Determination of Activity Concentration of Natural Radionuclides and Radiation Hazards' Assessment of Building Materials in High Background Radiation Areas of Homa and Ruri, Kenya.

The areas around Homa and Ruri hills in Homa Bay County in Kenya are associated with high background radiation levels. The activity concentration of the natural radionuclides (226Ra, 232Th, and 40K) in earthen building materials used in the areas of Homa and Ruri hills has been measured using a NaI (Tl) detector in this work. The measured values of radioactivity concentrations are used to estimate the associated radiological risk. The earthen building material samples from Ruri registered relatively high 232Th concentration values averaging 1094 ± 55 Bq/kg, nearly three times those of the samples from Homa. 226Ra level was not significantly different in both regions with Homa reporting 129 ± 10 Bq/kg and Ruri 111 ± 6 Bq/kg. 40K was however higher in the samples from Homa by an approximate factor of 2 relative to those from Ruri where the activity concentration was 489 ± 24 Bq/kg. The radium equivalents for 226Ra, 232Th, and 40K in the samples from Ruri were 111 ± 9, 1564 ± 125, and 38 ± 3 Bq/kg, while in Homa, the values were 129 ± 10, 570 ± 46, and 69 ± 5 Bq/kg, respectively. The calculated value of total radium equivalent in Ruri was 1713 ± 137 Bq/kg which was two times higher than that of Homa. 232Th contributed about 74% and 91% to the total radium equivalent in Homa and Ruri, respectively; thus, it was the one with the largest contribution to radiation exposure in both regions. The average indoor annual effective dose rates were 1.74 ± 0.14 and 3.78 ± 0.30 mSv/y in Homa and Ruri, respectively, both of which were above the recommended safety limit of 1 mSv/y.

RADON AND THORON EXHALATION RATES FROM EARTHEN BUILDING MATERIALS USED IN HIGH BACKGROUND RADIATION AREAS OF HOMA AND RURI, KENYA.

222Rn and 220Rn surface exhalation rates from earthen building materials used in high background radiation areas of Homa and Ruri, Kenya have been measured using an accumulation chamber coupled with RAD7 detector. Activity concentrations of 226Ra and 232Th in the building materials were determined by γ-ray spectroscopy. In Homa the average 222Rn surface exhalation was 1 ± 0.1 mBqm-2 s-1, while that of 220Rn was 18 ± 2 Bqm-2 s-1; in Ruri 222Rn was 0.9 ± 0.1 mBqm-2 s-1 and 220Rn was 25 ± 3 Bqm-2 s-1. 222Rn was 26 times lower than world average and 220Rn was higher by a factor of 21. Average 232Th in Ruri was 1094 ± 55 Bq/kg, three times that in Homa; 226Ra was 129 ± 10 and 111 ± 6 Bq/kg in Homa and Ruri, respectively. There was a strong correlation between exhalation rate of 222Rn and concentration of 226Ra, as well as between 232Th and 220Rn. Thus, 220Rn was the major contributor to the inhaled dose in earthen dwellings of the two regions.

Gamma Ray Spectrometric Analysis of Sand Samples from Selected Beaches along Kenyan Coastline.

In this study, the activity concentration levels of 238U, 232Th, and 40K in sand samples collected from Shanzu, Nyali, Kenyatta, Tiwi, Shelly, and Diani beaches selected along the Kenyan coastline were determined using a gamma ray spectrometer with a NaI(Tl) detector. The average activity concentrations of 238U, 232Th, and 40K in sand samples were analyzed as 87 ± 4, 98 ± 4, and 1254 ± 62 Bq/kg, respectively. Also, radium equivalent (Raeq) activity and internal (H in) and external (H ex) hazard index were calculated to assess the radiological hazards associated with the use of sand samples as building materials. The average values of Raeq, H in, and H ex were found as 327 ± 16 Bq/kg, 0.98, and 0.72, respectively. The average values of outdoor and indoor annual effective dose rates were estimated as of 0.23 and 0.63 mSv/y, respectively, which are below maximum recommended limit of 1 mSv/y. Generally, these results indicate no significant radiological health hazards for the studied beaches.

MEASUREMENT OF RADON ACTIVITY CONCENTRATION IN UNDERGROUND WATER OF BURETI SUB-COUNTY OF KERICHO COUNTY KENYA.

The activity concentration of radon in underground water of Bureti sub-county was measured using liquid scintillating counter device. The average radon activity concentration in all the water samples was 12.41 Bql-1. The maximum and minimum activity concentrations of radon were 22.5 and 4.57 Bql-1, respectively. In total, 53% of the total samples analysed had radon concentration levels above the US Environmental Protection Agency-recommended limit of 11.1 Bql-1. The annual dose received by an individual as a result of waterborne radon was determined according to the United Nations Scientific Committee on the Effect of Atomic Radiation reports and was found to be 33.23 ðœ‡Svy-1. All the samples recorded a value <100 ðœ‡Svy-1 recommended by the World Health Organization and the European Union council.

Assessment of Levels of Natural Radioactivity in Sand Samples Collected from Ekalakala in Machakos County, Kenya.

Construction sand is naturally polluted with radionuclides of terrestrial origin. In this study, specific activities of 238U, 232Th, and 40K in 30 sand samples collected along the Ekalakala River, Machakos County, Kenya, were measured using a high-purity germanium γ-ray spectrometer. The specific activities ranged between 9.7 Bqkg-1 and 24.0 Bqkg-1, 11.5 Bqkg-1 and 26.2 Bqkg-1, and 820 Bqkg-1 and 1850 Bqkg-1 for 238U, 232Th, and 40K, respectively. While the mean specific activities for 238U and 232Th were less than half of the world average values of 33 Bqkg-1 and 45 Bqkg-1, respectively, the average specific activity of 40K was significant since it was three times the global mean value of 420 Bqkg-1. A calculated absorbed radiation dose rate for the sand varied between 46.8 nGyh-1 and 94.2 nGyh-1 with a mean of 68.5 ± 13.3 nGyh-1. This is not significantly different from the world average dose rate of 60 nGyh-1 for geological samples. The AEDR and Hex had maximum values of 0.29 mSvy-1 and 0.52, respectively, both within the recommended limits of radiation exposure for members of the general public. Based on these results, the sand from Ekalakala River does not pose significant health implication to the sand harvesters as well as the inhabitants of the houses constructed using this sand.

Radon and Thoron; Radioactive Gases Lurking in Earthen Houses in Rural Kenya.

In this paper, documented studies on radon and thoron concentrations in earthen dwellings and 238U and 232Th concentrations in soil in Kenya are reviewed. High concentrations of the isotopes were recorded in the earthen dwellings despite being generally well ventilated. Mrima Hill in the Coast region recorded the highest thoron levels with a mean of 652 Bq m-3. Twenty five percent of dwellings had thoron concentration in excess of 1,000 Bq m-3. Notably high indoor radon levels were recorded in Taita Taveta also in the Coast region, and in Kenyatta University situated in Nairobi in the Central region of the country. Radon concentration in the Rift Valley region was found to be too low to contribute significantly to radiation exposure. Based on studies on the concentration of 238U and 232Th in soil, the Southwestern region of the country was anticipated to have elevated radon/thoron concentrations in earthen dwellings. Existing studies involving measurement of indoor radon and thoron, and 226Ra and 232Th in soil are relatively few and of a small scale. More extensive studies are therefore necessary not only to corroborate the risk projections but to also generate sufficient data to enable countrywide mapping of indoor radon/thoron risk-prone areas.

Association of lifestyle modification and pharmacological adherence on blood pressure control among patients with hypertension at Kenyatta National Hospital, Kenya: a cross-sectional study.

OBJECTIVE: Association of lifestyle modification and pharmacological adherence among patients with hypertension attending a national referral hospital in Kenya. DESIGN: Descriptive, cross-sectional. SETTING: Medical wards and outpatient clinic of a national referral hospital. PARTICIPANTS: Patients (n=229) diagnosed with primary hypertension for at least 6 months. PRIMARY OUTCOMES: Clinical makers, cholesterol levels, anthropometrics, lifestyle/dietary habits adjusted for age, gender and education; antihypertensive adherence; views on prevention of hypertension and adequacy of hypertension information. RESULTS: Ageing was associated with elevated diastolic blood pressure (BP) (p<0.05), heart rate (HR) and cholesterol. Females had higher body mass index (BMI). More males reported drinking alcohol and smoking (p<0.001), especially the highly educated. Higher BPs were observed in smokers and drinkers (p<0.05). Daily vegetables and fruits intake were linked to lower BP, HR and BMI (p<0.05). Intake of foods high in saturated fat and cholesterol were associated with raised HR (p<0.05). Respondents on antihypertensive medication, those engaged in healthy lifestyle and took their prescribed medications had lower mean BPs than those on medication only (138/85 vs 140/90). Few respondents (30.8%) considered hypertension as preventable, mainly the single and highly educated (p<0.05). Respondents (53.6%) believed they should stop taking their antihypertensive medication once hypertension is controlled. CONCLUSION: Missed targets for BP control and hypertension-related risks are associated with ageing, female gender, fast food and animal fat intake. Alcohol and smoking is common in males associated with poor BP control. Daily vegetables and fruits intake are associated with better BP control and overall hypertension risk reduction. Observed suboptimal BP control despite pharmacological adherence suggests lifestyle modification is needed besides antihypertensive medication. Interventions should address modifiable risk factors aggravated by age and adverse lifestyles through adopting combined lifestyle modification, pharmacological adherence and tailored expert delivered hypertension-related information.

Barriers to Screening Pregnant Women for Domestic Violence: A Cross-Sectional Study.

BACKGROUND INFORMATION: Domestic Violence (DV) is associated with serious consequences to the survivor's physical, emotional, sexual, social and mental well-being. DV screening ensures timely detection of violence and hence promotes timely intervention. This timely intervention has the potential of averting adverse outcomes of DV to the survivor. Globally, the prevalence of DV among women is 35% and in Kenya its 49% among women and 13.5% among pregnant women. Despite the adverse outcome of DV in pregnancy, screening during pregnancy lags behind in Kenya. PURPOSE: To assess the nursing barriers to screening pregnant women for DV. METHODOLOGY: A cross-sectional study of 125 nurses selected by random sampling method was conducted at a National Maternity Hospital in Kenya. Data was collected for 8 weeks using researchers developed structured questionnaire. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 20.0. Chi-square test was used to determine significance of relationships between nominal variables. A P-value of ≤ 0.05 was considered significant. RESULTS: Study results revealed that 16% (n=8) of nurses routinely screened pregnant women for DV. Non-screening behavior of nurses was associated with lack of DV screening training during their education program (P=0.002), fear of the partner's reaction (P=0.004) and lack of mentors and role models in DV screening (P=0.005). Lack of cooperation from other health professionals was also associated with non-screening of DV (P=0.016). THE SIGNIFICANCE OF THE STUDY: The results of this study point to the need of developing hospital's protocols on DV management and considering integrating DV screening in the routine medical screening of pregnant women during antenatal care. CONCLUSION: The study showed that the nurse's prevalence of screening pregnant women for DV is low at 16% due to various barriers.

Risk Factors Associated with Severity of Nongenetic Intellectual Disability (Mental Retardation) among Children Aged 2-18 Years Attending Kenyatta National Hospital.

BACKGROUND: Many of the nongenetic causal risk factors of intellectual disability (ID) can be prevented if they are identified early. There is paucity on information regarding potential risk factors associated with this condition in Kenya. This study aimed to establish risk factors associated with severity of nongenetic intellectual disability (ID) among children presenting with this condition at Kenyatta National Hospital (KNH). METHODS: A hospital-based cross-sectional study was conducted over the period between March and June 2017 in pediatric and child/youth mental health departments of Kenyatta National Hospital (KNH), Kenya. It included children aged 2-18 years diagnosed with ID without underlying known genetic cause. RESULTS: Of 97 patients with nongenetic ID, 24% had mild ID, 40% moderate, 23% severe-profound, and 10% unspecified ID. The mean age of children was 5.6 (±3.6) years. Male children were predominant (62%). Three independent factors including "labor complications" [AOR = 9.45, 95% CI = 1.23-113.29, P = 0.036], "admission to neonatal intensive care unit" [AOR = 8.09, 95% CI = 2.11-31.07, P = 0.002], and "cerebral palsy" [AOR = 21.18, CI = 4.18-107.40, P ≤ 0.001] were significantly associated with increased risk of severe/profound nongenetic ID. CONCLUSION: The present study findings suggest that perinatal complications as well as postnatal insults are associated with increased risk of developing severe-profound intellectual disability, implying that this occurrence may be reduced with appropriate antenatal, perinatal, and neonatal healthcare interventions.

Assessment of Parents' Perception of Quality of Pediatric Oncology Inpatient Care at Kenyatta National Hospital.

OBJECTIVE: Adequate knowledge of parents' perception of quality of pediatric cancer care helps to identify the areas of care improvement which would contribute to disease outcome in regard to the quality of life and satisfaction with the care provided. The aim of the study was to assess the parents' perception of the quality of Pediatric Oncology Inpatient Care at Kenyatta National Hospital. METHODS: A cross-sectional descriptive quantitative and qualitative study was undertaken using a pretested semi-structured questionnaire and a focused group discussion guide. Assessment of parents' perception of quality of care was done in relation to the institution's structures and care delivery processes. These included the ward environment, resources for cancer treatment, care processes, service providers, and parents' knowledge empowerment. Participants were systematically selected. Parents' perception was defined as satisfaction or dissatisfaction with the care provided. Data were analyzed using SPSS version 20.0 (Armonk, NY: IBM Corp.) and presented as frequencies and percentages. Chi-square was used to test the significant association between variables. Level of significance was set at a P ≤ 0.05. RESULTS: A total of 107 respondents were interviewed and 57.9% were satisfied with the overall quality of care they received. The determinants of overall satisfaction in this study were found to be related to resources for cancer treatment (odds ratio [OR] =3.10; 95% confidence interval [CI] =1.39-6.90; P = 0.005), care delivery processes (OR = 2.87; 95% CI = 1.28-6.43; P = 0.009), and the ward environment (OR = 2.59; 95% CI = 1.17-5.74; P = 0.018). CONCLUSIONS: The parents were moderately satisfied with the oncology care services their children received. The gaps identified in service delivery included those related to the availability of the required resources for efficient care delivery and also educational as well as psychosocial needs of the parents.

Early growth in preterm infants after hospital discharge in rural Kenya: longitudinal study.

INTRODUCTION: Prematurity is the single most important cause of mortality during the neonatal period. The early growth of these infants has been shown to be a predictor of their later growth and neurodevelopmental outcomes. The objective of this study was to establish the determinants of early growth in preterm infants after hospital discharge at the Kitui District Hospital, Kenya. METHODS: A short longitudinal study design was adopted to execute the study. During the period of April and June 2014, all the preterm infants who were discharged from the Kitui District Hospital Newborn Unit were enrolled in the study by obtaining written informed consent from their guardians. The anthropometric measurements of these infants were taken at discharge and repeated two weeks later at the Pediatric Outpatient Clinic and the Maternal Child health Clinic. A questionnaire guided interview was held with the guardians to establish infant and maternal characteristics which influenced the infants' early growth. RESULTS: A total of 112 participants were enrolled for the study with 106 (94.4%) of them being available for reassessment after two weeks. Majority (72.6%) had deficit in growth by failing to attain the recommended WHO average weight gain of 15g/kg/day. Most of the mothers (63.4%) were between the ages of 20-29 years with half of them being first time mothers. Many of them (66.1%) had only attained primary education and were married (66.1%) to self-employed husbands (56%). CONCLUSION: Most of the preterm infants at discharge were females who were born between 33 and 36 weeks gestation. Growth deficit was present in the majority and gestational age at birth was a major determinant of the early growth in these preterm infants.