Publications by authors named "J O Jowi"

17 Publications

Cardiovascular risk factors among people living with HIV in rural Kenya: a clinic-based study.

Cardiovasc J Afr 2019 Jan/Feb 23;30(1):52-56. Epub 2019 Jan 24.

School of Medicine, University of Nairobi, Nairobi, Kenya.

Objective: To determine the prevalence of cardiovascular risk factors and their association with antiretroviral therapy (ART) among HIV-infected adults in a rural sub-county hospital in Kenya.

Methods: This was a descriptive survey of patient charts characterising cardiovascular risk among adult patients (> 18 years) at Ukwala sub-county hospital between June 2013 and January 2015. Post-stratification survey weights were applied to obtain prevalence levels. Adjusted odds ratios (AOR) for each variable related to cardiovascular risk factors were calculated using logistic regression models.

Results: Overall, the prevalence of diabetes mellitus was 0.4%, 0.3% of patients had had a previous cardiovascular event (heart attack or stroke), 40.4% had pre-hypertension, while 10.4% had stage 1 and 2.9% stage 2 hypertension. Up to 14% of patients had elevated non-fasting total cholesterol levels. Factors associated with hypertension were male gender (AOR 1.59, = 0.0001), being over 40 years of age (AOR 1.78, = 0.0001) and having an increased waist circumference (OR 2.56, = 0.0014). Raised total cholesterol was more likely in those on tenofovir disoproxil fumarate (TDF) (AOR 2.2, p = 0.0042), azidothymidine (AZT) (AOR 2.5, = 0.0004) and stavudine (D4T) -containing regimens (AOR 3.13, = 0.0002).

Conclusions: An elevated prevalence of undiagnosed cardiovascular risk factors such as hypertension and raised total cholesterol levels was found among people living with HIV. There was an association between raised total cholesterol and nucleoside reverse-transcriptase inhibitor (NRTI) -based ART regimens. Our findings provide further rationale for integrating routine cardiovascular risk-factor screening into HIV-care services.
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http://dx.doi.org/10.5830/CVJA-2018-064DOI Listing
June 2019

Encephalocele.

Authors:
J O Jowi

East Afr Med J 2009 Feb;86(2):49-50

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February 2009

Pathological sub-types, risk factors and outcome of stroke at the Nairobi Hospital, Kenya.

Authors:
J O Jowi P M Mativo

East Afr Med J 2008 Dec;85(12):572-81

Department of Medicine, Aga Khan University Hospital, Nairobi, P.O. Box 30270-00100, Nairobi, Kenya.

Background: Stroke is one of the most common causes of morbidity and mortality the world over. Established risk factors such as arterial hypertension, diabetes mellitus, cigarette smoking, hyper-lipidaemia, micro-vascular rupture, male gender, age and observed co-morbities such as sickle cell disease, HIV/AIDS infection and cerebral malaria are increasingly being encountered in the tropics.

Objectives: To determine pathological sub-types, risk factors, in-hospital period prevalence and in-hospital outcome of stroke.

Design: Hospital-based retrospective study.

Setting: The Nairobi Hospital, Nairobi, Kenya.

Subjects: Patients with recorded diagnosis of stroke/cerebral vascular accident; as per WHO criteria for diagnosis of stroke, all gender and age > or = 18 years were studied.

Results: A total of 2629 patients were admitted to the division of medicine at the hospital during study period. Eighty patients had diagnosis of stroke; giving an in-hospital period prevalence of 3042/100,000. Mean age was 61.3 years, mode; 63 years, range 34-95 years. Males were 43 (53.8%), M to F ratio 1.2:1 stroke sub-types: Ischaemic stroke 68 (85%), haemorrhagic stroke seven (8.8%). In five patients (6.3%) no evidence of stroke sub-type was on-record. Established risk factors for stroke included hypertension and diabetes mellitus. Hypertension was found in 64 patients (80%) and diabetes-mellitus in 27 (33.7%). Twenty three patients (28.8%) had both hypertension and diabetes-mellitus. Co-morbidities were observed and included mitral-stenosis, cardiac-arrhythmias cardio-myopathy, HIV/AIDS, Left Ventricular Hypertrophy (LVH), infective endocarditis, atrial septal aneurysm, carotid plaques with or without stenosis and hyper-homocystenemia. Mean hospital stay was 12.5 days; range 22-70 days. Seventy five patients (93.8%) were discharged and four (5%) died in hospital. All patients who died had anterior circulation ischaemic stroke as per Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification.

Conclusion: Ischaemic stroke is the most common pathological sub-type observed in this study. Hypertension is the leading observed risk factor for stroke. Hospital period prevalence for stroke of 3042/100,000 was found. Seventy five patients (93.8%) were discharged and four (5%) died in hospital.
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http://dx.doi.org/10.4314/eamj.v85i12.43535DOI Listing
December 2008

Primary cerebral angitis of the central nervous system: case report.

East Afr Med J 2008 Jun;85(6):306-8

Department of Medicine, Aga Khan University Hospital, Nairobi, P.O. Box 30270-00100, Nairobi, Kenya.

We report a case of a 28 year old female who presented with variedly progressive stroke like illness and raised intracranial pressure. Brain MRI scans revealed pericallosal and periventricular hyperintensities with oedema. Various medications like intravenous immunoglobulin, antibiotics, acyclovir, methyl prednisolone and management for raised intracranial pressure were instituted. She rapidly deteroriated and died on tenth hospital day. Only at autopsy was the diagnosis of primary angitis of central nervous system established.
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http://dx.doi.org/10.4314/eamj.v85i6.9629DOI Listing
June 2008
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