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Pharmaceutical Journal of Kenya, Volume 24, No. 3 (2020)

Volume: 24, No. 3 (2020)
ISSN: 2411-6386;
Publisher: The Pharmaceutical Society of Kenya
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Articles in the journal

Editorial :Reporting of Adverse Drug Reactions

Author: Maima, A.

Adverse drug reaction occurrence, reporting and associated factors among patients in selected hospitals in Kirinyaga County, Kenya 53

Author: Muriithi, D. N., Mokaya, D., Muturi, S. K.
Keywords: Adverse drug reactions, Patients, Reporting, Occurrence, Pharmacovigilance
Background: Adverse drug reactions are a significant cause of prolonged hospitalization, hospital admissions, high monetary burden in health frameworks, disability, and death. Reporting these adverse drug reactions helps to reduce the public health burden of adverse drug reactions.
Objective: The aim of the current study was to determine factors affecting the occurrence and reporting of adverse drug reactions among patients in selected hospitals in Kirinyaga County, Kenya.
Methodology: A facility based cross-sectional study design was used. Data was collected from 360 patients using a pre-tested interviewer-administered questionnaire. Multistage sampling was used to recruit respondents. Data analysis was carried out using Statistical Package for Social Sciences version 23. The Chi-square test was used to determine association, while binary logistic regression assessed the strength of association. Fishers exact test was used to test significance. Outcomes were considered significant at a p value of <0.05.
Results: Of the total study respondents, 166 (46.1%) experienced adverse drug reactions. Of these, 145 (87.3%) patients reported adverse drug reactions to healthcare providers. Among those who reported adverse drug reactions, 122 (73.5%) were not aware of the patient alert card. Dizziness associated with efavirenz 38 (10.6%) was the most commonly occurring adverse drug reaction. The study showed that gender (χ2 = 7.072, df = 1, P = 0.009) affected the occurrence of adverse drug reactions. Notably, men had a 46.2% reduced chance of experiencing adverse drug reactions (OR 0.538, 95% CI 0.340–0.852, P = 0.008). Knowledge of the patient alert card (χ2= 0.053, df = 1, P =0.796) did not affect adverse drug reaction reporting.
Conclusion: Adverse drug reaction reporting among patients was high (87.3%). A gender effect on occurrence was noted, with men less likely to experience adverse drug reactions compared to women. There was a gap in knowledge of the patient alert card with 73% of patients being unaware. Therefore, regular sensitization and availing the patient alert card are highly recommended to improve adverse drug reaction reporting. Similar studies should be carried out to determine other determinants of occurrence and reporting adverse drug reactions among patients.

Factors that affect the availability of medicines in public health facilities in Kenya: A case study of Nairobi City County

Author: Ganatra N., Karimi P.N., Shital M., Kayumba C.
Keywords: drug shortages, unavailability of medicines, procurement
Background: According to the World Health Organization (WHO), drug shortage is a multifaceted and global problem, affecting both developing and developed countries. Medicines are a crucial part of healthcare, and their availability is important to ensure patients’ access to quality and affordable services. Drug shortages and misuse have a far-reaching effect on patients’ well-being and the hospital’s operations.
Objective: To evaluate the factors affecting the availability of medicines in public health facilities within Nairobi City County.
Methodology: A descriptive cross-sectional design was used. Purposive sampling was employed to select eight hospitals within Nairobi City County from which twenty-two participants were recruited. Within each facility, key informants were selected from the departments concerned with the management of medicines including pharmacy, procurement and finance departments. Data was collected using questionnaires and key informant interviews. Findings were summarized and presented in tables and graphs.
Results: All the facilities had experienced both drug shortages and drug expiries in the previous quarter, with 75% of them having a drug fill rate of between 50% and 70%. The selection and quantification of drugs was carried out by the pharmacy department. Competitive and direct procurement methods were the most common practices. Supplier evaluations were regularly carried out. Inadequate funds, delays in funds disbursement, staffing shortages and bureaucratic bottlenecks were cited as the major challenges. The use of manual data recording systems was common practice.
Conclusion: The availability of medicines was dependent on many factors that cut across departments. Lack of medicines was a chronic problem in all the facilities.

Challenges and solutions in handling medications by visually impaired patients

Author: Lumb P.J., Nyamweya N.
Keywords: handling medications, visually impaired patients

A review of Phytochemical Constituents and Pharmacological Activities of Ethnomedicinal Warburgia ugandensis Sprague ssp. ugandensis in East Africa

Author: Dharani N.
Keywords: Warburgia ugandensis, Medicinal uses, Phytochemistry, Antiplasmodial activities, Antimicrobial activities
Use of indigenous medicinal plants has been practiced in East Africa for centuries and is still being widely used to-date. The genus Warburgia belongs to family Canellaceae. The species Warburgia ugandensis Sprague ssp. Ugandensis (commonly known as East African greenheart, Pepper-bark tree) is an evergreen tree distributed throughout East Africa, including in the Democratic Republic of Congo, Ethiopia, Kenya, Malawi, Tanzania, and Uganda. The plant has been used for centuries by various local communities and several traditional healers in East Africa to treat many diseases including Malaria, constipation, tooth-ache, stomach-ache, diarrhoea, coughs and colds and general muscular and other body pains. The species, very well known to local communities by its local names, grows in natural habitats and also on farmlands where it has been domesticated. The present review describes the existing data on the botany and ecology, plant parts used, phytochemical constituents, traditional uses and pharmacological activities of W. ugandensis. The review established that during the last few decades, numerous folk medicine and scientific reports on the anti-plasmodial activitiy, antimicrobial activity and antifungal activity of this species have been cited in the literature. The chemical composition of the bark and leaves is relatively well studied. Literature review confirmed several chemical constituents isolated particularly from stem bark and leaves of this species. Drimane sesquiterpenes, including muzigadial, salutariolide, warburganal, polygodial and isopolygodial and mukaadial among several others have been reported in stem bark of W. ugandensis. The sesquiterpenes of Warburgia species are known to possess insect anti-feedant, anti-microbial, anti-plasmodial, anti-fungal anti-ulcer and molluscicidal properties. Further research by pharmaceutical companies and research institution needs to be carried out on W. ugandensis species for its potential in curing and treating diseases, particularly stem bark and leaves in regard to its antiplasmodial and antimicrobial activities. Therefore, pre-clinical and clinical trials need to be done to further validate the traditional medicine applications of W. ugandensis for possible antimalarial and antibacterial drug discovery.

Factors associated with complications among type 2 diabetes patients visiting a regional referral hospital in Nairobi, Kenya

Author: Ochoki Evans, Mutai Joseph, Nyamongo Daniel
Keywords: Type 2 diabetes, complications
AbstractBackground: Diabetes mellitus is a major public health concern globally. In Kenya, 2019 estimates by the World Health Organization indicated a prevalence of 3.3%, equivalent to 1.5 million people. The prevalence is expected to increase by 4.5% by the year 2030 in the absence of effective preventive measures.Objective: This study sought to investigate the risks involved in the development of chronic complications of type 2 diabetes mellitus amongst patients visiting a regional referral hospital in Nairobi, Kenya.Methods: A cross-sectional approach was used. The target population was diabetes patients aged 18 years and over at Mama Lucy Kibaki Referral Hospital in Nairobi, Kenya. Consecutive sampling technique was used to select patients. Primary data was collected by the use of semi-structured questionnaires and an interview guide. Three focus group discussions were conducted and key informant interviews done with doctors, nurses and the medical superintendent of the hospital. Chi-square test was used to explore associations between various variables.Results: The prevalence of type 2 diabetes mellitus complications among patients attending the hospital was estimated at 58.3 % (95% confidence interval, C.I., 52.3% - 64.2%). In bivariate analysis, three factors were significantly associated with complication status at 5% level of significance; age-group (P < 0.001), occupation (P < 0.001) and herbal medicine use (P < 0.001). In multivariate analysis, age above 70 years vs 18-35 years (prevalence ratio, PR, 1.72, CI 1.15-2.58), age 56-70 years vs 18-35 years (PR 1.59, CI 1.14-2.23), and herbal medicine use (PR 1.62, CI 1.36-1.94) were significantly associated with complication status.Conclusion: We found that older persons, obese persons and persons using herbal medicines were more likely to have complications of type 2 diabetes mellitus. Health providers and care givers should be supported to provide health promotion and nutrition programs to their diabetes patients. Attempts should be made to include herbal medicine practitioners in patient management programs to ensure their practices support rather than interfere with treatment.

The Role of Banknotes in the Spread of COVID-19

Author: Oker A.N., Butt N.
Keywords: COVID-19, banknotes

Publishing your articles in the Pharmaceutical Journal of Kenya: notes from a career seminar at the Jomo Kenyatta University of Agriculture and Technology

Author: Mugo, P.
Keywords: publishing