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Biomedical subjects

W Odero

Publications and source records attributed to W Odero.

7 recordsLinked to original sources
PubMed2001

Major obstetric interventions among encamped refugees and the local population in Turkana District, Kenya.

BACKGROUND: Maternal mortality in developing countries remains high due to lack of appropriate emergency obstetric care. Major obstetric intervention (MOI) rate can be used as an indicator of unmet obstetric needs and quality of care. OBJECTIVES: Identify indications for major obstetric interventions, determine MOI rates and assess extent of unmet obstetric need for women in Turkana district, Kenya. DESIGN: Descriptive bi-directional study. SETTING: Turkana district: Kakuma Refugee Camp, Kakuma Catholic Mission and Lodwar District Hospitals. SUBJECTS: Four thousand two hundred and eighty encamped refugee women and 7,630 women from the host population delivering in Turkana district between January 1995 and September 1999. DATA SOURCES: Maternity registers, inpatient case notes and theatre registers. MAIN OUTCOME MEASURES: Maternal mortality, perinatal mortality, major obstetric interventions, unmet obstetric need and length of stay. RESULTS: The subjects from the two study populations were similar with respect to age, parity and indications for surgical intervention. Caesarean section was the only major obstetric intervention. Overall, caesarean section rate was significantly higher among refugees than in the host population (3.1% versus 2.1%, p<0.01; CI 1.4-2.1). Maternal indications were the main reasons for c/s in both populations, with the c/s rate being higher for refugees than for local women (2.5% versus 1.7%). At least 0.8% of parturient women from the host population had unmet obstetric needs: this translates to 61 pregnant women who may have died or experienced birth-related complications over the study period. The mean length of hospital stay was much less for refugee women than for the host population (8.1 days versus 11.3 days). CONCLUSION: Encamped refugee women in Kakuma have better obstetric care than those from the host population, and the level of unmet obstetric needs in the district is high. This imbalance could be reduced through resource sharing and integration of refugee health care services with that for the host population.

Adolescent↗
PubMed1999

An evaluation of sensitivity and specificity of blood alcohol concentrations obtained by a breathalyser survey in a casualty department in Kenya.

Whereas breathalysers have been shown to provide blood alcohol concentration (BAC) measurements comparable to those obtained by gas chromatography, such evidence has not been reported in low and middle income countries where measures for preventing alcohol-related injuries are virtually non-existent. Before promoting any method of blood alcohol evaluation, as a routine procedure for monitoring the association of alcohol with different types of injuries in Kenya, we sought to assess the reliability and validity of blood alcohol results obtained by a breathalyser, using gas chromatography analysis values as the reference, in a sample of 179 trauma-affected adults presenting to casualty departments. No differences in proportions of subjects with high levels of blood alcohol (equal to or greater than 50 mg%) were detected by breath and blood test procedures (58.7 vs 60.3%). Breathalyser readings yielded high levels of sensitivity and specificity (97.2 and 100%, respectively) with optimal positive and negative predictive values (100 and 95.9%, respectively) at higher BACs (> or = 50 mg%). The study thus reaffirms that breathalyser tests are of value in detecting high blood alcohol levels and can be used to rapidly identify intoxicated subjects. The procedure is easy to perform and can be used for monitoring the association between blood alcohol level and driving in low-income developing countries.

Accidents, Traffic↗
PubMed1998

Alcohol-related road traffic injuries in Eldoret, Kenya.

OBJECTIVE: To establish the extent of alcohol involvement in motor vehicle crashes occurring in Eldoret in western Kenya. DESIGN: A descriptive hospital-based study. SETTING AND SUBJECTS: Crash-involved patients aged 16 years and above presenting for treatment in all hospitals located in Eldoret town over a period of six months. METHODS: Casualties were enrolled consecutively. A questionnaire eliciting demographics and crash circumstances was administered. Blood alcohol concentration (BAC) was evaluated either by breath tests or venous blood sample analysis in consenting casualties presenting within 10 hours of the crash. BAC levels of 5 mg% and greater were taken as a positive test; patients registering BAC levels equal to or greater than 50 mg% were considered as being intoxicated. RESULTS: Of the 188 patients evaluated, 23.4% were BAC positive and 12.2% were intoxicated. Males were twice as likely as females to have been drinking prior to the crash (26.4% versus 13.6%; p = 0.08). Significantly greater proportions of night-time and weekend crashes involved intoxicated subjects (p = 0.02 and p = 0.03, respectively). Motor vehicle drives were the most affected by alcohol (60%), whereas pedestrians (33.3%), passengers (16%) and pedal cyclists (8.3%) were involved to a lesser extent. In comparison to passengers, drivers were eight times more likely to have been drinking (OR = 7.9, p = 0.04). CONCLUSIONS: Alcohol is a contributing factor in a substantial proportion of traffic crashes occurring in western Kenya. Policy response and specific interventions for discouraging driving under the influence of alcohol, including the establishment and enforcement of a legal BAC limit are needed.

Accidents, Traffic↗
PubMed1997

Drinking and driving in an urban setting in Kenya.

A roadside alcohol prevalence survey of drivers randomly selected from the general traffic was conducted in Eldoret, Kenya. Blood alcohol concentration (BAC) data obtained by a breath test in 90% of the sample (n = 479) was analysed by demographic and travel characteristics. 19.9% had a positive breath test (BAC > or = 5 mg%), 8.4% had BACs greater than 50 mg%, and 4% exceeded 80 mg%. A greater proportion of males (20%) had been drinking compared to females (12.5%): all drivers with high BACs (> or = 50 mg%) were males. The likelihood of having consumed alcohol was greater in motorists aged 25 years and above (20.4%) than in younger drivers aged 16-24 years (15.4%), their mean BACs were also more elevated (57 mg% versus 31 mg%). In comparison to operators of public service vehicles (PSV), people driving personal cars were more than twice as likely to have been drinking: with 21.9% being BAC positive against 10.8% (OR = 2.3; 95% CI, 1.0 to 6.3, p = 0.05). Educated individuals with skilled careers tended to indulge in drink-driving to a greater extent than professional drivers (operators of public transport, taxi and heavy goods vehicles), with BAC prevalence rates of 23.7% and 15.5%, respectively. Other circumstances influencing the probability of drink-driving were number of vehicle occupants, distance to destination, road location, time of the night and whether it was a weekend or weekday. These findings are discussed in relation to the potential for promotion of relevant deterrent measures, including the establishment of an appropriate BAC legal limit for drivers in Kenya.

Adult↗
PubMed1995

Road traffic accidents in Kenya: an epidemiological appraisal.

A descriptive analysis of road traffic accident (RTA) and injury data in Kenya was done using routine accident reports, official statistical abstracts, published and unpublished surveys. The characteristics of injury-producing accidents examined included trends, distribution patterns, risk factors, types of vehicles involved, and road-users injured or killed. The numbers killed increased by 578%, while non-fatal casualties rose by 506% between 1962 and 1992. Fatality rate per 10,000 vehicles increased from 50.7 to 64.2, while fatality per 100,000 population ranged between 7.3 and 8.6. 66% of the accidents occurred during daytime. 60% of the reported RTAs occurred on rural roads and had a higher case fatality rate (CFR) of 16% compared to those occurring in urban areas (11%). Human factors were responsible for 85% of all causes. Vehicle-pedestrian collisions were most severe and had the highest CFR of 24%, while only 12% of injuries resulting from vehicle-vehicle accidents were fatal. Utility vehicles, 'matatus' and buses were involved in 62% of the injury producing accidents. Of all traffic fatalities reported, pedestrians comprised 42%, passengers 38%, drivers 12%, and cyclists 8%. The high pedestrian and passenger deaths imply the need to investigate the underlying risk factors, operational and policy issues involved in the transport system, and to develop and implement appropriate responsive road safety interventions.

Accidents, Traffic↗