Browsing by Author "Onyango, Peter"

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    A Randomized Trial of Artemether-Lumefantrine and Dihydroartemisinin-Piperaquine In The Treatment of Uncomplicated Malaria among Children in Western Kenya
    (Malaria Journal, 2013) Onyango, Peter; McMorrow, Meredith; Otieno, Kephas; Agarwal, Aarti; Odero, Christopher; Williamson, John; Kariuki, Simon; Kachur, Stephen Patrick; Slutsker, Laurence; Desai, Meghna
    Background: Artemether-lumefantrine (AL) was adopted as first-line treatment for uncomplicated malaria in Kenya in 2006. Monitoring drug efficacy at regular intervals is essential to prevent unnecessary morbidity and mortality. The efficacy of AL and dihydroartemisinin-piperaquine (DP) were evaluated for the treatment of uncomplicated malaria in children aged six to 59 months in western Kenya. Methods: From October 2010 to August 2011, children with fever or history of fever with uncomplicated Plasmodium falciparum mono-infection were enrolled in an in vivo efficacy trial in accordance with World Health Organization (WHO) guidelines. The children were randomized to treatment with a three-day course of AL or DP and efficacy outcomes were measured at 28 and 42 days after treatment initiation. Results: A total of 137 children were enrolled in each treatment arm. There were no early treatment failures and all children except one had cleared parasites by day 3. Polymerase chain reaction (PCR)-uncorrected adequate clinical and parasitological response rate (ACPR) was 61% in the AL arm and 83% in the DP arm at day 28 (p = 0.001). PCR-corrected ACPR at day 28 was 97% in the AL group and 99% in the DP group, and it was 96% in both arms at day 42. Conclusions: AL and DP remain efficacious for the treatment of uncomplicated malaria among children in western Kenya. The longer half-life of piperaquine relative to lumefantrine may provide a prophylactic effect, accounting for the lower rate of re-infection in the first 28 days after treatment in the DP arm.
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    Ethical Challenges that Arise at The Community Interface of Health Research: Village Reporters’ Experiences in Western Kenya.
    (Developing World Bioethics, 2013) Onyango, Peter; Chantler, Tracey; Otewa, Faith; Okoth, Ben; Odhiambo, Frank; Parker, Michael; Geissler, Wenzel Paul
    Community Engagement (CE) has been presented by bio-ethicists and scientists as a straightforward and unequivocal good which can minimize the risks of exploitation and ensure a fair distribution of research benefits in developing countries. By means of ethnographic fieldwork undertaken in Kenya between 2007 and 2009 we explored how CE is understood and enacted in paediatric vaccine trials conducted by the Kenyan Medical Research Institute and the US Centers for Disease Control (KEMRI/CDC). In this paper we focus on the role of paid volunteers who act as an interface between villagers KEMRI/CDC. Village Reporters’ (VRs) position of being both with the community and with KEMRI/CDC is advantageous for the conduct of trials. However it is also problematic in terms of exercising trust, balancing allegiances and representing community views. VRs role is shaped by ambiguities related to their employment status and their dual accountability to researchers and their villages. VRs are understandably careful to stress their commitment to self-less community service since it augments their respectability at community level and opens up opportunities for financial gain and self-development. Simultaneously VRs association with KEMRI/CDC and proximity to trial participants requires them to negotiate implicit and explicit expectations for material and medical assistance in a cultural setting in which much importance is placed on sharing and mutuality. To ensure continuity of productive interactions between VRs, and similar community intermediaries, and researchers, open discussion is needed about the problematic aspects of relational ethics, issues concerning undue influence, power relations and negotiating expectations.
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    Psychological Effects Of Caring For Patients With Mental Disorders: A Case Of Caregivers With Patients At Mathare National Teaching And Referral Hospital, Nairobi County.
    (School of Applied Human Sciences, Daystar University, 2023-10) Onyango, Peter
    The study aimed to explore the mental health impacts on informal caregivers of patients with mental disorders at Mathari National Teaching and Referral Hospital. Using a sample size of 93 and a descriptive survey approach, the study employed sociodemographic questionnaires and psychological tools like Zarit Burden Interview, Depression and Anxiety Stress Scale and Brief Cope Scale for data collection. Data was analyzed using SPSS version 25 to understand the relationships between various factors. The study found that 48.8% reported normal depression levels, 45% normal anxiety, and 52.5% normal stress. Mild symptoms were present in 32.4% for depression, 38.8% for anxiety, and 30% for stress. Moderate levels were reported by 18.8% for depression, 12.4% for anxiety, and 11.3% for stress. Severe symptoms were less common, with 3.8% for anxiety and 6.2% for stress; no one reported severe or extremely severe depression. Sociodemographic factors like gender and age showed no significant correlation with mental health status. In terms of coping strategies, problem-focused coping had the highest mean score of 3.1045, followed by emotion-focused at 2.5055 and avoidant coping at 1.6313. The study found no significant association between burden level and coping strategies, with a Pearson Association value of 0.019. The study recommended urgent, tailored mental health support for informal caregivers at Mathari Mental Hospital, including specialized therapy, stress-management workshops, and financial aid. A comprehensive mental health support framework specifically targeting this group could be established. Community support groups could be set up, offering a platform for caregivers to share experiences, advice, and coping strategies.