United States International University Africa

Bipolar disorder (BD) is a chronic psychiatric illness associated with significant morbidity and functional impairment. Although symptom control is a key goal of pharmacological treatment, functional recovery often remains elusive. In sub-Saharan Africa, and particularly Kenya, limited data exist on treatment outcomes for BD. This study assessed remission, functional recovery, and suicidality among bipolar patients at Mathari National Teaching and Referral Hospital, Kenya’s primary mental health institution. A cross-sectional descriptive design was carried out among 51 adult patients diagnosed with BD (Type I or II) and treated for at least 6 months. Manic and depressive symptoms were assessed at the time of evaluation by using the Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HAM-D); functional outcomes were measured using the Functioning Assessment Short Test (FAST). Suicidality was assessed through structured clinical interview questions. Approximately 92.2% scored below the threshold for clinically significant manic symptoms at the time of assessment, and 74.5% for depression. However, only 45.1% achieved functional recovery (FAST score < 11). Occupational and interpersonal functioning were the most impaired domains. Suicidal thoughts or behaviors were reported by a minority of participants. Specifically, 15.7% (n = 8) reported suicidal ideation and 5.9% (n = 3) reported a history of suicide attempt. Even though a high proportion of participants scored below symptomatic thresholds, indicating low current symptom burden, substantial functional impairment persisted, underscoring the need for integrative treatment strategies targeting psychosocial and occupational domains in BD management. Not applicable.

Psychology research in North America and Europe faces a credibility crisis, with speculations of a global-scale crisis has spurred the development of a broad array of open science practices to improve different aspects of the research process. Alongside this development, a broad array of stakeholders have noted that African science is at its own crossroads, as investments in this sector can facilitate human development on the continent. Here we argue that these two movements can facilitate each other: psychology in North America and Europe can benefit from stronger psychology research communities on the African continent, while African scientists can benefit from credible evidence generated through open, freely-available open science practices and tools. However, this synergy will only materialize if a wide array of stakeholders invest in African science through providing resources, training, and specially adapted research tools while simultaneously avoiding ethical pitfalls such as corruption and research colonialism. Synergizing these efforts enables psychology in Africa to benefit from credible and accessible research, and African psychology can advance the credibility of psychology research worldwide.

This study aimed to address the critical gap in the limited application of machine learning (ML) for identifying developmental delays in low-resource settings by developing models to predict off-track development in infants aged 0 to 6 months and identify key predictors. A cross-sectional study involving 1,995 singleton infants aged 0 to 6 months was conducted in Kaloleni and Rabai sub-counties, Kilifi, Kenya, between March 2023 and March 2024. Development was assessed using the World Health Organization's Indicators of Infant and Young Child Development tool, with Development-for-Age Z-scores used to classify infants as on- or off-track. Ridge logistic regression (LR), random forest (RF), and extreme gradient boosting (XGBoost) models were trained using sociodemographic, psychosocial, clinical/biological, nutritional, and health-related predictors. Performance was evaluated using area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity. SHapley Additive exPlanations enhanced model interpretability. Approximately 10.4% of infants were developmentally off-track. Ridge LR, RF, and XGBoost showed similar performance, with AUCs of 76.6%, 75.8%, and 76.1%, respectively. Limited psychosocial stimulation and increasing infant age were the strongest predictors. This study highlights the burden of developmental delays in low-resource settings. ML models show promise for early risk prediction and targeted intervention, though further validation is recommended. Early intervention programs are proven to enhance optimal childhood development, yet the vital step of early identification of developmental delays is often overlooked. While machine learning is increasingly used to predict or identify health outcomes, its application in identifying developmental outcomes, particularly in low-resource settings, remains limited. This study contributes to the literature by applying machine learning to identify infants who are developmentally off-track and highlights key predictors. Limited psychosocial stimulation and increasing infant age were the strongest predictors, alongside low socioeconomic status, maternal mental health challenges, limited healthcare access, and nutritional and biological risks.

Community pharmacists serve as the most accessible healthcare providers, playing a pivotal role in patient counselling, health education, and disease prevention. Despite their critical function in the healthcare system, limited research has examined their actual involvement in these areas within Nairobi, Kenya. This study aimed to assess community pharmacists' engagement in patient counselling and health education, comparing self-reported practices with observed behaviours using a simulated patient approach. This study employed a cross-sectional descriptive design incorporating both structured questionnaires and a simulated patient (SP) methodology to compare self-reported and observed counselling practices among registered community pharmacies in Nairobi. Sixty pharmacies were randomly selected, and forty-eight pharmacists completed the study. Data were collected using structured questionnaires that assessed pharmacists' self-reported counselling and health education practices, alongside simulated patient visits that evaluated actual pharmacist-patient interactions. The case scenarios included a request for diabetes medication without a prescription, an over-the-counter acne treatment request, and a consultation for severe acne. These encounters were used to assess counselling competence, regulatory adherence, and patient education. Data were analysed using descriptive statistics to compare self-reported practices with observed behaviours. While 66.7% of pharmacists reported providing detailed counselling, only 26.7% of simulated visits reflected this practice. Additionally, 75% of pharmacists provided minimal verbal counselling beyond stating the drug name and dosage. Patient satisfaction levels were low, with most simulated patients rating their encounters poorly on a 20-point scale. The study underscores critical gaps in patient counselling, health education, and adherence to prescription regulations among community pharmacists in Nairobi. The disconnect between self-reported and observed counselling practices suggests the need for targeted training programs to enhance pharmacists' communication skills, regulatory compliance, and disease prevention counselling. Strengthening enforcement mechanisms and integrating patient-centred education strategies in pharmacy curricula are essential to optimizing pharmacists' roles in healthcare. These findings highlight the need for targeted training and regulatory enforcement to strengthen pharmacists' roles in patient counselling and health education in Nairobi.

Kenyan universities are increasingly integrating digital technologies into their academic and administrative operations. However, this digital transformation has exposed institutions to escalating cybersecurity threats, including data breaches, ransomware attacks, and unauthorized access to critical information. This study evaluates the effectiveness of existing cybersecurity measures and incident management systems in Kenyan universities, aiming to identify key vulnerabilities and areas for improvement. A structured survey was conducted among IT personnel from four major Kenyan universities, gathering data on cybersecurity preparedness, existing frameworks, and incident response strategies. The findings indicate that while universities have implemented basic cybersecurity measures such as firewall protections and access controls, there are significant gaps in real-time threat detection, incident response preparedness, and cybersecurity training programs. Many institutions lack dedicated cybersecurity teams, and incident response mechanisms are largely reactive rather than proactive. Additionally, limited financial and technical resources hinder effective implementation of cybersecurity policies. This paper highlights critical deficiencies in cybersecurity frameworks currently in use and emphasizes the need for real-time monitoring systems, improved staff training, and the adoption of automated threat detection tools. The study recommends a multi-stakeholder approach involving universities, government agencies, and cybersecurity experts to enhance resilience against evolving cyber threats. Addressing these gaps will allow Kenyan universities can strengthen their cybersecurity posture, protect academic assets, and safeguard the privacy of students and faculty members. This research contributes to ongoing discussions on cybersecurity in higher education and provides a foundation for developing more effective cybersecurity policies and frameworks in African academic institutions.

SummaryExtreme heat impacts on child health and well-being due to immature thermoregulation, less sweating and a high surface-to-body mass ratio that make them more vulnerable to heat-related illness. Severe dehydration, especially if struggling with breastfeeding, renal failure and electrolyte imbalance, and neurological and cardiorespiratory failure may result. This late preterm was born healthy during a heatwave and developed lethargy and minimal responsiveness from day of life (DOL) 5, developed seizures at DOL 12, then demised at DOL 20. All hospitals involved in the diagnostic workup and treatment presumed severe sepsis and treated accordingly. However, microbiology results were always negative. In infants, especially if preterm, it is challenging to distinguish septic shock from heat-related illness, as well as other neonatal diagnoses. Medical history, including risk factors for infection and heat-related disease, must be thoroughly explored. It is important for healthcare workers and the public to be aware of potentially fatal neonatal heat-related illness.

This study examined the perceptions of farmers towards Indigenous Technical Knowledge (ITK) in ricebean (Vigna umbellata) production. It was guided by the perception-adoption mediation framework based on the diffusion of innovations and technology adoption theories. The survey design applied was a cross-sectional survey on ricebean-growing farmers in the Nyanza region. Purposive, systematic and snowball sampling was used to recruit 397 respondents. Data were collected through a structured questionnaire and key informant interview and analysed using descriptive statistics, the perception index and multivariate regression analysis. Farmers highly ranked ITK in terms of environmental friendliness (mean=4.49), low cost (4.33), accessibility (4.18), cultural acceptability (4.17) and human safety (4.16). Moderate ratings were given to effectiveness, and similarity to CK was the lowest (3.08). Education had a significant effect on the perceptions of effectiveness (p ≤ 0.001), availability (p ≤ 0.013) and affordability (p ≤ 0.020); land size had an effect on the perceptions of effectiveness (p = 0.058) and environmental friendliness (p ≤ 0.005); income level had an effect on the perceptions of effectiveness (p ≤ 0.001) and affordability (p ≤ 0.041). Differences in genders were significant with human safety (p ≤ 0.033), environmental friendliness (p ≤ 0.033) and ITK resembling CK (p ≤ 0.070). The results indicate that ITK is significant in that it is cost-effective and environmentally friendly and culturally acceptable, and there is a need to tailor-create interventions according to the socio-demographic variables in order to make ricebean farming sustainable.

Globally, emerging adults (EAs) aged 18–29 face a disproportionate burden of substance use and mental health challenges, with particularly acute impacts in sub-Saharan Africa. In Kenya’s coastal region, high rates of cannabis, khat, alcohol, cigarettes, and heroin use among EAs intersect with limited mental health awareness, stigma, and restricted access to care. This developmental stage—characterised by identity formation, educational transitions, and economic instability—heightens vulnerability to mental disorders and maladaptive coping. This qualitative study examined mental health challenges, psychological problems, and maladaptive coping mechanisms among EAs with substance use disorders (SUDs) in coastal Kenya. Nine focus group discussions (FGDs) were conducted with 88 participants recruited from treatment facilities across Mombasa, Kilifi, and Kwale counties. Data were collected using a semi-structured guide, transcribed, translated, and thematically analysed using NVivo 11. Findings revealed significant mental health challenges, mainly depression and anxiety; key psychosocial problems, including poor educational and occupational outcomes, dysfunctional relationships, and maladaptive coping strategies. These interconnected issues hurt treatment outcomes for this population. A key limitation of the study is the exclusion of non-treatment-seeking individuals, which may limit generalizability. Stakeholders should prioritise the integration of WHO’s PM+/PM+A and evidence-based CBT approaches to expand culturally responsive, community-based mental health care. While the study focused on treatment-seeking individuals, future research should include non-treatment-seeking EAs and explore gendered experiences to inform inclusive interventions.

&lt;b&gt;Background:&lt;/b&gt; Personalised medicine through pharmacogenomics is revolutionalizing healthcare delivery by encouraging individualized therapy that takes into consideration an individual's genetic profile, environment and lifestyle. Pharmacogenomics is an aspect of pharmacy that studies the relationship between genetic profile and response to therapeutic agents.&amp;nbsp; However, the application of the concepts of pharmacogenomics in healthcare helps in achieving more effective and safe responses from therapy. This study evaluates the application and benefits of pharmacogenomics in clinical practice based on evidence from current practices in various medical fields.&lt;br /&gt; &lt;b&gt;Methods:&lt;/b&gt; In carrying out this review, PubMed database was the primary literature source and we analyzed and synthesized findings from the included literature thematically as it relates to pharmacogenomics applications, benefits and challenges as well as safety and ethical concerns.&lt;br /&gt; &lt;b&gt;Results:&lt;/b&gt; Pharmacogenomics has been widely applied in various aspects of healthcare such as in dosing, choice of treatment, reducing and management of adverse reactions, individualization of therapy, optimizing efficacy of therapy. Despite its numerous applications, its adoption faces challenges such as limited clinical evidence, lack of specialized training among healthcare professionals, cost and complexity of genetic mapping as well as ethical concerns.&amp;nbsp;&lt;br /&gt; &lt;b&gt;Conclusion:&lt;/b&gt; With ongoing advances in genomic technologies, pharmacogenomics is becoming an integral aspect of individualization therapy in clinical practice and more widely applied in different healthcare sectors.