Biomedical subjects

S Gatiti

Publications and source records attributed to S Gatiti.

3 recordsLinked to original sources

PubMed1991

Comprehensive primary health care antiepileptic drug treatment programme in rural and semi-urban Kenya. ICBERG (International Community-based Epilepsy Research Group)

A programme of antiepileptic treatment in a rural and semi-urban region in Kenya was assessed. Patients with generalised tonic-clonic seizures were treated according to one of two simple drug protocols. Health workers screened cases reported by key informants in the community. From the 529 patients identified by health workers as having active seizures 302 patients aged 6-65 years were recruited by a psychiatrist for therapy with carbamazepine or phenobarbitone. Treatment was supervised largely by primary health workers, and the programme was monitored by a research team, which assessed the effectiveness of treatment. Of the 249 patients who completed the study, 53% became seizure-free in the second 6 months of therapy, and another 26% had substantially (50% or more reduction) fewer seizures than in the 6 months before therapy. The similarity of these findings to those obtained in newly diagnosed patients in the developed world, the low drop-out rate, the low rate of withdrawal due to adverse effects, and the acceptable compliance with therapy indicate that health workers can monitor therapy adequately. Most patients had had several years of delay before starting therapy for their epilepsy, yet they responded well--a finding that does not support the suggestion that the disorder becomes intractable if not treated early.

Adolescent↗

PubMed1991

A comprehensive community epilepsy programme: the Nakuru project.

The methodology of a programme of investigation of epilepsy carried out at a community health level in Nakuru district, Kenya, East Africa, and the characteristics of patients with tonic-clonic epilepsy in this community, are presented. The study identified a group of 302 patients with untreated generalised tonic-clonic seizures (with or without other seizure types) from the general population. Case finding was carried out using the key informant method over a 12-month period. The clinical characteristics of this cohort of patients, the majority of whom had never had previous contact with a formal medical system, is described. Most were young, living in a rural area, with a mean age of seizure onset of 14 years and a mean duration of seizures of 7 years. Thirty-eight per cent had a clinically evident focal disturbance associated with the tonic-clonic seizures. In 77% of the cases, no aetiology was established. Most cases had had a substantial number of seizures during the course of their condition and only about a third of the patients had less than 1 seizure a month in the previous year. Only 26% had ever had previous anti-epileptic drug treatment. In addition to the medical inquiry, psychological and sociological studies were also conducted and a prospective treatment programme was carried out. Throughout the study, strict definitions and standardised instruments were used, and the study was the result of a collaboration between local investigators, an international neurological team, the Kenyan Government agencies and the pharmaceutical industry. We consider this a model for community-based investigations for the management of epilepsy in developing countries.

Adolescent↗

PubMed1990

Oral rehydration therapy and social marketing in rural Kenya.

In just a few years, oral rehydration therapy (ORT) has become the standard treatment to reduce infant diarrhoeal disease mortality in the developing world. The paper describes an ORT intervention campaign in a rural area in Western Kenya (Kakamega District). After about a year of careful preparation, the campaign was launched in January 1986 and compared the use of a value-added product (flavoured sachets) sold through private outlets in addition to primary care distribution of an unflavoured sachet in an experimental cell (Bukura Division). In a control cell (Novakholo Division), only unflavoured sachets were distributed free of charge through primary health care facilities. Using local perceptions of diarrhoeal disease management, the campaign in the experimental cell was carefully designed and mass communication techniques employed and adapted accordingly. Outcome assessments of the campaign, which lasted until March 1987, included the overall ORT utilisation over time. Changes in perceptions towards diarrhoeal disease management, direct assessments of mixing a 'safe and effective' solution accurately and other relevant process parameters were evaluated. Comparing several recent ORT intervention projects, the paper concludes that a combination of a commercial approach and mass communication techniques can further ORS use. If a proper incentive system for shopkeepers is installed and message design and ORS product are fully tailored to the perception and preferences of the target population, the commercial availability of ORS will create an extra demand of the product. However, this will not replace distribution of ORS salts delivered free of charge through primary care sources.

Child, Preschool↗