Umma Staff Publications
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Item Determinants of cancer care pathways at Wajir County, Kenya: patient perspectives(Researchecancer, 2025-02-12) Affey, Fatuma; Halake, Dabo Galgalo; Wainaina, Grace Muira; Osman, Hussein Ali; Ndukui, James G; Abdourahman, Houda; Abdihamid, OmarBackground: Cancer represents a major public health issue with substantial morbidity and mortality in low-resource settings such as Kenya. This study focuses on Wajir County in northern Kenya, a region with limited cancer care infrastructure and high unmet needs. Despite recent efforts to decentralize cancer care in Kenya, including establishing regional cancer centres in Garissa, Nakuru, and Mombasa, access to screening, diagnostics, and treatment remains constrained, particularly in rural areas. The absence of comprehen- sive cancer care pathways and a specialized oncology workforce in Wajir County exac- erbates challenges in early detection, treatment, and palliative care. The study evaluated the availability of cancer care services at Wajir County Referral Hospital (WCRH), includ- ing screening, diagnostic services, treatment modalities, and referral systems. The study further explores the gaps in cancer care, focusing on patient perspectives, and proposes potential solutions to address these challenges. Methods: This study used mixed-methods (qualitative and quantitative) methods to understand cancer care from the perspective of patients at WCRH. It involved adult patients (over 18) with a confirmed cancer diagnosis who were receiving treatment or follow-up care between February and April 2024. Data were gathered through inter- views and surveys, with research assistants helping with language translation and com- munity navigation. The study collected information on demographics, cancer types, and prevalence rates, which were analysed using descriptive statistics. The qualitative data focused on patients' experiences with cancer awareness, treatment, and care gaps, and were analysed for common themes. Ethical approval was obtained, and informed consent was given by all participants. Results: This study involved 25 cancer patients (12 males, 13 females) receiving treat- ment at WCRH. The most common cancers were esophageal (44%), cervical (28%), breast (24%), and prostate (8%). Delays in diagnosis were significant, with 12% of patients wait- ing over 6 years, 24% waiting 4–6 years, and 40% waiting 1–3 years before seeking care. Most diagnoses were made at WCRH (64%), with others diagnosed at the Garissa Can- cer Centre (22%) or in Nairobi (20%). Diagnostic tools available at WCRH included pap smears, mammograms, PSA tests, ultrasound, CT scans, and biopsies. However, access to these tools was limited, with barium swallow (32%) being the most frequently used for esophageal cancer, followed by pap smears, biopsies, and ultrasound (16% each). Patient awareness of cancer screening was higher for cervical (68%) and breast cancer (60%) but lower for prostate cancer (32%) and esophageal cancer (4%). Despite awareness, only 8% had previously undergone screening. Regarding treatment, most patients (80%) were aware of surgical options, while fewer knew about chemo- therapy (28%) or palliative care (12%). When treatment was unavailable at WCRH, most patients preferred the Garissa Cancer Centre (80%) or Nairobi (52%). Financial challenges were the primary barrier to treatment for 88% of patients, and patients suggested improving local cancer care, subsidizing treatment, and enhancing early detection and screening services. Conclusion: The findings indicate a high burden of late-stage cancer diagnoses, insufficient cancer screening and treatment services, and limited access to cancer care pathways and patient navigation systems. These results underscore the urgent need for improved cancer care pathways, enhanced awareness, and increased healthcare capacity to reduce cancer morbidity and mortality in northern Kenya. This study contributes to understanding the cancer care landscape in Wajir County and provides a foundation for future health policy initiatives aimed at bridging existing gaps in cancer care.Item Association between the workload of nurses and patients’ safety consequences at Erdogan referral hospital, Mogadishu, Somalia; A cross-sectional Study(2023-09-01) Abdirahman, Sowda Ibrahim; Hussein, Anisa Abdullahi; Mohammed, Zeynab Ahmed; Osman, Hussein Ali; Elmi, Omar SaladThe nursing workload is a significant public health concern and one of the most persistent themes in health worldwide. The Insufficient nurses staffing or overworked of nurses in hospital-based care could lead severe consequences of patients' safety outcomes, such as mortality, infections, and failure to rescue, as well as decrease quality of care. No previous study has been done in Somalia in this regard. Therefore. This study aimed to determine the association between nurses' workload and patient safety outcomes at Mogadishu, Turkey's Recep Tayyip Erdogan Training and Research Hospital, Mogadishu, Somalia. The study was a cross-sectional study was conducted among registered working nurses and selected patients who were registered and admitted at Mogadishu, Somalia—Turkey's Recep Tayyip Erdogan Training and Research Hospital. The study populations were selected using simple random sampling methods, and data were analysed using multiple logistic regression analysis. A total of 360 participants were analysed. Overwhelmingly, 93 (51.7%) nurses worked between 8 and 12 hours per day in each shift on daily based. Every five nurse respondents, one worked more than 12 hours daily—63 (35%). According to the findings of this study, the majority of nurses (82.88%) were have felt stressed due to their workload. Multiple logistic regression analysis revealed the risk factors associated with patients’ safety outcomes were Urinary Trac Infection (UTI) was (AOR = 0.03 95% CI = (0.163-0.571, P = 0.001), Blood Stream Infection (BSI) (OR = 3.909, 95% CI = 2.312-6.610, P = 0.001), and patient monitoring tragedy (AOR = 0.61 95% CI = (0.031-0.199, P = 0.001). The results revealed that most nurses worked between 8 and 12 hours per day and were highly stressed due to the burden of their work. The risk factors associated with nurses' workload and patients' safety were the incidence of UTI, BSI and patient monitoring tragedy. This study emphasised that nurses' workloads directly affected patients' safety consequences. This study reported a lack of the following recommended international Labouré Standardization (ILS) guidelines in Somalia for nurses' rights and work standardisation. Also, immediate action needs to be taken by Somalia's health authorities to protect the nurse's rights.Item Genotyping of Helicobacter pylori cagA Gene from a Patient Who Failed Eradication Therapy: A Case Report and Review of the Literature(2015-04-01) Osman, Hussein Ali; Hasan, Habsah; Suppian, Rapeah; Arjunan, Saravanan; B. A., ZilfalilHelicobacter pylori (H. pylori) is a bacterium that causes chronic gastritis, gastric and duodenal ulcers and gastric cancer. Here we report a female patient presenting with dyspepsia. She was tested positive six times by the Rapid Urease test and Urea breath test (UBT). A culture of gastric biopsy was done and the isolate showed resistance to Clarithromycin and Metronidazole while polymerase chain reaction (PCR) revealed the presence of cagA H. pylori virulence gene. Presence of cagA might not be a risk factor in development of Metronidazole resistance to antibiotic therapy. In conclusion, we report a female Malaysian Indian with cagA positive H. pylori infection, but experienced Metronidazole resistance to antibiotic therapy.Item A Global Survey of COVID-19 Vaccine Acceptance Among Healthcare Workers(Frontiers in public health, 2022-02-08) Noushad, Mohammed; Rastam, Samer; Nassani, Mohammad Zakaria; Al-Saqqaf, Inas Shakeeb; Hussain, Mudassir; Yaroko, Ali Ango; Arshad, Mohammed; Kirfi, Abdullahi Musa; Koppolu, Pradeep; Niazi, Fayez Hussain; Elkandow, Ali; Darwish, Mahmoud; Nassar, Ahmad Salim Abdalla; Mohammed, Sami Osman Abuzied; Hassan, Nasser Hassan Abdalrady; Abusalim, Ghadah Salim; Samran, Abdulaziz; Alsalhani, Anas B; Demachkia, Amir Mohiddin; Marques de Melo, Renata; Luddin, Norhayati; Husein, Adam; Habib, Adnan; Suleyman, Firas; Osman, Hussein Ali; Al-Awar, Mohammed Sadeg; Dimashkieh, Mohiddin R.; Swapna, Lingam Amara; Barakat, Ali; Alqerban, AliEven though several effective vaccines are available to combat the COVID-19 pandemic, wide disparities in vaccine distribution, and vaccine acceptance rates between high- and low-income countries appear to be major threats toward achieving population immunity. Our global descriptive study aims to inform policymakers on factors affecting COVID-19 vaccine acceptance among healthcare workers (HCWs) in 12 countries, based on income index. We also looked for possible predictors of vaccine acceptance among the study sample.Item Evaluation of the Atlas Helicobacter pylori Stool Antigen Test for Diagnosis of Infection in Adult Patients(Asian Pacific Journal of Cancer Prevention, 2014) Osman, Hussein Ali; Hasan, Habsah; Suppian, Rapeah; Bahar, Norhaniza; Hussin, Nurzam Suhaila Che; Rahim, Amry Abdul; Hassan, Syed; Andee, Dzulkarnaen Zakaria; Zilfalil, Bin-AlwiBackground: Helicobacter pylori (H.pylori) is one of the most important causes of dyspepsia and gastric cancer and diagnosis can be made by invasive or non-invasive methods. The Atlas Helicobacter pylori antigen test is a new rapid non-invasive method which is simple to conduct. The aim of this study was to determine its sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Materials and Methods: This prospective study was conducted between July 2012 and December 2013. Stool samples of 59 dyspeptic patients who underwent upper endoscopy were evaluated for H. pylori stool antigen. Results: From the 59 patients who participated in this study, there were 36 (61%) males and 23 (39%) females. H. pylori was diagnosed in 24 (40.7%) gastric biopsies, 22 (91.7 %) of these being positive for the Atlas H. pylori antigen test. The sensitivity, specificity, PPV, NPV and accuracy were 91.7%, 100%, 100%, 94.6% and 96.6% respectively. Conclusions: The Atlas H. pylori antigen test is a new non-invasive method which is simple to perform and avails reliable results in a few minutes. Thus it can be the best option for the diagnosis of H. pylori infection due to its high sensitivity and specificity.