Kenyatta National Hospital

Nairobi, Kenya

Kenyatta National Hospital

Nairobi, Kenya
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News Article | December 2, 2016

The global Medical Education Market has a handful of players such as Apollo Hospitals, TACT Academy for Clinical Training, Zimmer Biomet Holdings, Inc. (Zimmer Institute), Olympus Corporation, Gundersen Health System, GE Healthcare, and Medical Training College. Transparency Market Research identifies Apollo Hospitals as the leading contributor to the growth of the overall market owing to its extensive course portfolio, strong market penetration in countries in Asia Pacific, and vast scope for practical hospital experience. “Geographical expansion in several developing countries has been Apollo Hospitals’ leading growth strategy, in addition to the acquisition of smaller local players,” finds the lead author of the TMR study. In July 2016, Apollo Hospitals Group signed MoUs with Kenyatta National Hospital and Airtel Kenya to not just focus on capacity building in the Kenyan healthcare sector but to also conduct educational lectures and training programs in the country. In the same month, the company signed an agreement with Hainan Ecological Smart City Group in China to develop a highly integrated modern healthcare service facility in the Hainan province, which is likely to lend nursing, medical, and paramedical colleges in the island city tremendous support. Advantages of Online Training over Traditional Modes of Education a Driving Factor The demand for medical education is primarily driven by the growing preference for online education. “Online education is a highly lucrative investment avenue,” a TMR analyst observes. “The exposure to modern technologies around the world and the increasing penetration of the internet has greatly fueled the preference of students for online education.” Moreover, online training presents several advantages over traditional modes of education, including variation in training and educational programs, lower cost, comfortable and flexible learning programs, and opportunities for improved technical skills. In line with this growing trend, TMR predicts that the emergence of e-learning markets in several developing countries will be a major opportunity for players in the medical education market. Get Exclusive Sample Paper of this Research - The cost of higher education, especially in developed countries, continues to pose a key challenge for low-income students. “Medical education is one of the most expensive fields and the tuition fee for classroom courses as well as on-campus training is extremely high. This acts as a major barrier for the medical education market,” the author of the study says. In addition to this, the declining preference for distance education in medicine and paramedical training is likely to restrict the growth of the medical education market to an extent. Expanding at a 4.3% CAGR over the course of the forecast period, the global medical education market is poised to rise from a value of US$25.9 bn in 2015 to US$38.4 bn by 2024. By mode of education, the medical education market is led by on-campus training. Changing student preferences will restrict the demand for distance training by 2024, TMR predicts. However, online training is fast emerging as a lucrative mode of medical education and this segment is likely to register the highest CAGR of 7.29% from 2016 to 2024. By type of training, the demand for cardiothoracic training has surpassed the rest, while training in radiology presents the highest scope for growth. By geography, North America led the overall medical education market with Asia Pacific as the most rapidly expanding regional segment through the forecast period. This review is based on the findings of a TMR report titled “Medical Education Market - Global Industry Analysis, Size, Share, Growth, Trends, and Forecast 2016 - 2024.” Speak with Research Expert, and know more about Emerging trends in Medical Education Market - Transparency Market Research (TMR) is a market intelligence company, providing global business information reports and services. Our exclusive blend of quantitative forecasting and trends analysis provides forward-looking insight for thousands of decision makers. TMR’s experienced team of analysts, researchers, and consultants, use proprietary data sources and various tools and techniques to gather, and analyze information. Our business offerings represent the latest and the most reliable information indispensable for businesses to sustain a competitive edge. Each TMR syndicated research report covers a different sector - such as pharmaceuticals, chemicals, energy, food & beverages, semiconductors, med-devices, consumer goods and technology. These reports provide in-depth analysis and deep segmentation to possible micro levels. With wider scope and stratified research methodology, TMR’s syndicated reports strive to provide clients to serve their overall research requirement.

Heffron R.,University of Washington | Donnell D.,Fred Hutchinson Cancer Research Center | Rees H.,University of Witwatersrand | Celum C.,University of Washington | And 13 more authors.
The Lancet Infectious Diseases | Year: 2012

Background: Hormonal contraceptives are used widely but their effects on HIV-1 risk are unclear. We aimed to assess the association between hormonal contraceptive use and risk of HIV-1 acquisition by women and HIV-1 transmission from HIV-1-infected women to their male partners. Methods: In this prospective study, we followed up 3790 heterosexual HIV-1-serodiscordant couples participating in two longitudinal studies of HIV-1 incidence in seven African countries. Among injectable and oral hormonal contraceptive users and non-users, we compared rates of HIV-1 acquisition by women and HIV-1 transmission from women to men. The primary outcome measure was HIV-1 seroconversion. We used Cox proportional hazards regression and marginal structural modelling to assess the effect of contraceptive use on HIV-1 risk. Findings: Among 1314 couples in which the HIV-1-seronegative partner was female (median follow-up 18·0 [IQR 12·6-24·2] months), rates of HIV-1 acquisition were 6·61 per 100 person-years in women who used hormonal contraception and 3·78 per 100 person-years in those who did not (adjusted hazard ratio 1·98, 95% CI 1·06-3·68, p=0·03). Among 2476 couples in which the HIV-1-seronegative partner was male (median follow-up 18·7 [IQR 12·8-24·2] months), rates of HIV-1 transmission from women to men were 2·61 per 100 person-years in couples in which women used hormonal contraception and 1·51 per 100 person-years in couples in which women did not use hormonal contraception (adjusted hazard ratio 1·97, 95% CI 1·12-3·45, p=0·02). Marginal structural model analyses generated much the same results to the Cox proportional hazards regression. Interpretation: Women should be counselled about potentially increased risk of HIV-1 acquisition and transmission with hormonal contraception, especially injectable methods, and about the importance of dual protection with condoms to decrease HIV-1 risk. Non-hormonal or low-dose hormonal contraceptive methods should be considered for women with or at-risk for HIV-1. Funding: US National Institutes of Health and the Bill & Melinda Gates Foundation. © 2012 Elsevier Ltd.

Dimaras H.,Hospital for Sick Children | Dimaras H.,University of Toronto | Kimani K.,Kenyatta National Hospital | Dimba E.A.O.,University of Nairobi | And 7 more authors.
The Lancet | Year: 2012

Retinoblastoma is an aggressive eye cancer of infancy and childhood. Survival and the chance of saving vision depend on severity of disease at presentation. Retinoblastoma was the first tumour to draw attention to the genetic aetiology of cancer. Despite good understanding of its aetiology, mortality from retinoblastoma is about 70 in countries of low and middle income, where most affected children live. Poor public and medical awareness, and an absence of rigorous clinical trials to assess innovative treatments impede progress. Worldwide, most of the estimated 9000 newly diagnosed patients every year will die. However, global digital communications present opportunities to optimise standards of care for children and families affected by this rare and often devastating cancer. Parents are now leading the effort for widespread awareness of the danger of leucocoria. Genome-level technologies could make genetic testing a reality for every family affected by retinoblastoma. Best-practice guidelines, online sharing of pathological images, point-of-care data entry, multidisciplinary research, and clinical trials can reduce mortality. Most importantly, active participation of survivors and families will ensure that the whole wellbeing of the child is prioritised in any treatment plan. © 2012 Elsevier Ltd.

Mugwanya K.K.,University of Washington | Mugwanya K.K.,Makerere University | Donnell D.,Fred Hutchinson Cancer Research Center | Donnell D.,University of Washington | And 11 more authors.
The Lancet Infectious Diseases | Year: 2013

Background: Scarce data are available to assess sexual behaviour of individuals using antiretroviral pre-exposure prophylaxis for HIV prevention. Increased sexual risk taking by individuals using effective HIV prevention strategies, like pre-exposure prophylaxis, could offset the benefits of HIV prevention. We studied whether the use of pre-exposure prophylaxis in HIV-uninfected men and women in HIV-serodiscordant couples was associated with increased sexual risk behaviour. Methods: We undertook a longitudinal analysis of data from the Partners PrEP Study, a double-blind, randomised, placebo-controlled trial of daily oral pre-exposure prophylaxis among HIV-uninfected partners of heterosexual HIV-serodiscordant couples (n=3163, ≥18 years of age). Efficacy for HIV prevention was publicly reported in July 2011, and participants continued monthly follow-up thereafter. We used regression analyses to compare the frequency of sex-unprotected by a condom-during the 12 months after compared with the 12 months before July 2011, to assess whether knowledge of pre-exposure prophylaxis efficacy for HIV prevention caused increased sexual risk behaviour. Results: We analysed 56132 person-months from 3024 HIV-uninfected individuals (64% male). The average frequency of unprotected sex with the HIV-infected study partner was 59 per 100 person-months before unmasking versus 53 after unmasking; we recorded no immediate change (p=0·66) or change over time (p=0·25) after July, 2011. We identified a significant increase in unprotected sex with outside partners after July, 2011, but the effect was small (average of 6·8 unprotected sex acts per year vs 6·2 acts in a predicted counterfactual scenario had patients remained masked, p=0·04). Compared with before July, 2011, we noted no significant increase in incident sexually transmitted infections or pregnancy after July, 2011. Interpretation: Pre-exposure prophylaxis, provided as part of a comprehensive prevention package, might not result in substantial changes in risk-taking sexual behaviour by heterosexual couples. Funding: The Bill & Melinda Gates Foundation and the US National Institute of Mental Health. © 2013 Elsevier Ltd.

Wambani J.S.,Kenyatta National Hospital
East African medical journal | Year: 2010

To assess the level of patient dose in Computed Tomography examination in Kenya, compare with the international diagnostic reference levels and establish the initial national diagnostic reference levels. The patient doses for brain, chest, abdomen and pelvis examinations were assessed using typical exposure factors on head and body dosimetry phantoms. A log normal graphical method was developed and used in deriving the initial national diagnostic reference levels for the two dose quantities. Twenty one representative Computed Tomography facilities at different hospitals and clinics. A questionnaire method was developed and used in recording the scanning parameters for head, chest, abdomen and pelvis adult examinations at each facility. The radiation exposure from Computed Tomography examinations was determined to be below the weighted Computed Tomography Dose Index (CTDIw) and Dose Length Product (DLP) reference levels by 90% and 62% respectively. The mean CTDIw measurements for the adult patients were below Diagnostic Reference levels (DRLs). The mean DLP values for adult patients in some examination were above DRLs, with large variations of up to a factor of eleven. This indicates the need for local optimised scanning protocols and use of local diagnostic reference level in order to reduce patient doses without affecting diagnostic image quality.

Ekwom P.E.,Kenyatta National Hospital
Clinical Rheumatology | Year: 2013

Systemic lupus erythematosus (SLE) is a complex disease with varied clinical presentation and autoantibody production. It has previously been reported as rare in Black Africans. We established a Rheumatology clinic at the Kenyatta National Hospital in April 2010, and a 1 year audit of this clinic was carried out in September 2011. This is a report of this audit of patients who met the American College of Rheumatology (ACR) criteria for SLE. Thirteen patients met the ACR criteria; their mean age was 34 years, and they were all female. The commonest manifestations were malar rash and arthritis in 69.2 %. Antinuclear antibody was present in 79.6 %, and anti-dsDNA was present in 38.5 %. None of them had human immunodeficiency virus infection; 30 % had other comorbidities (hypertension, diabetes, and renal failure). Thirty percent also had an infection during this period. All these 13 were on prednisolone and 92 % of them were on hydroxychloroquine. There was no reported death during the study period. This confirms the presence of SLE in patients in Kenya who meet the ACR criteria. © 2013 Clinical Rheumatology.

Koech K.J.,Kenyatta National Hospital
East African Medical Journal | Year: 2010

New cases of cancrum oris in adults are rare and there are no previous reports in the literature from Kenya. Since noma is related to factors associated with poverty and immunosuppression, reducing the incidence of noma can be achieved with improvement in socio-economic status of communities and prevention of HIV infection. An unusual case of a human immunodeficiency virus (HIV) infected a 49 year old female with a full thickness cheek defect following a recent cancrum oris infection is reported. The disfiguring defect was successfully reconstructed using a two staged delto-pectoral flap with a satisfactory aesthetic and functional outcome.

Ekwom P.E.,Kenyatta National Hospital
East African medical journal | Year: 2010

Articular manifestations have been reported in HIV infection with a prevalence ranging from 2.5 to 68%. To determine the prevalence, types and characteristics of articular manifestations in the anti-retroviral treatment naive HIV infected patients. Cross sectional descriptive study. Comprehensive care clinic (HIV outpatient clinic) at the Kenyatta National Hospital (KNH) from October 2007 to March 2008. One hundread and ninety three patients; 135 females and 58 males, aged between 19 to 65 years with Human immunodeficiency virus (HIV) infection who were naive to anti - retroviral drug therapy. Presence of articular manifestations that included HIV associated arthritis, HIV associated spondyloarthropathies, HIV associated arthralgia, painful articular syndrome and avascular necrosis. Thirty three of these 193 patients had articular manifestation with a prevalence of 17.1%. The type prevalence was; HIV associated arthralgia, 15.6%; undifferentiated spondyloarthropathy, 1% and HIV associated arthritis; 0.5%. Their mean age was 36 +/- 9 years, range 23-63 years; majority were female, male to female ratio of 1: 2.3 and the majority were in World health organization (WHO) clinical staging of HIV infection, class II and III with a mean CD4 cell count of 330 cells/mm3. Seventeen (51.5%) of the patients with articular disease had oligo - articular presentation, 10(30.3%) mono - articular while 6(18.2%) had poly - articular presentation. The mean duration of joint pains was 53.3 days (range of 2-365 days). Six (18.2%) of these 33 patients missed work, home making activities or school due to the articular disease. Articular manifestations are common in HIV infection with a prevalence of 17.1%. HIV associated arthralgia was the most common manifestation. Majority of these patients were female, male to female ratio of 1: 2.3. The mean age of these patients was 36 years with a mean CD4 cell count of 330 cells/mm3 with 18.2% of them missing school or work.

Strauss-Albee D.M.,Stanford University | Fukuyama J.,Stanford University | Liang E.C.,Stanford University | Yao Y.,Yale University | And 7 more authors.
Science Translational Medicine | Year: 2015

Innate natural killer (NK) cells are diverse at the single-cell level because of variegated expressions of activating and inhibitory receptors, yet the developmental roots and functional consequences of this diversity remain unknown. Because NK cells are critical for antiviral and antitumor responses, a better understanding of their diversity could lead to an improved ability to harness them therapeutically. We found that NK diversity is lower at birth than in adults. During an antiviral response to either HIV-1 or West Nile virus, NK diversity increases, resulting in terminal differentiation and cytokine production at the cost of cell division and degranulation. In African women matched for HIV-1 exposure risk, high NK diversity is associated with increased risk of HIV-1 acquisition. Existing diversity may therefore decrease the flexibility of the antiviral response. Collectively, the data reveal that human NK diversity is a previously undefined metric of immune history and function that may be clinically useful in forecasting the outcomes of infection and malignancy. © 2015, American Association for the Advancement of Science. All rights reserved.

Mungure E.K.,Kenyatta National Hospital
East African medical journal | Year: 2010

Needle stick injuries (NSI) are the commonest route by which blood borne viruses and/or infections such as HIV, Hepatitis B and C are transmitted from patients to health care workers (HCW). Dental students are also at risk of such infections and injuries due to accidental contamination during their practical occupational exposure. There is hardly any information regarding the knowledge and experiences of NSI among dental students in Kenya. To determine the knowledge and experiences of NSI among dental students at the University of Nairobi Dental Hospital (UONDH). Descriptive cross-sectional study. University of Nairobi Dental Hospital premises. The population included undergraduate and postgraduate dental students pursuing their degrees at the university. Seventy two questionnaires were issued and a response rate of 62 (81%) was achieved. The age of the respondents ranged from 21-35 years with a mean age of 24 years (SD +/- 4.7) years. There were 33 (53%) males and 29 (47%) females. Most of the students were undergraduates (87%) while the rest were postgraduate students (13%). The majority (97%) of the respondents reported that NSI was a means of cross-infection. Only 29% of the respondents had suffered NSI. Of those who had suffered NSI, 36% of the incidents occurred when administering local anaesthesia, while 23% were during scaling, 18% when recapping needles, 18% while clearing up and 5% when suturing. Only seven of those who had suffered NSI (39%) had reported of NSI. The reasons for not reporting were: fear of stigmatisation (25%) or the fear of consequences of cross-infection (38%). All the respondents who had experienced NSI were undergraduates with no statistical significant difference between the undergraduate and postgraduate students (chi2=3.758, p=0.052). Among the respondents who had experienced NSI, nine were males and nine were females with no statistical significance between the two genders (chi2=0.106, p=0.481). All the respondents recorded inadequate knowledge on the modes of prevention of NSI. Less than half (27%) of the respondents had accurate knowledge on the procedure followed in case of NSI. Only 27% of the respondents had taken post-exposure prophylaxis (PEP) after suffering NSI with no statistically significant difference between males and females (chi2=44, p=0.108). Although the level of knowledge on the risk of cross-infection from NSI was high, there was decreased awareness on the means of prevention and protocol.

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