Masters Students

Stephen Makori Gichana

I was born and brought up in Nyamira county. I attended my primary and secondary school education both in Nyamira County. I then proceeded to India to pursue a bachelor of pharmacy from Dr. M.G.R Medical University, Chennai. Upon completion I came back to Kenya and I was subsequently registered by the Pharmacy and Poisons Board, Kenya. I then proceeded for a one year internship training offered by the Ministry of Health, Kenya. Upon successful completion I was posted by the Ministry of Health to Kitale County Hospital to practice as a registered Pharmacist. I rose through the ranks to become a senior
pharmacist. Over time I have continuously championed and promoted the rationale use of antimicrobials. Currently I am a pharmaceutical care specialist with special interest in NCDs. I have also championed the
palliative and end-of-life care from the pharmacist’s perspective. I also hold an MBA (strategic management option) and a senior management course (Kenya School of Governance).

Project Summary

Determinants and management of cardiac toxicities induced by anthracycline-based regimens in adult patients
with cancer at Kenyatta national hospital.

Background: Anthracyclines are used in the standard treatment protocols for solid and hematological cancers. Despite their extensive usage, they cause cardiac toxicities. These toxicities require prompt management to reduce the risk of their complications.


Objective: To investigate the determinants and management strategies of anthracyclines induced cardiotoxicities in adult patients with cancer at Kenyatta National Hospital.


Methodology: A cross-sectional study was conducted at the Kenyatta National Hospital. A total of 149 adult cancer patients on the anthracycline-based regimen were recruited to participate in the study through consecutive sampling. Data was collected using a researcher administered questionnaire. The analysis was carried out using STATA version 13 and the level of significance set at 0.05.


Results
There was female predominance (97.3%) and twenty-two (14.8%) participants had comorbidities especially hypertension (10, 6.7%). The majority (140, 94.0%) had breast cancer and 59 (39.6%) had the disease for a duration of 1-2years. One hundred and thirty-four (89.9%) were using doxorubicin and cyclophosphamide combination. Nineteen (12.8%) participants had a reduced ejection fraction along with type I diastolic dysfunction. Independent predictors of cardiotoxicity were hypertension (p=0.026);
trastuzumab use (p=0.011), occupation (p=0.046) and Body mass index (p=0.043) respectively.
However, all the participants were not put on any intervention geared towards managing the cardiac toxicities.


Conclusion
High BMI was an independent predictor of cardiac toxicities. Similarly, the presence of hypertension and the use of trastuzumab were also identified as independent predictors of cardiac toxicities in patients using the anthracyclines-based regimen.


Recommendations
Weight reduction should be encouraged and hypertension appropriately controlled.

Supervisors

Dr. Peter Karimi
Dr. Irene Weru
Dr. Stanley Ndwigah

Links

GradType
64th

Kolek Chester Omondi

Kolek Chester Omondi

My name is Kolek Chester Omondi. I am a Registered Pharmacist under the Pharmacy and Poisons Act of Kenya CAP 244 registration No.2537. I graduated with Bachelor of Pharmacy at the University of Nairobi in the year 2011. Recently I just concluded my master’s education at the same institution where I was undertaking master’s in clinical pharmacy majoring in Internal Medicine and looking forward to graduating on the 11th December 2020. I have also acquired knowledge on Renal Pharmacy Preceptorship having attended a three-month course training at the Kenyatta National Teaching and Referral Hospital in 2016.

I am an employee at the Migori County Level IV Hospital where I serve in the capacity of Sub-County and Hospital Pharmacist Officer-in-Charge.

I am also a certified trainer having facilitated trainings on Malarial case management, supported by USAID and APHIA Plus, organized Workshop program on -Orientation of satellites on revised ART LMIS, facilitated Sensitization session on TB commodity management, facilitated reproductive health and reproductive health commodity training, facilitated National HIV integrated training on ARV [drug/food/co-morbid] toxicities and Interactions and commodity management, facilitated a seminar organized by lands Aid Gemeinsamhelfen and Migori county ministry of  Lands and environment on pedagogical and structural disaster management.

Above all, I am a result oriented and charismatic leader, with strengths in management. I love challenging designation with prospects of advancement and an environment that will enable me to utilize my experiences, academic and professional training. I have interest and potential in contributing positively towards the set objectives

Project Summary

DETERMINANTS OF HPV VACCINE HESITANCY AMONG PARENTS ATTENDING KENYATTA NATIONAL HOSPITAL OUTPATIENT CLINICS

Background: Cervical cancer is mainly caused by the oncogenic Human Papilloma Virus (HPV) infection which is prevented among pre-adolescent girls by prophylactic administration of the HPV vaccine prior to sexual debut. Kenya has recently rolled out the HPV vaccine in the national routine Immunization initiative. There are concerns that parents may be hesitant about taking their children for vaccination.

Objective: The purpose of this study was to identify the prevalence, reasons and risk factors for HPV vaccination hesitancy among parents attending Kenyatta National Hospital (KNH) outpatient clinics.

Methods: A prospective descriptive cross-sectional study was conducted in the Kenyatta National Hospital Medical clinics in the year 2020. The study participants included both male and female patients who were parents of adolescents. Participants were selected using quasi random sampling approach. Data collection was done using a structured questionnaire that was administered by face-to-face interviews. Data that was collected included participants’ socio-demographic, their knowledge and beliefs about the HPV vaccine as well as their reasons for vaccination acceptance. STATA 13 was used to analyze the data. Descriptive, inferential statistics and logistic regression analyses were done. The levels of significance were set at 0.05.

Results: Cumulatively, 93.5% of the 195 parents recruited into the study were aged above 30 years. The largest age group were those aged above 40 years. Despite low knowledge levels about the HPV vaccine, and a high prevalence of negative beliefs (30%), parental willingness was high with 90% willing to have their children vaccinated. The main reasons given for hesitancy to have their children vaccinated were safety concerns (76%) and the feeling that the child was too young (48%). Positive beliefs, knowledge score and gender were positively associated with willingness to have the child vaccine. High education attainment was negatively associated and increasing age were negatively associated with willingness to have the child vaccinated. Male parents had lower levels of knowledge about the HPV infection, cervical cancer and the HPV vaccine compared to their female counter parts. The most widely cited source of information on HPV vaccine was fellow workers in the work place followed by the television.  Education status was positively associated knowledge levels. The beliefs on the HPV vaccine were noted to be average. More females than males believe the vaccine is effective. Beliefs were positively influenced by knowledge and occupation. We found that 59% of parents would consult their daughters before initiating the vaccination process and 77% recommended adolescents sex education.

Conclusion: Gender neutral interventions should be encouraged. Interventions that simultaneously involve both adolescents and parents should be designed and disseminated.

Supervisors

Dr. Sylvia A. Opanga (PhD)

Department of Pharmaceutics and Pharmacy Practice,

University of Nairobi.

Dr. Alfred R. Birichi  (M.Pharm)

Deputy Director, Pharmaceutical Services,

Kenyatta National Hospital.

Links

GradType
64th

Murila Babra Ligogo

Murila Babra Ligogo

I am a Pharmacist registered with the Pharmacy and Poisons Board of Kenya and a graduate of the University of Nairobi with a bachelor’s degree in Pharmacy. I have just completed my masters in Clinical Pharmacy at the University of Nairobi awaiting to graduate. I have outstanding interpersonal skills, I am reliable, trustworthy, numerate and meticulous. I am passionate about causing a positive change in people’s lives; this I do daily by ensuring that the people I encounter and interact with get the best medication outcomes for their illnesses. Currently I work as hospital Pharmacist at Kakamega County General Teaching and Referral Hospital.

Project Summary

Rational Use of Antibiotics Among Patients Admitted to Critical Care Units at Kenyatta National Hospital and Its Impact on Clinical Outcomes.

Background: Irrational use of antibiotics is associated with antimicrobial resistance and high mortality rate in the critical care units. In Kenya, there is scarce data on rational use of antibiotics within critical care units and its impact on patient clinical outcomes.

Objectives: To evaluate rational use of antibiotics among patients admitted to various Critical Care Units at Kenyatta National Hospital and its impact on clinical outcomes.

Methods: Retrospective, cross-sectional record review of admissions to the KNH CCUs conducted over two years. Socio-demographic and clinical characteristics of patients were captured in a predesigned tool. Associations between clinical characteristics and mortality were calculated at p<0.05.

Results: Cephalosporins (49.6%), 5-nitroimidazoles (18.2%) and penicillins (14.2%) were the most frequently prescribed classes of antibiotics. The prevalence of irrational use of antibiotics was high at 81.5%. Mortality at critical care units was 11.1%, with the odds of death being at least five times among intubated patients compared to those who were not (AOR 5.5, 95% CI=1.1-28.1, p=0.042).

Conclusion: The prevalence of rational antibiotic use was 18.5%. The high proportion of irrational use was contributed by incorrect choice and incorrect duration of antibiotic use.

Supervisors

Dr. David G. Nyamu,

Dr. Rosaline N. Kinuthia,

Dr. Peter Njogu

Links

GradType
64th

Kagiri Marjorie Watetu

Kagiri Marjorie Watetu

Dr. Marjorie Watetu Kagiri is an exceptionally hardworking pharmacist with 7 years of experience. She holds a Bachelor of Pharmacy (B.Pharm) from the University of Nairobi (2013) and she followed it up with a Masters in Clinical Pharmacy  from the University of Nairobi (2020).

Her career started off at Nanyuki Teaching and Referral Hospital as a pharmacist intern.  While awaiting deployment, she volunteered at the Kenyatta National Hospital in the Oncology department. She was then posted to Nakuru county, Elburgon sub county hospital as a pharmacist. Here, she implemented an inventory system to improve on the management of commodities.

Being passionate about patient care, she implemented a pharmacist led-medication assessment tool as well as adherence and counseling sessions in the outpatient clinics. These interventions greatly improved patient outcomes. She took on more responsibility as the pharmacist in charge as well as the Secretary to the Pharmaceutical Society of Kenya (Central Rift Branch) in 2017 where she had been diligently serving until her study leave in 2018. She undertook a Senior Management Course at the Kenya School of Government to hone her interpersonal skills.

Dr. Marjorie Kagiri has a keen focus on non-communicable disease with a special interest in Oncology. She is driven towards cancer patient care and furthering research work in the field of hemato-oncology.

Her awards include the Award of University of Nairobi Scholarship.

Project Summary

HEALTH-RELATED QUALITY OF LIFE AND DRUG THERAPY PROBLEMS IN PATIENTS WITH SICKLE CELL DISEASE ON HYDROXYUREA AT KENYATTA NATIONAL HOSPITAL

Background: Sickle cell disease is an inherited genetic disorder caused by presence of a mutated form of hemoglobin. Multi-organ involvement and painful crises are the hallmarks of sickle cell disease. Studies have revealed that patients with sickle cell disease have a lower quality of life compared to the general population. Hydroxyurea is the standard therapy for the management of sickle cell disease.

Objective: To determine the health-related quality of life and drug therapy problems with hydroxyurea use in patients with sickle cell disease at Kenyatta National Hospital.

Methods: A cross-sectional study was conducted at the Kenyatta National hospital hemato-oncology clinic. Sixty-seven participants were eligible. Enrolled participants answered questionnaires designed to collect information on the socio-demographic and medical characteristics. The World health organization Quality of Life (QoL) tool was used to determine the health-related quality of life score. 

Results: Participants had a median age of 20.7 (±7.2) years, 52% were male and had experienced several sickle cell disease-related complications with acute chest syndrome (65.7%) being the most prevalent. The most frequently reported clinical symptoms included headache (44%) and painful crisis (38.8%). Non-compliance (86.6%) was the most prevalent drug therapy problem. In the quality of life assessment, psychological health had the highest score of 68.2%. Positive family history (p=0.030) (6.58 CI 0.66, 12.50) was significantly associated with better overall quality of life scores. Vomiting (p=0.099) (4.77 CI -10.46, 0.93) and chest pain (p=0.697) (1.71 CI -10.43, 7.02) were associated with lower overall quality of life scores.

Supervisors

Dr. Peter N. Karimi

Professor Faith A. Okalebo

Links

GradType
64th

Mercy Kapkarich Siyoi

I did my undergraduate about 10 years ago in this very institution and was eager to come back after sufficiently practicing in this field to specialize in an area that will be beneficial to the community I serve. I am a pharmacist working for the county government, my primary areas are validation of prescriptions, dispensing medications, improving and monitoring use of medicines, extemporaneous preparations, primary health care, pharmacovigilance and being part of various multi-disciplinary teams in the public hospital where I am stationed. I have also worked in public, private and academia before My dissertation for is about formulating and characterizing an oral gel of Nystatin-lidocaine. In formulating this gel I hope this gel will be used by all groups of the general population to whom it will be accessible, improve compliance and quality of life

Project Summary

Formulation and in vitro characterization of Nystatin-Lidocaine oral gel

Due to changes in the practice of medicine such as the introduction of broad-spectrum antibiotics, immunosuppressive agents, transplants, in-dwelling catheters and the rise of morbid conditions such as diabetes, severe malnutrition in children and HIV/AIDS, the incidence of fungal infections especially candidiasis has increased. Candidiasis is a frequent cause of discomfort in the mouth, pain, altered taste and aversion to food.

Currently, drug delivery systems such as bucco-adhesive tablets, mouthwashes, oral suspension and oral gels are used for a various conditions of the oral mucosa. These required repeated dosing to achieve optimum concentration at infection sites. Oral gels are preferred because they provide better drug absorption due to longer residence time and can be modified to give controlled release. By formulating nystatin-lidocaine oral gel that will hopefully be locally adsorbed for a longer period of time, hence have fewer dosing frequency than the oral solution.,while lidocaine numbs the pain on site with local lesions..

Nystatin-lidocaine gels were obtained using a two level, three model factorial experimental design. The concentration of carbopol 940 (at 0.25 and 0.7%), tween 20(at 0.5 and 2%) and glycerol (at 0.5 and 0.8%), were varied while the other excipients were held constant. From the formed gels, a 32 factorial design facilitated optimization of the formulations using the Design Expert® (version 12). The formulated gels were evaluated for quality by conducting analytical testing for drug content, spreadability, pH and viscosity. The analytical parameters tested were found to be fit-for-purpose.

Supervisors

Dr. Shital Maru

Dr.Alex Okaru

GradType
64th