired everyday memory outcome in children with exposure to CM was profound coma [95% CI, 0.02 to 0.88, p = 0.037] and multiple episodes of hypoglycaemia [95% CI, 0.05 to 0.78, p = 0.020], but not seizures. Discussion: The findings show that exposure to CM was associated with a specific impairment of everyday memory. Seizures commonly observed in severe malaria may not have a causal relationship with poor outcome, but rather be associated with profound coma and repeated metabolic insults (multihypoglycaemia) that are strongly associated with impaired everyday memory
Impairment of Executive Function in Kenyan Children Exposed to Severe Falciparum Malaria with Neurological Involvement.
(Malaria Journal, 2014) Kihara, Michael; Newton, C. R.; Abubakar, Amina; Kariuki,Symon M.
Background: Persistent neurocognitive impairments occur in a fifth of children hospitalized with severe falciparum malaria. There is little data on the association between different neurological phenotypes of severe malaria (seizures, impaired consciousness and prostration) and impairments in executive function. Methods: Executive functioning of children exposed to severe malaria with different neurological phenotypes (N =58) and in those unexposed (N=56) was examined using neuropsychological tests such as vigilance test, test for everyday attention test for children (TEA-Ch), contingency naming test (CNT) and self-ordered pointing test (SOPT). Linear regression was used to determine the association between neurological phenotypes of severe malaria and executive function performance scores, accounting for potential confounders. Results: Children with complex seizures in severe malaria performed more poorly than unexposed controls in the vigilance (median efficiency scores (interquartile range) = 4.84 (1.28-5.68) vs. 5.84 (4.71-6.42), P = 0.030) and SOPT (mean errors (standard deviation) = 29.50 (8.82) vs. 24.80 (6.50), P = 0.029) tests, but no differences were observed in TEA-Ch and CNT tests. Performance scores for other neurological phenotypes of severe malaria were similar with those of unexposed controls. After accounting for potential confounders, such as child’s age, sex, schooling; maternal age, schooling and economic activity; perinatal factors and history of seizures, complex seizures remained associated with efficiency scores in the vigilance test (beta coefficient (β) (95% confidence interval (CI)) = −0.40 (−0.67, −0.13), P = 0.006) and everyday attention scores of the TEA-Ch test (β (95% CI) = −0.57 (−1.04, −0.10), P = 0.019); the association with SOPT error scores was weak (β (95% CI)=4.57 (−0.73-9.89), P = 0.089). Combined neurological phenotypes were not significantly associated with executive function performance scores. Conclusion: Executive function impairment in children with severe malaria is associated with specific neurological phenotypes, particularly complex seizures. Effective prophylaxis and management of malaria-associated acute seizures may improve executive functioning performance scores of children.
Influence of Age and Gender on Mental Health Help-Seeking Behavior among Mental Patients in Nyeri County: A Survey of Nyeri County Referral Hospital
(African Journal of Education, Science and Technology, 2021-01) Gichimu, Elizabeth Wangari; Rono, C. Ruthie; Kihara, Michael
In a given year, around one in five people over the age of 18, suffer from a diagnosable mental disorder. According toWorld Health Organization (WHO) this condition interferes with their functionality and thus impacting their productivity in society. Considering the role played by the adult population in community development,this papersought to establish how their functionality has lagged behind due to the mental health of this category of people in Nyeri County. The study, therefore, sought to establish the effects of age as well as gender on the mental wellbeing and help-hunting conduct of adults attending Nyeri County Referral Hospital. The study employed a cross-sectional survey design targeting the adult population. A sample size of 200respondents was purposively selected andfrom whom data was collected using a General Help-Seeking Questionnaire (GHSQ) guide. The collected data was then descriptively analyzed and presented in structure of percentages, frequencies, and mean together with standard deviation. To find relationships for testing the hypothesis, chi-square tests were employed. Chi-square outcomes displayed a significant relationship [χ2(21) = 56.976, p= 0.000, v= 0.549] between age and seeking mental health help from a friend. Similarly, there was a significant relationship [χ2(21) = 37.530, p=0.015, v= 0.442] between age and seeking mental health help from relatives or family members. There was a significant relationship (χ2(3) = 10.368, p= 0.016, v= 0.234) between gender and seeking mental health help from parent. Age was found to have a greater influence on mental health seeking behavior in the County as compared with gender.
Levels of Depression in Men and Women Survivors of Intimate Partner Violence at a Gender Violence Recovery Centre in Kenya
(African Journal of Clinical Psychology, 2022) Waithira, Teresa; Arasa, Josephine; Kihara, Michael
Intimate Partner Violence (IPV) is a worldwide human rights violation and a preventable public health concern. It affects males and females globally and has been linked to adverse health sequela, including depression, PTSD, and suicidal ideation. Literature shows that developing countries are the worst affected by IPV. This mixed-methods study aimed to identify levels of depression and associated demographic risk factors among male and female survivors of IPV seeking services at a Gender Violence and Recovery Centre (GVRC) in Nyeri County, Kenya. Study Questionnaires were distributed to 117 respondents, with an additional 30 reached through focus group discussions from May 2019-October 2019. Ten items derived from a shortened version of The Centre for Epidemiologic Studies Depression Scale (CES-D scale) were used to assess current depression amongst IPV survivors. The study found that more than half of the respondents (59%) reported severe depression, 34.2% indicated moderate depression, and 6.8% reported mild depression. This study adds to the growing literature on IPV and mental well-being. Regarding demographic risk factors, there was a significant association between gender and level of depression, χ 2 (2, N=117) = 1.038, p= .023), occupation status, χ 2 (6, N=117) = 11.25, p= .03) and presence of a previous partner, χ 2 (2, N=117) = 2.72, p= 0.041). Screening for depression and allied risk factors among male and female IPV survivors would be considered a vital intervention component and management tailored toward treatment therapies that help the survivors identify and change negative thought patterns and allied behaviors.
Mental Disorders and Help-Seeking Behavior among Adults Attending Nyeri County Referral Hospital, Kenya
(African Journal of Education,Science and Technology, 2021-05) Gichimu, Elizabeth Wangari; RonoC. Ruthie; Kihara, Michael
Mental illness has become a growing concern of public health which based on World Health Organization has affected roughly500 million persons across the globe. What is more worrying however is that due to high level of stigmatization in society there has not been timely response and decisiveness on the part of patientsor caregivers on seeking help. This has in turn increasedthe disease burden since it is relatively less understood. While most studies have attributed low uptake of mental health services to help-seeking manners of persons having mental infection, it does not go without mention that there is little on record ofhow the disease has affected the lives of many in Kenya.This study with particular interest in Nyeri County investigated the prevalence of mental disorders based on various socio-demographic characteristics of adult patients attending Nyeri County Referral Hospital. The paper further conducted an assessment of the help-seeking behaviour among patients. The study was anchored in the health belief model and employed a cross-sectional survey design. The study targeted Adults attending Nyeri County ReferralHospital from which a sample of 200 respondents were purposeful selected. Questionnaire guide was used to collect data which was later analysed descriptively. The study established that women were more affected than menand that seeking help was intentional among the patients despite the fact that some respondents could not seek help for fear of intimidation or lack of trust in the system. Nonetheless, most (79%) respondents had intentions of seekingmental health help infuture even though they did not know where to get the help from. The study recommends that public health officials should diversify the channels of health messages on mental health services to reach majority of people
Parents’ and Professionals’ Perceptions on Causes and Treatment Options for Autism Spectrum Disorders (ASD) in a Multicultural Context on the Kenyan Coast
(PLoS ONE, 2015) Kihara, Michael; Gona, J. K.; Newton, C. R.; Rimba, K.; Mapenzi, R.; Vijver, F. V.; Abubakar, A.
Objective To explore parents’ and professionals’ perceived causes and treatment of Autism Spectrum Disorders (ASD) on the Kenyan Coast. Methods In-depth interviews and focus group discussions using guiding questions were utilized in data collection. One hundred and three participants, who included parents of children with ASD, special needs teachers, clinicians, and social workers from diverse cultural background, participated in this study. The interviews and focus groups were recorded, transcribed verbatim and then translated to English. Themes were generated using content analysis. Results Preternatural causes were mentioned and included evil spirits, witchcraft, and curses. Biomedical causes comprised infections, drug abuse, birth complications, malnutrition, and genetic related problems. Treatment varied from traditional and spiritual healing to modern treatment in health facilities, and included consultations with traditional healers, offering prayers to God, and visits to hospitals. Conclusions The results suggest that regardless of cultural backgrounds, people on the Kenyan Coast have similar views on perceived causes and treatment of ASD. These findings provide valuable conceptual understanding for professionals when planning and implementing community based rehabilitation interventions targeting children with ASD within a local context.
Prevalence of Symptoms of Depression among Inpatients with Substance Use Disorders in Drug Rehabilitation Centres in Nairobi, Kenya
(African Journal of Clinical Psychology, 2023) Onyango, Audrey; Kihara, Michael; Nyagwencha, Stella Kemuma
Substance Use Disorders are patrimonial psychiatric disorders with global health concerns connected to many clinical correlations and mental health comorbidities. This study aimed to investigate the prevalence of symptoms of depression in a sample of SUD patients. The study adopted a correlational design using the quantitative research method involving 178 participants, 91% male and 9% female, in drug rehabilitation centres in Nairobi, Kenya. The Self-Medication and Substance-Induced Enhancement theories guided the study. A researcher developed a socio-demographic questionnaire, and the BDI II were used to collect data. Data were analysed using the Statistical Package for Social Scientists version 23 (SPSS v. 23.0). Findings from the study established that 45.5% of the respondents had symptoms of depression. The study recommends a regular assessment of symptoms of depression among clients in inpatient and outpatient treatment centres for successful treatment outcomes.
The Effect of Plasmodium Falciparum on Cognition: A Systematic Review.
(Tropical Medicine and International Health, 2006) Kihara, Michael; Carter, Julie A.; Charles, R. J.; Newton, C.
objective Systematic review to investigate the relationship between Plasmodium falciparum infection and cognitive function. method We searched MEDLINE, EMBASE and PsycINFO, and hand-searched journals and PhD theses. The inclusion criteria were (1) use of standardized tests for the specific populations and/or appropriate controls; (2) clear differentiation between children and adults. Eighteen studies were eligible, of which three gave information on all cognitive domains considered in the review. results Deficits in attention, memory, visuo-spatial skills, language and executive functions may occur after malaria infection. These deficits are not only caused by cerebral falciparum malaria, but also appear to occur in less severe infections. P. falciparum seems to affect the brain globally, not in a localised fashion. Outcome depends on both biological and social risk factors. conclusion Future research should seek to establish the extent of these cognitive deficits using culturally appropriate techniques and well-defined criteria of disease.
The INTERGROWTH-21st Project Neurodevelopment Package: A Novel Method for the Multi-Dimensional Assessment of Neurodevelopment in Pre-School Age Children.
(PLoS ONE, 2014) Fernandes, Michelle; Stein, Allan; Newton, C. R.; Cheikh-Ismail, Leila; Kihara, Michael
Background: The International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) Project is a population-based, longitudinal study describing early growth and development in an optimally healthy cohort of 4607 mothers and newborns. At 24 months, children are assessed for neurodevelopmental outcomes with the INTERGROWTH-21st Neurodevelopment Package. This paper describes neurodevelopment tools for preschoolers and the systematic approach leading to the development of the Package. Methods: An advisory panel shortlisted project-specific criteria (such as multidimensional assessments and suitability for international populations) to be fulfilled by a neurodevelopment instrument. A literature review of well-established tools for preschoolers revealed 47 candidates, none of which fulfilled all the project’s criteria. A multi-dimensional assessment was, therefore, compiled using a package-basedapproach by: (i) categorizing desired outcomes into domains, (ii) devising domainspecific criteria for tool selection, and (iii) selecting the most appropriate measure for each domain. Results: The Package measures vision (Cardiff tests); cortical auditory processing (auditory evoked potentials to a novelty oddball paradigm); and cognition, language skills, behavior, motor skills and attention (the INTERGROWTH-21st Neurodevelopment Assessment) in 35–45 minutes. Sleep-wake patterns (actigraphy) are also assessed. Tablet-based applications with integrated quality checks and automated, wireless electroencephalography make the Package easy to administer in the field by non-specialist staff. The Package is in use in Brazil, India, Italy, Kenya and the United Kingdom. Conclusions: The INTERGROWTH-21st Neurodevelopment Package is a multidimensional instrument measuring early child development (ECD). Its developmental approach may be useful to those involved in large-scale ECD research and surveillance efforts.
The Relationship Between Complex Trauma and Post-Traumatic Growth Among Adolescents Living in Kibagare Informal Settlement
(African Journal of Clinical Psychology, 2023) Muraguri, Caroline W.; Arasa, Josephine; Kihara, Michael
The relationship between trauma and post-traumatic growth in adolescents examines how the pathological effects of trauma are counteracted with great, long-lasting developmental growth impacts. The present study examined the relationship between complex trauma and post-traumatic growth among adolescents living in Kibagare Informal settlements. A descriptive-analytic quantitative design was used to measure the exposure to complex trauma outcomes of PTG elements of adolescents aged 8 to 18 years in the Kibagare Informal Settlement. The study's target population was adolescents from 3,000 households of Kibagare Informal Settlement attending St. Martin's School. Multi-stage sampling was conducted and the sample used in the study was 265 participants. The Child and Adolescent Trauma screening (CATS) tool was used to assess for exposure to traumatic life events and Post-Traumatic Growth Inventory for Children Revised (PTGI -C-R) for measuring post-traumatic growth elements. A socio demographic and social support questionnaire was also used. The results showed that despite adolescents being exposed to complex trauma, they were capable of experiencing PTG. The study found a strong significant relationship between complex trauma and post-traumatic growth components and a medium to weak association of complex trauma components and post-traumatic growth elements. A Chi square and the Phi-Cramer's V test were used. The was a high association of exposure to community violence PS, χ² (6) = 132.137, p< 0.001, Phi of 0.706 and Cramer's V of 0.316; NP χ² (6) = 107.597, p< 0.001, Phi of 0.637 and Cramer's V of 0.285; AL, χ² (6) = 102.360, p< 0.001, Phi of 0.622 and Cramer's V of 0.278. Developing and nurturing PTG among adolescents who are exposed to complex trauma may foster a change in their core belief after a traumatic experience.

Browsing by Author "Kihara, Michael"

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