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Biomedical subjects

K O Rogo

Publications and source records attributed to K O Rogo.

At least 19 recordsLinked to original sources
PubMed2001

FIGO society survey: acceptance and use of new ethical guidelines regarding induced abortion for non-medical reasons.

OBJECTIVE: FIGO's Ethical guidelines regarding induced abortion for non-medical reasons offer guidance concerning women's right to safe abortion services and the medical community's attendant responsibilities. Ipas surveyed FIGO constituent societies to determine their agreement with the Guidelines' recommendations and their readiness to use them to improve and expand services. METHOD: Ten months after the Guidelines publication in IJGO, a ten-item questionnaire was mailed to 283 Officers of the 101 FIGO societies, with follow-up prompts to non-respondents. RESULTS: Officers of 59 societies responded, divided evenly between those in countries whose laws permit induced abortion on non-medical grounds and those in countries prohibiting it. In 'permitting' countries all responding societies supported the recommendations, and 85% said they should adopt them or had already done so. Two-thirds in 'prohibiting' countries supported the recommendations, but less than half believed their FIGO society, or their government, should adopt them. However, 20% in the 'prohibiting' countries had adopted or formally considered the recommendations and 23% had already brought them to the attention of their governments. CONCLUSION: The FIGO constituent societies showed overall strong support for the recommendations, but efforts need to be made to encourage those in 'prohibiting' countries to promote implementation of the recommendations.

Abortion, Induced↗
PubMed2001

Maternal mortality in Kenya: the state of health facilities in a rural district.

BACKGROUND: This study was formulated from the premise that the known causes of maternal mortality, namely haemorrhage, sepsis, obstructed labour and abortion belie the more fundamental development problems that influence it, such as the state of local medical services, quality of care and the facilities' ability to respond to reproductive health emergencies. OBJECTIVE: To document some of the underlying problems and how they were found to influence maternal mortality in Kenya, with specific reference to a rural district. DESIGN: The researchers used the Prevention of Maternal Mortality Network (PMMN) methodology/study design to assess the current state of health facilities, their level of function, and factors influencing their utilisation. Both qualitative and quantitative methods of data collection tools were used. SETTING: Siaya District in the western region of Kenya. Data were collected from thirty facilities, which provide obstetric care in the district. PARTICIPANTS: Data were collected by nurse/midwives, nursing school tutors and social scientists with experience in qualitative research methods. Respondents included health service providers and managers at the 30 health facilities. Qualitative data were obtained through focus group discussions with health facility staff as well as community members. RESULTS: All the thirty facilities studied, were grossly wanting in terms of staffing, equipment, essential drugs and supplies. Both quality of care and record keeping were well below acceptable standards. CONCLUSIONS: The study findings are a sad but a fair reflection of our situation not only in Kenya but also in sub-Saharan Africa ten years after the declaration of the Safe Motherhood Initiative (SMI). The results indicate a predictable, widening gap in basic service provision that must be urgently bridged as a prerequisite to any serious and meaningful approaches to reducing maternal mortality in Africa.

Data Collection↗
PubMed1999

Abortion: behaviour of adolescents in two districts in Kenya.

BACKGROUND: In Kenya the reported high rates of unwanted pregnancies (more than 90%), among adolescents have subsequently resulted in unsafely induced abortions with the associated high morbidity and mortality rates. OBJECTIVE: To evaluate the adolescents' behaviour regarding induced abortion. DESIGN: A cross-sectional, prospective study done from July 1995 to June 1996. SETTING: Schools and health facilities in Kiambu and Nairobi districts in Kenya. PARTICIPANTS: Interviews were conducted among adolescents aged 10-19 years in schools at the two districts and selected using a multi-stage random sampling procedure, as well as adolescent girls at two hospitals and two clinics in the immediate post-abortion period. MAIN OUTCOME MEASURES: The number of adolescents health programmes, aimed at reducing the dangers of unsafely induced abortion, which are designed and subsequently implemented. DATA COLLECTION: Demographic and health data, as well as data on behaviour regarding induced abortion were collected using a self-administered questionnaire. RESULTS: The study sample comprised 1820 adolescents. These were 1048 school girls (SG), 580 school boys (SB) and 192 post-abortion (PA). Many adolescents were aware of abortion dangers, with the awareness being significantly lower among the SB whose girlfriends (GF) had aborted than those whose GF had not (p < 0.01). The practice of abortion was reported among 3.4% SG, 9.3% SBs' GF and 100% PA. Direct and indirect costs of abortion were heavy on the girls. Knowledge of the abortion dangers had no influence on the choice of the abortionist. Abortion encounter positively influenced approval by the adolescents, of abortion for pregnant school girls (p < 0.01). CONCLUSION: Despite the costs and awareness of abortion dangers by adolescents, they will take risks.

Abortion, Illegal↗
PubMed1999

Abortion: knowledge and perceptions of adolescents in two districts in Kenya.

BACKGROUND: Pregnancy among adolescents is unplanned in many instances. Although some pregnant adolescents carry the pregnancy to term, abortion, in many instances unsafely induced, is a commonly sought solution in Kenya. OBJECTIVE: To determine adolescents' perceptions of induced abortion. DESIGN: A cross-sectional descriptive study carried out between July 1995 and June 1996. SETTING: An urban and a rural district in Kenya. PARTICIPANTS: Adolescents aged 10-19 years in schools in Nairobi and Kiambu districts, and a group of immediate post-abortion adolescent girls in some health facilities in Nairobi. MAIN OUTCOME MEASURES: The number of health programmes formulated and put into use, which are adolescent-friendly and providing information, education and communication on abortion issues. DATA COLLECTION: One thousand eight hundred and twenty adolescents were subjected to a self-administered questionnaire that collected demographic and health data as well as perceptions of induced abortion. Focus group discussions on perceptions of abortion were held with 12 groups of adolescents in schools and the information obtained recorded on paper and in a tape-recorder. RESULTS: One thousand nine hundred and fifty two adolescents, comprising of 1048 school girls (SG), 580 boys (SB), 192 post-abortion girls (PA) and 132 adolescents in the focus group discussions, formed the study sample. More than 90% were aware of induced abortion (IA). Knowledge of IA correlated positively with level of education (P < 0.01). Seventy one per cent of SG, 84% of PA and 40% of SB were aware of abortion-related complications, the most common being infections, death and infertility. Eighty three per cent of PA felt that complications were preventable by seeking care from a qualified doctor compared to one quarter each for the SB and SG. 56% PA, 69% SB and 72% SG felt that abortions were preventable. However, less than 40% proposed abstinence as a primary strategy. The most important source of information on abortion was the media followed by friends and teachers. CONCLUSION: Adolescents are aware of abortion and the related complications, but there is more variability in their knowledge and preventive measures.

Abortion, Illegal↗
PubMed1996

Induced abortion in Kenya: its determinants and associated factors.

In a study involving 1077 women who were admitted and treated for incomplete abortion and its related problems at eight hospitals (seven district and one mission hospitals) in six of the eight provinces of Kenya, between October 1988 and March 1989, 169 (15.7%) had illegally induced unsafe abortion, based on their own history and clinical findings. The illegally induced unsafe abortions were common among both rural and urban dwellers, and women from almost all social and economic strata were involved. However, they were more common among the youth (< 25 year olds), school girls, those with high formal education, in formal employment, and not currently married. Majority (90.4%), of the induced group said their pregnancies were unwanted, as compared to only 29.1% of the non-induced (p < 0.05). The main determining factor for termination of pregnancy amongst these women appeared to be the fact that it was unwanted and/or unplanned, either because of inappropriate timing, the type of man responsible, the relationship itself and the social and economic implications thereof. This is contributed to by poor contraceptive use inspite of very good awareness, and/or desire to use. There is urgent need to integrate abortion care and related services into the overall reproductive health care and as a part of the broader safe motherhood initiative in Kenya. In addition it is necessary to revise the legal provisions on abortion so as to make them more relevant. Appropriate management of adolescent fertility, should be undertaken with the aim of reducing the extent of illegally induced unsafe abortion with attendant sequealae.

Abortion, Illegal↗
PubMed1995

Socio-economic client characteristics and consequences of abortion in Nairobi.

In Nairobi, 281 women presenting with alleged miscarriage were subdivided in the following subgroups, 91 spontaneous abortions (group 1), 152 suspected induced abortions (group 2) and 38 admittedly induced abortions (group 3). In the statistical analysis women in group 1 were compared with women from groups 2 and 3 combined (here referred to as group 4). Group 4 differed significantly from group 1 in the following respects: they were younger (p = 0.03) although they had previously born more babies (p = 0.008), lived more often together with their parents (p = 0.024), were less often married (p = 0.000012), worked more often as housewives (p = 0.00079), and lived in bigger households (p = 0.000015). No significant differences were encountered regarding religious beliefs. Group 4 women were more informed about contraceptives than group 1 (p = 0.04), particularly regarding injectables (p = 0.000096) and oral contraceptives (p = 0.0013) but also intra uterine devices (p = 0.024). Almost 90% of group 4 women indicated post abortion contraceptive interest, while only 1/3 of group 1 women did so. Group 3 women needed extensive parenteral treatment with a total hospital treatment cost amounting to 300 times that of group 1. The total cost of intravenous infusions was almost 10 times as high in group 3 as in group 1. The total number of days in hospital was significantly higher in group 4 than in group 1 (p = 0.0098).(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Illegal↗
PubMed1993

Management of recurrent cervical cancer: the place of ultra-radical surgery.

Although mortality from cervical cancer has decreased substantially the incidence of recurrent disease, at 35-50%, remains unaltered. Many more young patients are seen with recurrent cervical cancer today. This paper reviews this problem--its diagnosis and available modes of treatment. The place of re-irradiation, chemotherapy and ultra-radical surgery are discussed and their limitations highlighted. Better patient selection and individualised treatment planning are emphasised. Newer, more objective prognostic indicators based on molecular understanding of cancer cells are mentioned as hopeful means through which patient selection and treatment could be improved in the future. In the developing world where persistent or recurrent disease is more common, the situation is unlikely to improve soon.

Antineoplastic Agents↗
PubMed1993

Induced abortion in sub-Saharan Africa.

Unsafe abortions and their complications are a major cause of maternal mortality. Hospital based studies from most African countries confirm that up to 50% of maternal deaths are due to abortion. This paper reviews problem of induced abortion in sub-Saharan Africa. Issues of prevalence and prevention are addressed while acknowledging the need to review the legal regimes operating in these countries.

Abortion, Induced↗
PubMed1993

Menstrual disorders in patients with chronic renal failure.

Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

Adolescent↗
PubMed1992

High-risk human papillomavirus types in cytologically normal cervical scrapes from Kenya.

Seventy-seven women with normal cervical cytology on routine visit to a family planning clinic in Nairobi, Kenya, were analysed for genital human papillomavirus (HPV) types by polymerase chain reaction (PCR). We applied a general primer pair (GP60/GP124) recognising sequences conserved among HPV types 6, 11, 16, 18, 31 and 33. Of the 77 specimens tested 15 (19.5%) proved to be positive for genital HPV. Amplification products were examined for the presence of high-risk HPV types by Slot-blot hybridization. Out of the 15 PCR-positive samples, 4 were positive for HPV 16.3 for HPV 18, while 1 contained both HPV 16 and 33. HPV DNA prevalence in this group of women from a "high-risk" area is similar to that in "low-risk" Swedish women but much lower than in cervical cancer samples from the same region.

Adult↗
PubMed1992

Management of shoulder dystocia.

Shoulder dystocia is a rare obstetric emergency with which few clinicians have adequate experience. A case which was successfully managed is presented and current management procedures reviewed.

Adult↗
PubMed1992

Factors influencing early perinatal mortality in a rural district hospital.

Early perinatal mortality (EPM) was prospectively analysed in a rural District Hospital during a 4 month period. 2,171 deliveries were recorded with an early perinatal mortality rate (EPMR) of 53/1000. Factors significantly influencing EPM included maternal age, education, marital and socio-economic status. Antenatal care, gestation at delivery, birthweight, pregnancy and labour complications were other significant factors. A maternal mortality rate of 2.8/1000 was also recorded. The study findings and possible lines of intervention are discussed.

Adolescent↗
PubMed1992

Introduction of afterloading low dose-rate brachytherapy for cervical cancer in Kenya.

The Amersham afterloading low dose-rate brachytherapy system for cervical cancer was introduced in Kenya in 1986. The long intrauterine and medium size vaginal applicators were the most frequently used. Complications were generally few except for vesicovaginal fistulae (4%), some of which may not have been entirely due to irradiation. The system was acceptable to both patients and staff. The prolonged treatment times of approximately 50 hours was however, a drawback, and grossly limited the number of patients treatable per week. Low dose-rate brachytherapy is safe and acceptable but is not recommended for units with heavy patient loads. Constraints to establishment of radiotherapy facilities in developing countries are discussed and recommendations for further improvement of services in Kenya highlighted.

Adult↗
PubMed1991

Interaction between cytostatics and nutrients.

Cancer patients have the highest prevalence of malnutrition of any group of hospitalized patients. The presence of the tumor alone may lead to reduced intake of different nutrients and treatment modalities such as surgery, chemotherapy and radiation therapy may further exacerbate nutritional disturbances. Dietary manipulation in experimental systems has shown improvement of tumor response to cancer therapy. Drug pharmacokinetics has been shown to be altered by changes in nutritional delivery. This article reviews the present knowledge, from experimental and clinical standpoints, of the potential role of different nutritional factors on the specific cancer treatment. It is obvious that alteration of at least some dietary factors affect the outcome of different forms of cancer treatment. Indeed, although interest in the clinical significance of optimal dietary intake and supplementation during cancer therapy so far remain marginal, accumulating data indicate that this area deserves further research attention.

Antineoplastic Agents↗