DOCTOR OF PHILOSOPHY DEGREE IN PHARMACOGNOSY AND COMPLEMENTARY
MEDICINE
Thesis title: An Evaluation of Antioxidants And Anti-inflammatory Effects of Natural Food and Medicinal Plants of the Ilkisonko Maasai Community, Kenya.
I did my undergraduate about 10 years ago in this very institution and was eager to come back after sufficiently practicing in this field to specialize in an area that will be beneficial to the community I serve. I am a pharmacist working for the county government, my primary areas are validation of prescriptions, dispensing medications, improving and monitoring use of medicines, extemporaneous preparations, primary health care, pharmacovigilance and being part of various multi-disciplinary teams in the public hospital where I am stationed. I have also worked in public, private and academia before My dissertation for is about formulating and characterizing an oral gel of Nystatin-lidocaine. In formulating this gel I hope this gel will be used by all groups of the general population to whom it will be accessible, improve compliance and quality of life
Formulation and in vitro characterization of Nystatin-Lidocaine oral gel
Due to changes in the practice of medicine such as the introduction of broad-spectrum antibiotics, immunosuppressive agents, transplants, in-dwelling catheters and the rise of morbid conditions such as diabetes, severe malnutrition in children and HIV/AIDS, the incidence of fungal infections especially candidiasis has increased. Candidiasis is a frequent cause of discomfort in the mouth, pain, altered taste and aversion to food.
Currently, drug delivery systems such as bucco-adhesive tablets, mouthwashes, oral suspension and oral gels are used for a various conditions of the oral mucosa. These required repeated dosing to achieve optimum concentration at infection sites. Oral gels are preferred because they provide better drug absorption due to longer residence time and can be modified to give controlled release. By formulating nystatin-lidocaine oral gel that will hopefully be locally adsorbed for a longer period of time, hence have fewer dosing frequency than the oral solution.,while lidocaine numbs the pain on site with local lesions..
Nystatin-lidocaine gels were obtained using a two level, three model factorial experimental design. The concentration of carbopol 940 (at 0.25 and 0.7%), tween 20(at 0.5 and 2%) and glycerol (at 0.5 and 0.8%), were varied while the other excipients were held constant. From the formed gels, a 32 factorial design facilitated optimization of the formulations using the Design Expert® (version 12). The formulated gels were evaluated for quality by conducting analytical testing for drug content, spreadability, pH and viscosity. The analytical parameters tested were found to be fit-for-purpose.
Supervisors
Dr. Shital Maru
Dr.Alex Okaru
Simon Kigoro was born in Nyandarua county where he attended Waka Junior school and did KCPE in 2006. He proceeded to Nyandarua High School where he did his KCSE in 2010 with an excellent score of A plain. He joined Kenyatta University in 2011 where he pursued Bachelor of Pharmacy degree and later graduated in 2016. He did his internship at Kitale level 5 Hospital and was registered as a pharmacist in 2018. He enrolled for the Masters of Pharmacy in Clinical Pharmacy at The University of Nairobi where he graduated in 2020 with masters in Clinical Pharmacy.
DRUG THERAPY PROBLEMS AMONG PATIENTS WITH THYROID DISEASE IN KENYATTA NATIONAL HOSPITAL
Background: The prevalence of thyroid dysfunction has been on the rise in sub-Saharan Africa. Patients with thyroid disorders are more likely to present with other comorbidities such as hypertension, diabetes, cardiomyopathies and auto immune diseases. These patients are likely to be on various categories of drugs including those with a narrow therapeutic index such as levothyroxine and others which affects thyroid function. In view of such interventions occurrence of drug therapy problems severely limits achievement of therapeutic goals. Information regarding drug therapy problems in this subset of patients is limited and only mentioned in few inconclusive studies. This study aimed to evaluate the various drug therapy problems that maybe encountered in such patients in Kenya
Study Objectives: The aim of this study was to assess and characterize the various drug therapy problems which occur among patients presenting with thyroid disorders and are being followed up at the endocrinology clinic located within Kenyatta National Hospital.
Methodology: The study adopted a cross-sectional design. A simple random sample of patients presenting with thyroid dysfunctions and who met the inclusion criteria was taken. All relevant patient data was extracted using a questionnaire modified from the Helper and Strand tool. The relevant laboratory reports and medication prescription data was extracted from the patient’s files. Assessment of drug therapy problems was done using the Helper and Strand tool. The data obtained was entered in Microsoft excel and analyzed using STATA. Descriptive summary statistics were presented as means with standard deviations for normally distributed data for continuous variables and medians and interquartile ranges for non-normally distributed data. Categorical variables were summarized using frequencies and percentage proportions.
Results
Among the 85 participants recruited, 71 (83%) were females and 14 (17%) were males. The male to female ratio was 1:5. The mean age of participants was 51.4(SD 14.8) with a range of 21-83 years. Hyperthyroidism was the most prevalent thyroid condition (47%) followed by hypothyroidism (25%). The major type of comorbidity was hypertension (36%) followed by both hypertension and diabetes (9%). Eighty seven percent of the participants had a DTP. The most prevalent type of DTP was noncompliance (38%) followed by dosage too low (25%) and need for additional drug therapy (16%). The most significant risk factors for noncompliance to thyroid medication were level of education (p -0.004), income (p -0.030) and type of drugs (p -0.026).
1st supervisor- Dr Sylvia Opanga
2nd supervisor- Prof Faith Okalebo
My name is Preston Ochieng Otieno and I am an Assistant Director of Pharmaceutical Services and the Pharmacist In-Charge of the Kitale County Hospital Comprehensive Care Centre. I am a skilled pharmaceutical systems expert and a registered Pharmacist with a broad range of experience in the health sector and strong background in Pharmacovigilance, Quality Assurance, Pharmacoeconomics, Health Systems Strengthening, Health Policy Analysis, Health Technologies Assessment (HTA) and Procurement/supply chain management.
I have successfully led projects in Pharmacovigilance/Patient Safety Management, Antimicrobial Resistance Stewardship, Pharmaceutical Supply Chain Systems Strengthening, immunization and disease management/control.
I currently serve as the Managing Director Virgil Science Ltd ( https://virgilscience.co.ke/ ) a contract research organization focusing on Pharmacovigilance, Medicines Regulatory compliance and Clinical Research.
Recently, I was part of the part of the Management Sciences for Health-Kenya(MSH-Kenya) team that developed the Pharmacovigilance curriculum for Healthcare workers in the EAC/IGAD regions. I hold a Master of Pharmacy (Pharmacoepidemiology & Pharmacovigilance) and Bachelor of Pharmacy from the University of Nairobi. I also have an MBA in Finance and a Certificate in Health Systems Strengthening from the University of Melbourne.
OUTCOMES OF THE HEALTHY HEART AFRICA PROGRAM ON THE MANANGEMENT OF HYPERTENSIVE PATIENTS IN NAIROBI COUNTY, KENYA
ABSTRACT
Background: Hypertension is an independent risk factor for developing cardiovascular and renal diseases worldwide. Hypertensive patients in Sub-Saharan Africa have low hypertension awareness, treatment levels and control. In response to these problems, AstraZeneca, a British-Swedish Pharmaceutical Company, introduced the Healthy Heart Africa program which it implements in partnership with AMREF Health Africa in Nairobi.
Study objective: To compare the management and treatment outcomes of hypertensive patients enrolled into the Healthy Heart Africa (HHA) program and their unenrolled counterparts.
Method: This study was conducted in two phases a six (6) months’ period. A comparative retrospective cohort study where confirmed hypertensive patients were conveniently sampled from 2 HHA and 2 non-HHA Health Centers in Nairobi preceded a second qualitative phase. The latter involved patient interviews to assess their level of adherence to anti- hypertensive medicines. To elicit hypertension management practices prescriber interviews were conducted. A descriptive thematic approach was used to analyze the qualitative data. Key and meaningful themes/patterns from these interviews were identified and interpreted by triangulation of all the provided information. Statistical data analysis was performed using Stata® 10 (Stata Corp, USA).
Results: Of the 265 patients screened over a 6 months’ period, 250 (91%) met the inclusion criteria and 205 were recruited; 58.5% were female; mean age was 54 years; mean duration of hypertension management was <2 years. Seventy-eight (72%) patients enrolled in HHA had adequate BP control compared to forty-two (43%) in the non-HHA sites after 6 months of treatment. Seventy (34.1%) of the patients were fully adherent to medication. Patients in the HHA (OR 2.6 95% CI 1.5, 4.6; p <0.001) had their BP better controlled compared to their unenrolled counterparts. Adherence to medication (OR 0.87 95% CI 0.8, 0.9; p<0.001) significantly contributed to BP control.
Conclusion: The Healthy Heart Africa program strategies improved access to medicines and patients’ adherence. Hence, patients enrolled their BP better controlled compared to their unenrolled counterparts.
Esther Mokaya completed her undergraduate (Bachelor of Pharmacy) in 2008 and postgraduate studies (Master of Pharmacy in Pharmaceutical Analysis) in 2020, both from the University of Nairobi. She is currently in working pharmaceutical industry, with sound background in regulatory affairs, pharmacovigilance, quality assurance and good distribution of pharmaceutical products.
A Retrospective Review of Pharmaceutical Product Dossiers Submitted at the Pharmacy and Poisons Board Between 2010 and 2014
Background:
Efficient regulation of pharmaceutical products ensures that medicines marketed within a specified territory meet the standards of quality, safety and efficacy. The national medicine regulatory authority is responsible for drug regulation by ensuring that the products marketed meet required standards before issuing a registration certificate. The objective of this study was to carry out a retrospective review of dossiers submitted to PPB between January 2010 and December 2014.
Methodology:
The study was carried out at PPB. Data was gathered using a data collection tool, entered into a database then exported to STATA version 14.0 software for analysis. 347 dossiers were reviewed after being stratified based on their respective therapeutic categories. The time taken to obtain registration was calculated. A comparative study was done on the regulatory requirements for dossier submissions in Kenya, Uganda and Tanzania based on the respective drug registration guidelines.
Results and discussion
78.7% of the products had obtained registration within the specified period. Majority of the products were registered in a period of more than 12 months (47%), and 31% were registered in less than 12 months. The median time for registration was 413 days, approximately 14months. Majority of the products submitted were anti-infectives, 31% of the total files reviewed. Kenya’s regulatory processes and requirements were found comparable to those of Uganda and Tanzania.
Conclusion:
The average time taken to register a pharmaceutical product in Kenya was found to be approximately 14 months. The drug registration requirements and practices followed by PPB are comparable to those of Uganda, Tanzania and EAC-Compedium.
Research Supervisors
Dr. Kennedy O. Abuga, PhD
Dr. Beatrice K. Amugune, PhD
