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Background: Awareness and perception are critical determinants in the uptake of a health intervention. This study assessed the level of awareness and perception in relation to the uptake of interventions of computer vision syndrome (CVS) among university students. Material and methods: From a target population of 21,000 students, 384 students were included in the study. Participants were recruited from Maseno, Kenya. Structured in-depth questionnaires were administered to the participants. Composite awareness scale and summative perception score were used to quantify the level of awareness and perception. Results: Out of the 384 participants, 48.7% were males, and 51.3% females. The study denoted a modal age of 18–24 years with a mean age of 19.5 years (SD = 0.747). The prevalence of CVS was 60.4% (n = 232), and almost half of the participants (47.8%) had a low level of awareness. There was a statistically significant difference (p = 0.001) in the level of awareness among participants. Based on perception, nearly three quarter of the participants (60%) perceived CVS as a global issue of public health concern in relation to the introduction of portable electronic devices used on a daily basis. Based on CVS precautions, almost half of the participants (40%) did not practice the preventive measures. Conclusion: Computer vision syndrome was present in about two out of every five students, while awareness remained significantly low, as well as uptake of preventive measures. We emphasize the need for interventions to increase CVS awareness. Developing an item bank for measuring CVS is desirable.

Purpose : The declaration of free maternal and child Health services by the government of Kenya was meant to address some of the systemic service access challenges and increase the number of clients using MNCH services, consequently reducing maternal and neonatal deaths. However, persistent poor maternal and child health indicators in Kenya even with free MNCH services as evident in Kisumu County portends considerable concern hence the reason for this study. There was need to identify factors or factor combinations that affect MNCH service quality in Kisumu County. Methodology: This was a descriptive analytical study whereby data was collected from a sample of 284 mothers seeking MNCH services in Kisumu tier three public health facilities using structured questionnaires and data was analyzed using the Statistical Package for the Social Sciences. Univariate statistics was used to assess patterns of responses to the client satisfaction questionnaire items. Bivariate logistic regression was used to assess association between client satisfaction and dimensions of their characteristics; p-values of less than 0.05 were considered significant. Results: Mothers aged 30-39 years were more likely to report being satisfied with maternal, newborn and child health services as compared to those aged 15-19 years (aOR=0.52, 95%CI=0.28-0.96, p-Value=0.035). The clients who had 1 pregnancy (aOR=2.29, 95%CI=1.04-5.05, p-value=0.040) and 2 pregnancies (aOR=3.22, 95%CI=1.54-6.70, p-Value=0.002) were more likely to report being satisfied with maternal child health services in public health facilities. Similarly, there was significant increased odds of being satisfied among those who resided in rural areas (aOR=2.24, 95%CI=1.05-4.79, p-Value=0.037), those who use vehicles as means of transport (aOR=6.87, 95%CI=1.38-34.28, p-Value=0.019) and those who use motorbike as means of transport (aOR=7.79, 95%CI=1.61-37.77, p-Value=0.011) and maternal child health services satisfaction. Unique contribution to practice and policy: The feedback from this study can be used by national and county governments, state agencies and other health stakeholders in designing communication and advocacy strategies for targeted groups or populations both at the community and health facilities to increase access and acceptability of MNCH services.

INTRODUCTION: Pre-exposure Prophylaxis (PrEP), an effective user-dependent HIV prevention method is especially viable for adolescent girls and young women (AGYW). Behavioral interventions designed to enhance uptake of and adherence to PrEP among AGYW are few and their effectiveness unclear. METHODS: a descriptive cross-sectional study design was used to evaluate level of exposure to Jipende JiPrEP mass media campaign. It assessed intention to use PrEP amongst those exposed to the campaign of which 419 females aged 15-24 years participated. Linear framework and poisson regression analysis was performed to estimate prevalence ratios and show significant predictors of intention to use PrEP. Chi-square test for trend was used to test whether the proportion of intention to use PrEP increases or decreases across level of exposure. RESULTS: at least 67.1% (281/419) participants had low exposure to the campaign messages. More urbanites (7.2%) and those with higher education levels (9.2%) had higher exposure to the campaign messages. There was no change in intention to use PrEP with increased exposure (Chi-trend p-value= 0.403). Intention to use PrEP was higher with exposure to leaflets (aPR=1.51, 95% CI 1.01, 2.26, p= 0.043) and using radio almost every day (aPR=1.81, 95% CI 1.22, 2.69, p= 0.003). Those exposed to newspapers were 55% less likely to report intention to use PrEP (aPR=0.45, 95% CI 0.25, 0.81, p= 0.008). CONCLUSIONS: Jipende JiPrEP campaign has low reach among AGYW while majority of them reported low intent to use PrEP even after exposure to the campaign. Therefore, innovative messaging approaches are needed to improve campaign effectiveness.

Background: Numerous factors have been shown to reduce symptomatic and non-symptomatic forms for computer vision syndrome. However, little is known on the impact among computer users diagnosed with severe symptoms of computer vision syndrome. The study assessed whether reduced visual acuity, ocular pathology and refractive error are associated with computer vision syndrome. Methods: A cross sectional university based study in Kenya. Seven hundred and eighty three participants were included in the study. Visual acuity was determined using snellens chart and converted to logMAR chart. Ocular pathology was determined through comprehensive examination using a slit lamp. Computer vision syndrome was determined using a validated questionnaire. Finally Retinoscopy was conducted to determine the type of refractive error. Results: Participants with refractive error above ± 0.50 dioptres had a greater odds, multivariate adjusted ratio 0.73 (95% CI 0.63-0.90) for developing computer vision syndrome. Similar to visual acuity with multivariate adjusted odds ratio of 0.31 (95% CI 0.24-0.47) and ocular pathologies being significantly associated with computer vision syndrome (p=.04). Ocular condition like sub conjunctival hemorrhage was not significantly associated with computer vision syndrome (P=.12). Conclusion: Reduced visual acuity, presence of ocular pathology and refractive error were associated with greater likelihood of computer vision syndrome. Particularly among those who had never had optical correction. Eye care providers are well placed to come up with proper diagnosis of CVS.

Child sexual abuse is a public health problem with negative physical, mental, behavioral and learning outcomes to survivors. Recent Kenya Demographic Health Survey showed that 22% of women and 13% of men in western Kenya have experienced sexual abuse compared to 14% women and 6% men nationally. Its burden, predisposing factors and, sources of or reasons for differential exposure for boys are yet unclear. Whereas schools have a major influence on a child’s development and behavior, they have been identified as important settings where child sexual abuse might occur. However, how sexual abuse is patterned by type and location of school remains an open question. The present study investigated risk factors of sexual abuse among school-going children in primary schools in Kisumu County. Using a cross-sectional study design and guided by the ecological model, the study determined association between type of school and sexual abuse; association between location of school and sexual abuse, and spaces that predispose school-going children to sexual abuse in primary schools. A sample of 398 pupils aged between 10 – 16 years randomly identified participants from 37 pre-selected primary schools in Kisumu Central and Kisumu West sub-Counties was used. The schools had been stratified by location (rural and urban) and type (public or private, boarding or day). Parental permission was sought for respective pupils to participate in the study. Data from pupils was collected using self-administered questionnaires and focus group discussions, and key informant interviews from guidance and counseling teachers. The mean age of participants was 13 years. More pupils attended day schools than boarding schools (88% versus 12%; p= 0.017). Forced sex (29%) was the most common type of sexual abuse. More girls than boys had ever experienced any type of sexual abuse 29% versus 20%; p=0.038. Whereas there was no statistical difference in pupils’ experience of sexual abuse by type and location of school x2= 2.044; p>0.05 and x2= 0.823 p>0.05, pupils thought that attending public day schools is associated with higher risk for sexual abuse mainly while walking to and from home. Pupils cited bushes inside school (52%), latrines/toilets (51%) and bushes outside school (50%) as spaces where one is more likely to experience sexual abuse. Being a female pupil was the most significant risk factor for sexual abuse in the primary schools surveyed. This indicates that gendered predisposition plays an important role in occurrence of sexual abuse in primary schools. Though not statistically significant in this study, it is plausible that risky spaces and type of schools might modify female gender predisposition in subtler ways as suggested from the pupils’ perspectives. There is need for a gendered focus in a complex primary schooling environment

Background Computer vision syndrome is a multi-factorial condition of the eye that results in symptoms of stress and discomfort among computer users. It causes chronic vision-related morbidity and reduced work productivity. Ninety percent and 75% of computer users globally and in Africa respectively suffer from CVS. It is an insidious chronic condition that however, has hitherto received little attention, both by health providers as well as computer users. Also, it is likely to be under diagnosed as it mimics other eye conditions. The risk factors for CVS include prolonged period of electronic device use and glare. In Kenya, lack of awareness of the disease is a key barrier to early detection, health seeking and use of interventions. The burden of CVS and how much computer users in learning institutions are aware of and perceive CVS remains unknown.Methods This study adopted cross-sectional study design to determine the level of awareness, perception of CVS, uptake of preventive measures by students at Maseno University. In total, we administered questionnaires to 384 randomly selected students.Results The mean age was 19.5 years (SD= 0.747) with 18-24 years as the modal age group. Females comprised 51.3% (n=197) and males 48.7%. Participants who had at least 5 symptoms of CVS were 60.4% (n= 232). Awareness level was classified as low in 47.8%; medium level in 38.2% and high level in 13.8% of respondents . Sixty percent of respondents did not perceive CVS as an issue of public health concern compared to 39.8% who perceived CVS as an issue of public health concern ( p=0.001). In terms of precautionary measures, only duration of computer use (46.2%, p = 0.001 ) were practiced. The study results show that at least 3 out of 5 students have at least five symptoms of CVS, whereas awareness of the disease and related risks remain low.Conclusion The results of the present study indicate that CVS is a less recognized health concern among university students. Consequently, screening for the disease sensitization of students on CVS and awareness campaigns to improve early recognition and diagnosis of disease as well as uptake of interventions is recommended.

Summary Background Hearing-impaired children who are identified early and appropriately managed have improved outcomes in speech, language, cognitive and social development. Enhanced parental awareness of their child's hearing disability, behavioral, developmental and psychosocial limitations is essential to sustaining timely detection and appropriate intervention. Additionally, availability of services for diagnosis, treatment and habilitation would improve the demand for pedaudiological care in this community. Objective To describe level of parental awareness of childhood HI and the pattern of access to and utilization of ambulatory care services. Subjects Thirty-three parents of lower primary school-going children who failed audiometric screening from sampled schools in Kisumu district, western Kenya. Main outcome measures First person to detect HI, age of child at first suspicion of HI, source of ambulatory health care and use of the health care facilities. Results The prevalence of HI was 2.48%. Most parents/guardians (69.7%) were aware of their child's hearing impairment. Of these, 63.6% were first to detect HI in the pupils, while 30.3% were detected by screen. Most children (57.2%) were first recognized with (HI) after age 2 years. The mean age at identification was 5.5 years. The median travel distance to the preferred health care facility was 2 km (IQR 1–2.5). Parents seldom sought or lacked help for their hearing-impaired children. Of 27.3% who asked for hearing assessment, 9.1% received some counsel on HI and 12.1% received medication, one (3%) was referred for audiological assessment and none used a hearing aid. Use of health facilities for maternal care was (65.7%) and immunization (62.9%). Conclusions Despite adequate parental awareness of chronic childhood disability, health facilities were underutilized. This indicates the need to further stimulate and maintain a desirable level of uptake of services for diagnosis, treatment and habilitation of childhood HI, while sustaining delivery of effective and acceptable high quality paediatric care.

Introduction: We examined male circumcision outcomes among young adults in an African setting. Materials and Methods: Participants were healthy, sexually active, uncircumcised, HIV-seronegative males aged 18–24 years. The main outcomes measured included complications, healing, satisfaction and resumption of activities. Results: Of 1,475 procedures, 26 (1.8%) were associated with 27 adverse events, most commonly wound disruption/delayed healing (0.6%), wound infection (0.4%), and bleeding (0.3%). Adverse events per clinician averaged 3.8 and 2.1% for procedures 1–100 and 101–200, respectively, and 400, respectively (p < 0.001). Participants resumed normal general activities after a median of 1 postoperative day and 93% with regular employment resumed working within 1 week. After 30 days, 99% of participants reported being very satisfied. After 90 days, 65% reported having had sex, 45% reported that their partners had expressed an opinion, 92% of whom were very satisfied with the outcome. Conclusions: Safe and acceptable adult male circumcision services can be delivered in developing country settings.